What is diverticular disease?
Diverticular disease is a common condition in which small pouches or “pockets” (known as diverticula) form in the lining of the large bowel or colon. When there are multiple diverticula, this is known as diverticulosis. Diverticulitis is when the diverticula become inflamed or infected.
Diagnosing diverticulosis and diverticulitis Diverticula can be seen during a colonoscopy or on imaging tests, such as a CT scan, that you are having for other unrelated symptoms.
Common Symptoms of Diverticular Disease
Diverticulosis:
- Most people have no symptoms.
- Possible mild symptoms include crampy abdominal discomfort, bloating, constipation, or diarrhea.
- Symptoms can be similar to those of irritable bowel syndrome or bowel cancer.
Diverticulitis:
- Constant pain in the lower left abdomen.
- May include fever, nausea, vomiting, or loss of appetite.
- Possible changes in bowel habits (constipation or diarrhea).
- Symptoms usually resolve after the infection and inflammation subside.
- Most patients have only one episode; however, about one in seven will have another, and repeated episodes are likely in some individuals.
Causes and Risk Factors of Diverticulosis
- Main risk: Low-fiber diet leading to hard stools and high colon pressure.
- Other risks: High red meat/fat intake, smoking, alcohol, obesity, genetics.
- Common location: Sigmoid colon; less common in the small intestine.
Prevention of Diverticulitis
- Eat at least 30 grams of fiber daily to soften stools and prevent constipation.
- Include fibrous fruits (apples, pears), vegetables, whole grains, baked beans, and legumes.
- Nuts, seeds, and corn are safe to eat.
- Fiber supplements or unprocessed wheat bran can add 4-6 grams of fiber.
- Drink 8 cups of water daily.
- Exercise regularly.
- Avoid obesity and smoking to reduce risks of diverticulitis and complications.
Treatment of Diverticulitis
Mild Cases:
- Often resolve without antibiotics.
- Oral antibiotics if immune-compromised, severe symptoms, or symptoms last over 3 days.
- Low-fiber or fluid-only diet recommended until recovery.
- Paracetamol for pain relief.
Severe Cases:
- Hospital admission for IV antibiotics and fluids.
- Stronger pain relief as needed.
- Surgery may be required for complications, repeated attacks, or emergency situations.
- Temporary stoma may be necessary, often reversible.
Post-Surgery:
- Laparoscopic surgery is common for faster recovery.
- Bowel function and health typically return to normal, with rare recurrence of issues.
Source: Gesa https://www.gesa.org.au/resources/patient-resources/
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