Diverticular disease is a condition found primarily in the large intestine. Small pouches form where weak spots in the wall of the colon, or large intestine, yield to pressure from food or gas within the colon. These tiny pockets are called diverticula. Diverticula can develop anywhere but are mostly located in the sigmoid colon.
While it can be uncomfortable in itself, it is not a serious condition. However, it can lead to inflammation known as diverticulitis. The pouches can also perforate or rupture. This is very uncommon; only 1% to 5% of patients will develop such a complication. Occasionally, the pouches may erode into blood vessels, causing bleeding. Generally, perforation and bleeding of diverticula can be controlled medically. Sometimes, hospitalization and surgical treatment are required to control these complications. Only about 15% to 30% of patients with diverticulitis require surgery. This condition has no direct relation to cancer.
Causes
The precise cause of diverticulosis is obscure. The process of aging and muscle shrinkage may weaken the wall of the colon, allowing the pouches to develop. Fiber deficiency, a leading cause of constipation, results in small hard stools that do not fill out the colon. The colon then develops areas of spasm which force the pouches through the muscle wall.
Probably the principal factor in the high incidence of diverticulosis among Americans is the low-residue, low-fiber diet consumed in western countries. Africans and Orientals living in rural areas who eat plenty of natural fiber or roughage rarely get diverticulosis. Fiber is a non-nutrient, but it is essential for normal bowel function.
Can a diet high in fiber prevent it?
A diet high in fiber may help reduce the risk of diverticular disease, but it will not remove pouches that have already formed. It can also help correct constipation due to improper diet.
Symptoms
The symptoms are most commonly nonspecific. They usually include gas, stomach cramps, pain, and diarrhea alternating with constipation. Aren't these symptoms common in other disorders? Yes, including some serious diseases; that is why you go through all those tests. Before making a diagnosis of diverticulosis, we must first exclude all other possible causes of the symptoms. X-ray tests and colonoscopy will confirm the diagnosis, distinguishing diverticulosis from other diseases of the colon with similar symptoms. If a complication of diverticulosis appears, this is typically pain, fever or bleeding.
Management of diverticulosis is mainly dietary. A daily fiber intake of 25 to 30 grams is recommended. Medications to reduce the muscular spasm in your colon may also be prescribed for a limited time. Fresh fruits and vegetables are also high in roughage, and you can have all you want. In fact, there are no dietary restrictions.
The only time to change this diet is in the event of the development of diverticulitis, with perforation of one of the pouches. Then, treatment with antibiotics and a low-residue diet is necessary. When patients do not respond to these simple measures and complications develop, hospitalization may be needed.
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