Diverticular disease is a medical term that includes three conditions: diverticulosis, diverticular bleeding, and diverticular infection/diverticulitis. Diverticulosis is the presence of diverticula (plural), saclike protrusions of the wall of the large bowel.
The high rate of hospitalization and surgery makes diverticular disease one of the five most expensive digestive diseases ahead of irritable bowel syndrome and inflammatory bowel diseases. Direct costs associated with diverticular disease are $88.6 million per year. The risk for symptomatic diverticular disease is negligible for 35 year olds or younger. However, at age 55 the risk increases by a factor of 10 and at 75 years the risk has increased to 40. 50% of Canadians over the age of 80 years develop diverticular disease. At present, there are no known risk factors other than advanced age.
What is Diverticulosis?
Diverticulosis is the presence of diverticula (plural), sac-like protrusions of the wall of the large bowel. A diverticulum is when the inner lining of the large bowel (colon) is pushed out through weak spots in the muscle causing a pouch or sac.
What is Diverticulitis?
Diverticulitis is a result of the infection and or inflammation of the small sacs that line the walls of your intestines. This complication occurs in a few patients who already have diverticulosis. Men and women are affected equally. The resulting infection can be mild, leading only to abdominal pain; or severe, with diffuse infection or sometimes the development of an abscess (a pocket of pus). There is usually fever and an elevated white cell count in the blood. With healing there can be scarring, leading to bowel narrowing and obstruction. Fortunately, severe episodes account for less than one-quarter of all episodes of diverticulitis. A diagnosis of diverticulitis is based on the symptoms and examination, with tests that help confirm the diagnosis. In ill patients, a CT scan is the safest and most-cost-effective method of diagnosis
What is Diverticular Bleeding?
Bleeding occurs less often than diverticulitis and is not related to episodes of diverticulitis. Often patients do not have symptoms before bleeding occurs. There may be fresh red blood or altered darker blood. Pain is not frequent but cramps can occur. All patients with bleeding need to be investigated to rule out other causes of bleeding. Patients with major bleeding or those who feel light-headed should go to the emergency department. Bleeding often stops on its own but still should be investigated. Most patients do not have further bleeding but in some it may recur. Patients with, recurrent episodes often require surgery.
How Can I Prevent Diverticular Disease?
In general, increasing the amount of fibre in the diet is recommended with adequate fluid intake. While this will not cause the diverticula present to become smaller or go away, the high fibre diet may reduce the formation of other diverticula. There is no evidence that avoiding foods such as popcorn or those with small seeds such as strawberries or tomatoes is useful, although this has been recommended in the past.