Diverticulosis is a condition in which outpouchings form in the walls of the intestines. These
pouches, known as diverticula, are about the size of large peas. They form in weakened areas of the
bowels, most often in the lower part of the colon (large intestine).
What Are the Symptoms of Diverticulosis?
Most people with diverticula do not have any symptoms from them. They may never know they
have the condition. Some people feel tenderness over the affected area or muscle spasms in the
abdomen. Pain may be felt on the lower left side of the abdomen or, less often, in the middle or on
the right side.
Although the diverticula themselves do not cause symptoms, complications such as bleeding andd
infection may occur. Bleeding is an uncommon symptom and is usually not severe. Sometimes thee
pouches become infected and inflamed, a more serious condition known as diverticulitis. (See figuree
2.) When inflammation is present, there may be fever and an increased white blood cell count, ass
well as acute abdominal pain. Diverticulitis also may result in large abscesses (infected areas of pus),,
bowel blockage, or breaks and leaks through the bowel wall..
How Are These Disorders Diagnosed?
Often diverticulosis is unsuspected and is discovered by an x-ray or intestinal examination done for
an unrelated reason. The doctor may see the diverticula through a flexible tube (colonoscope) that is
inserted through the anus. Through this scope, the diverticula may be seen as dark passages leading
out of the normal colon wall. The doctor also may do a barium enema, an x-ray that reveals the
outpouchings in the walls of the colon.
If rectal bleeding occurs, the doctor may take a special x-ray (angiography). In this procedure, dyee
is injected into an artery that goes to the colon, so that the site of the bleeding problem can bee
located. Diverticulitis may be diagnosed when a patient has pain and tenderness in the lowerr
abdomen with disturbed bowel function and fever..
How Common Are These Disorders?
Diverticulosis is very common, especially in older people. Studies show that about 10 percent of
people over the age of 40 and nearly half of people over age 60 have diverticulosis. But among
those who are found to have diverticula, only about 20 percent develop diverticulitis, and of those,
only a small number have very serious or life-threatening complications.
What Causes Diverticula to Form?
No one knows for sure why the pouches form. Scientists think they may be caused by increased
pressure inside the colon due to muscle spasms or straining. The sacs might form when increased
pressure acts on soft spots along the bowel wall, especially if the person has constipation problems
or uses laxatives too often.
How Serious Are These Disorders?
For most people, diverticulosis is not a problem. Diverticulitis, on the other hand, is a problem,
sometimes a serious one. For instance, when one of the sacs (a diverticulum)
becomes infected and inflamed, bacteria enter small tears in the surface of the bowel. This leads to
small abscesses. Such an infection may remain localized and go away within a few days. In rare
cases, the infection spreads and breaks through the wall of the colon causing peritonitis (infection of
the abdominal cavity) or abscesses in the abdomen. Such infections are very serious and can lead to
death unless treated without delay.
What Are the Treatments?
If you have diverticulosis with no symptoms, no treatment is needed. Some doctors advise eating a
high-fiber diet and avoiding certain foods. Laxatives and enemas should not be used regularly.
Patients with diverticulitis may be hospitalized and treated with bed rest, pain relievers, antibiotics,
fluids given by vein, and careful monitoring.
Is Surgery Ever Necessary?
The majority of patients will recover from diverticulitis without surgery. Sometimes patients need
surgery to drain an abscess that has resulted from a ruptured diverticulum and to remove that portion
of the colon. Surgery is reserved for patients with very severe or multiple attacks. In those cases, the
involved segment of colon can be removed and the colon rejoined.
In some cases, the two ends of the colon cannot be rejoined right away, so more than one operationn
is needed. For instance, an operation may be performed to drain an abscess and remove diseasedd
colon and a second operation done to rejoin the colon. In this case, the surgeon must connect thee
colon to a surgically created hole on the body's surface (colostomy) until a second operation can bee
done to reconnect the colon..
The delay between operations may be only a few weeks, or it might be several months if the patientt
needs time to overcome infection and build up strength. In rare cases, three operations are needed::
the first to drain an abscess, the second to remove part of the colon, and the third to rejoin thee
bowel..
What About Diet?
If you have diverticulosis with no symptoms, you don't need treatment, but it is a good idea to watch
your diet. The diet some doctors recommend is the same kind that is healthy for most people-eat
more foods high in fiber. (See Diet, Nutrition & Cancer Prevention: The Good News in the
additional readings section.) A fiber-rich diet helps prevent constipation and promotes a healthy
digestive tract. Fiber-rich foods include whole-grain cereals and breads, fruits, and vegetables. A
fiber-rich diet also is thought to help prevent diverticula from forming.
Remember, diverticula usually cause no problems at all, so a diagnosis of diverticulosis should not bee
a serious concern.
We offer you a list of qualified Gastroenterologysts to help you to deal with such kind of problems. If you are interested in more information, try our E-mail reference.
Links to other sites on the Web
Back to Other Gastroenterological Disorders
Information provided by Tomás Ordóñez M.D. Paseo Bolívar 12-101 Colonia Centro ZIP Code 31000 Chihuahua, Chihuahua, México. Tel. and Fax (14) 10 50 91.
© 1997 tomaso@mail.interred.net.mx
Get your own Free Home Page