What is diverticulosis of the colon?
Colonic diverticulosis is caused by the development of small pouches (diverticula) on the side of the large bowel (colon). Diverticula are very common and it is estimated that the proportion of the population with diverticulosis of the colon is equivalent to age; so, approximately 70% of 80 year olds will have the condition although the majority will experience no symptoms. Colonic diverticulosis is often discovered during investigations or tests for other problems.
What causes colonic diverticulosis?
Colonic diverticulosis is thought to be caused over a period of years by a diet relatively lacking in dietary fibre. A high fibre diet may help to reduce the risk of diverticular disease but cannot prevent it completely as diverticulae may also occur as part of the ageing process within the bowel.
What are the symptoms?
The majority of people with this condition will not experience any symptoms, however, if they do occur, they may include:
- Discomfort in the abdomen (commonly in the lower left side)
- Changes in bowel habit, with episodes of constipation or diarrhoea
- Feeling bloated
- Bleeding from the rectum (dark blood)
Diverticulae may also become inflamed or infected; this is known as “diverticulitis” and symptoms include:
- Severe pain in the abdomen and tenderness in the lower abdomen
- Feeling unwell, with racing pulse
When diverticulae become infected, it is possible they may bleed heavily or perforate, leading to peritonitis although this is uncommon. Scar tissue forming around a diverticula can also cause an obstruction in the bowel, but again this is uncommon. People who have diverticular disease may have a range of tests and investigations to exclude other bowel conditions that have similar symptoms. These include CT Scans and colonoscopy.
What treatment options are available?
No treatment is required for colonic diverticulosis without symptoms. In other cases, a high fibre diet (including plenty of fruit, vegetables and whole grains) is recommended, sometimes in conjunction with laxatives and / or antispasm medicines to help reduce any abdominal discomfort.
For episodes of diverticulitis, treatment includes antibiotics, extra fluids and rest (together with pain relief). In some cases (perhaps 5% of those who have symptomatic diverticular disease), emergency surgery may be needed for peritonitis or very severe episodes of diverticulitis. This generally involves removing the affected part of the bowel and rejoining the two healthy ends. An intestinal stoma may be required, usually on a temporary basis. Elective surgery may be undertaken to remove the affected part of the colon if symptoms become recurrent.