Diverticulosis is a condition that develops in the large intestine. This condition is uncommon among people below the age of 40. Around 10% of Americans over 40 years old and around half of all people who are over 60 years old have this condition. Most of the time it is asymptomatic but when symptoms are present, the condition is called diverticular disease. Additionally, it may only be discovered after tests and investigations for a different medical problem are done.
People with diverticulosis have pouches called diverticula in their colon. These diverticula, which are outpouchings of the colonic mucosa and submucosa, swell outward through the weak spots in the colon wall.
Causes – Diverticulosis
The causes of this condition are not yet completely understood. However, physicians believe that the pouches develop when high pressure presses against the colonic wall. When a person’s diet lacks fiber, the stool becomes small and hard, making it difficult for it to move. Additional pressure is usually needed for the stool to finally move. Furthermore, an inadequate amount of fiber in the body can also increase the length of time that the stool stays in the bowel, which adds to the high pressure.
Signs And Symptoms
Most people with this condition are unaware of the presence of diverticula in their large intestine. In cases where symptoms are present, the patient usually experiences discomfort in the lower abdomen, tenderness in the affected area, constipation, and bloating.
The presence of these symptoms may indicate the occurrence of a different medical condition or disease though, such as a stomach ulcer and irritable bowel syndrome. Moreover, a person with this condition may have had it for a few years already by the time the symptoms develop. Individuals with chronic symptoms should seek medical help, especially those that are over 40 years old.
Diagnosis – Diverticulosis
Oftentimes, a good history is enough to form a diagnosis of diverticular disease. It should be noted though that confirming the diagnosis and ruling out other pathologies and complications is vital since there could be other conditions related to the symptoms. As for asymptomatic diverticulosis, there are many different investigative procedures that can confirm its presence.
Just one of these is a plain abdominal x-ray, which may show signs of constipation, ileus, free air in the case of perforation, and small bowel obstruction. A colonoscopy is also a good method that is commonly used to find out whether a patient has this condition or not. A Contrast CT and a Barium Enema can confirm the presence of this condition as well.
There are many factors that may increase the risk of developing this type of condition. As mentioned earlier, this condition is common among people over 40 years of age. After the age 40, it will increase in incidence. Other risk factors include a high intake of meat, especially red meat, a diet that is high in fat or low in dietary fiber, constipation, and connective tissue disorders that can cause weakness in the large intestine.
Increasing the fiber intake of the patient will reduce the symptoms and may even prevent complications. This is because fiber keeps the stool soft and decreases the pressure in order for the bowel contents to pass through easily. An intake of 20 to 35 grams of fiber everyday is recommended by the American Dietetic Association. The amount of fiber present in foods can be found on the table printed on the food wrapper or container. Keeping a food diary may be helpful in looking after one’s diet.
Physicians may recommend patients to take fiber supplements such as psyllium or methylcellulose once to thrice a day. They are available in wafers, pills, and powder form and they contain 2 to 3.5 g per dose. These products must be taken with 8 ounces of water, at the very least.
Avoiding Constipation – Diverticulosis
Avoiding constipation is the best way to treat this condition. There are many ways to do this and having the right diet is one of them. The diverticulosis diet consists of a wide variety of foods, most are high in fiber. Fruits and vegetables are a must. Beans and even whole grains are necessary in the diet as well. Aside from eating foods that are high in fiber, patients should also drink plenty of fluids.
Moreover, patients should get an adequate amount of exercise every day. Moderate activity should be done at least 2 hours a week and vigorous activity should be done at least 1 hour a week. Scheduling time for a bowel movement everyday is also very important. Having a daily routine will decrease the occurrence of high pressure, and it will be easier for the stool to pass through as well.
Symptomatic Colonic Diverticulosis
People who are suffering from this complication have a disorganized motility, or the onward propulsive nature of contractions, of the bowel. It is the most common complication. Spasms may develop and pain may be felt in the left lower abdomen. It often goes together with the passage of small stools and slime, which can relieve the pain afterwards.
Bloating and changes in bowel movements, such as diarrhea or constipation, are common symptoms. There may also be chronic discomfort in the lower abdomen, with infrequent episodes of sharper pain. Another symptom is the occurrence of abdominal pain after meals.
Complicated Colonic Diverticulosis
This condition is not very common, but it is extremely dangerous. The diverticulum may bleed, and if its bleeds rapidly, it can cause bleeding through the rectum. If it bleeds slowly, it may lead to anaemia. The diverticulum may also become infected, and develop abscesses as well. It may even perforate. Bleeding from the rectum can be an indicator of inflammatory bowel disease, colonic polyps, or cancer, so medical investigation should be performed immediately.
Diverticulitis may develop when a diverticulum gets infected. The infection is often caused by stool collecting in the diverticulum. It occurs in 10% to 25% of people with diverticulosis. The most common symptom is abdominal pain. Those with this type of complication may experience tenderness in the lower left abdomen. Other symptoms include fever, nausea, vomiting, constipation, and cramping. The severity of symptoms often depends on the degree of the infection.