What is Diverticulosis?

Diverticulosis, also known as “diverticular disease”, refers to pouch-like structures that form in the muscular wall of the colon, called diverticula. It affects men and women equally, and the incidence increases with advancing age, reaching 60% at age 60. Interestingly, it is more common in developed countries.

Symptoms

The vast majority of patients with diverticulosis remain asymptomatic. However, infection and inflammation of one or multiple diverticuli can occur, a symptomatic condition called diverticulitis. This situation causes fever, bowel changes and abdominal pain, typically in the lower left part of the abdomen.

Risk

Development of diverticulosis has been associated with diets low in fiber and high in red meat. Symptomatic diverticulosis is more likely to occur with advancing age. Risk factors include physical inactivity, obesity, smoking, low vitamin D level and some medications such as anti-inflammatories (e.g. Advil, Aleve, Ibuprofen, Naprosyn), steroids, and narcotic pain medications.

Eating of nuts, seeds, and popcorn is not a risk factor – these foods do not need to be avoided.

Minimizing the risks of diverticulosis and its complications relies on good bowel habits, a diet high in fiber and low in red meat, physical activity, avoidance of obesity, and avoidance of anti-inflammatory medications and narcotics.

Tests & Diagnosis

Usually the diverticuli are seen during routine colonoscopy. If diverticulitis is suspected, a CT Scan can demonstrate the inflammation.

Treatment

Once diverticulosis has formed in the colon, this change is permanent. The main way to avoid complications is to ingest a high fiber diet (25-30 gm/day), avoid or minimize anti-inflammatory drugs and exercise regularly. If diverticulitis develops, it requires antibiotics for treatment. When severe, it may necessitate hospitalization. Recurrent attacks of uncomplicated diverticulitis may also require surgery to remove the segment of involved bowel.