Diverticulosis and Diverticulitis

What does it mean when my doctor tell me I have diverticulosis?  Is this the same as diverticulitis?

When you are told you have diverticulosis, it means you have small pouches or pockets in your colon that bulge outward through weak spots. Each pocket is called a diverticulum. Pockets (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis.

When the pouches become infected or inflamed, the condition is called diverticulitis. An easy way to remember is any medical term ending in –itis means you are sick.  Some people remember that tonsillitis and bronchitis mean you are sick. So if you have diverticulitis – your pockets are “sick”.  Diverticulosis and diverticulitis are also called diverticular disease.

Symptoms:

 

Diverticulosis

Most people with diverticulosis do not have any symptoms. Some people may experience mild cramps, bloating, and constipation but remember other diseases cause similar symptoms. You should visit your doctor if you have these troubling symptoms.

 

Diverticulitis

The most common symptom of diverticulitis is abdominal pain most commonly in the left lower abdomen, but it may occur in other areas. You may also have fever, nausea, vomiting, chills, and cramping. The severity of symptoms depends on the extent of the infection and complications.

 

What are the complications of diverticulitis?

Diverticulitis can lead to bleeding, infections, perforations or tears, or blockages.

 

Bleeding

When diverticula bleed, you will notice blood from your rectum. Bleeding can be severe, but it may stop by itself and not require treatment. If you have bleeding from the rectum, you should see your doctor. If the bleeding does not stop, surgery may be necessary.

 

Abscess, Perforation, and Peritonitis

The infection causing diverticulitis often clears up after a few days of treatment with antibiotics. If the condition gets worse, an abscess may form in the colon.

An abscess is an infected area with pus that may cause swelling and destroy tissue. Sometimes an infected diverticula may cause small holes, called perforations. These perforations allow pus to leak out of the colon into the abdominal area. If the abscess is small and remains in the colon, it may clear up after treatment with antibiotics. If the abscess does not clear up with antibiotics, the doctor may need to drain it.

To drain the abscess, the doctor uses a needle and a small tube called a catheter. The doctor inserts the needle through the skin and drains the fluid through the catheter. This procedure is called percutaneous catheter drainage. Sometimes surgery is needed to clean the abscess and, if necessary, remove part of the colon.

 

Intestinal Obstruction

Scarring caused by infection(s) in  your colon may cause partial or total blockage of the large intestine. When this happens, the colon is unable to move bowel contents normally. When the obstruction totally blocks the intestine, emergency surgery is necessary. Partial blockage is not an emergency, so the surgery to correct it can be planned.

 

What causes diverticular disease?

Although not proven a common theory is that a low-fiber diet is the main cause of diverticular disease. Many processed foods contain refined, low-fiber flour. Unlike whole-wheat flour, refined flour has no wheat bran.

Diverticular disease is common in developed countries—particularly the United States, England, and Australia—where low-fiber diets are common. The disease is rare in countries of Asia and Africa, where people eat high-fiber vegetable diets. Fiber makes stools softer and more easy to pass, preventing constipation.  Constipation is associated with more problems with diverticular disease.

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What is the correct diet for diverticular disease?

When you have diverticulosis the diet consists of high fiber and avoidance of certain types of foods.  During an acute attack of diverticulitis however, a low residue diet is to be adhered to.

 

Diverticulosis

Avoidance of nuts, popcorn, and sunflower, pumpkin, caraway, and sesame seeds has been recommended by physicians out of fear that food particles could enter, block, or irritate the diverticula. However, no scientific data support this treatment measure. Eating a high-fiber diet is the only requirement highly emphasized. The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, and poppy seeds, are generally considered harmless. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person.

 

Diverticulitis

The diet for diverticulitis focuses on clearing up the infection and inflammation by resting the colon. To help the colon rest, the doctor may recommend a liquid diet initially. The diet would be advanced to a low residue diet as your pain improves.  You can return to a high fiber diet after the infection has cleared.

 

Digestive Disease Consultants