Diverticulosis


What is diverticulosis/diverticulitis?
Diverticulosis of the colon is a common condition that afflicts about 50% of the population by age 60, and nearly all by the age 80. Only a small percentage of those with diverticulosis have symptoms, and even fewer will ever require surgery. Diverticula are pockets that develop in the colon wall, usually on the left side of the abdomen. Diverticulosis describes the presence of these pockets. Inflammation of these pockets is called diverticulitis.

What are the symptoms of diverticulosis?
The major symptoms of diverticulosis are:

  • abdominal pain (usually in the lower left abdomen)
  • diarrhoea
  • cramps
  • alteration of bowel habit
  • occasionally, severe rectal bleeding.

These symptoms occur in a small percentage of patients with the condition, and are sometimes difficult to distinguish from another common bowel condition - irritable bowel syndrome.

What are the symptoms of diverticulitis?

Diverticulitis - an infection of the diverticula - may cause one or more of the following symptoms:

  • pain
  • chills
  • fever
  • change in bowel habits.

More intense symptoms are associated with serious complications such as:

  • perforation
  • abscess or fistula formation (abnormal connection with other organs).

What is the cause of diverticulosis?
Indications are that a low-fibre diet over the years creates increased colon pressure, and results in pockets of diverticula. Genetic inheritance may also be important.

How is diverticulosis treated?
Symptomatic diverticulosis is usually treated by diet, and occasionally by medications, to help control pain, cramps and changes in bowel habits.

Increasing the amount of dietary fibre (grains, legumes, vegetables, etc.) and sometimes restricting certain foods, reduces the pressure in the colon, and complications may be less likely to arise. Sometimes however, such a diet – particularly if it includes nuts or seed-containing foods – may aggravate the condition.

How is diverticulitis treated?
Diverticulitis requires more intense management. Mild cases may be managed without hospitalisation, and treatment may consist of oral antibiotics, dietary restrictions and possibly stool softeners.

Severe cases require hospitalisation, with intravenous antibiotics and strict dietary restraints. Most acute attacks can be relieved with such methods. Surgery is reserved for recurrent episodes, complications or severe attacks where there is little or no response to medication. If surgery is necessary, usually part of the colon - commonly the left or sigmoid colon - is removed, and the colon is joined (or “anastomosed”) again to the rectum.

Sometimes a temporary artificial opening (stoma) may be necessary.

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