What is diverticulosis?
Diverticulosis is a condition where small pouches, called diverticula, bulge outward through weak spots in the colon (large intestine). This condition is very common, affecting more than half of all people over age 60. Many people with diverticulosis don’t have any symptoms and only find out they have it when tests are done for other reasons.
What are the symptoms of diverticulosis?
Most people with diverticulosis do not have any symptoms. However, some people may experience:
– Mild cramps, tenderness, bloating or discomfort in the lower abdomen
– Intermittent pain on the left side of the lower abdomen
– Constipation
– Diarrhea
Symptoms tend to come and go over time and can range from mild to severe. Pain from diverticulosis may be caused by:
– Small pieces of stool getting trapped in the diverticula, leading to inflammation
– Infection, called diverticulitis
– Bleeding from a diverticulum
When should you see a doctor for diverticulosis?
See your doctor if you have any persistent or severe abdominal pain, constipation, diarrhea, nausea or vomiting. Also see your doctor if you notice blood in your stool. These could be signs of a complication like diverticulitis or bleeding.
Your doctor may order tests such as:
– Blood tests to check for infection or anemia if bleeding is suspected
– CT scan of the abdomen to confirm diverticulosis or look for diverticulitis
– Colonoscopy to examine the lining of the colon in detail
What causes diverticulosis?
Doctors aren’t sure what causes diverticula to form. Contributing factors may include:
– A low-fiber diet. This can lead to constipation and hard stool, which increases pressure in the colon.
– Changes in bowel structure. The colon wall weakens with age, making diverticula more likely.
– Genetics. There seems to be an inherited component in some cases.
– Lack of exercise or being overweight. This increases pressure in the abdomen.
Diverticulosis becomes more common with increasing age due to these structural and lifestyle factors.
What are the complications of diverticulosis?
Possible complications of diverticulosis include:
Diverticulitis
– This is inflammation of one or more diverticula. Diverticulitis develops in 10-25% of people with diverticulosis.
– Symptoms include fever, nausea, vomiting, chills, cramping and constipation.
– It’s treated with antibiotics and a liquid diet. Severe cases may require hospitalization or surgery.
Bleeding
– Diverticula can sometimes bleed, often without any pain.
– Bleeding can be mild or severe. Severe blood loss may result in low blood pressure, weakness, fatigue or black stools.
– Bleeding usually stops on its own. Treatment may involve blood transfusions, colonoscopy or surgery.
Abscesses
– Bacteria may spread from a diverticulum and collect as an abscess in nearby tissue. This causes fever, chills, nausea and severe abdominal pain.
– Abscesses are drained with a needle guided by ultrasound or CT scan. IV antibiotics are also given.
Fistulas
– Chronic infection can lead to abnormal connections (fistulas) between the colon and nearby organs like the bladder.
– Fistulas can be treated with antibiotics but often require surgery.
Bowel obstruction
– Scar tissue from infection can lead to partial or total blockage of the large intestine.
– Blockages are treated with IV fluids, a liquid diet and possibly surgery.
Perforation
– Sometimes diverticulitis or infection causes a diverticulum to burst and create a hole in the colon.
– This is a medical emergency requiring hospitalization, antibiotics, bowel rest and likely emergency surgery.
How is diverticulosis treated?
– Most people require no treatment for diverticulosis if they have no symptoms. But lifestyle changes can help prevent complications.
– Eat a high-fiber diet with plenty of fruits, vegetables, beans and whole grains. Fiber helps soften stool and prevents constipation.
– Stay well hydrated by drinking 6-8 glasses of fluids daily.
– Exercise regularly to help intestinal contents move through the colon.
– Over-the-counter fiber supplements like Metamucil can help increase your daily fiber intake.
– For persistent symptoms, your doctor may recommend eliminating problem foods that irritate the colon, such as nuts, popcorn or seeds.
– Prescription medications can help regulate bowel function and reduce abdominal cramping or pain.
Treatment during a diverticulitis attack
Diverticulitis is treated aggressively to prevent complications. Treatment typically includes:
– Clear liquid diet: Clears the colon and prevents irritation.
– Oral antibiotics: Treat infection. IV antibiotics are used for severe infection.
– Pain medication: To help make you comfortable.
– Bowel rest: No solid food until symptoms resolve.
Follow your doctor’s instructions closely. With proper treatment, most attacks can clear up in a few days. Call your doctor right away if symptoms don’t improve or get worse.
How can diverticulosis be prevented?
You may be able to prevent diverticulosis or reduce complications by:
– Eating a high-fiber diet with plenty of fruits, vegetables and whole grains
– Drinking plenty of fluids
– Exercising regularly to keep the colon active
– Maintaining a healthy weight to avoid pressure on the abdomen
– Not smoking. Smoking is a risk factor for diverticulitis.
– Using anti-inflammatory drugs with care. These may increase the risk of diverticulitis.
Living with diverticulosis
Here are some tips for living with diverticulosis:
– See your doctor for any new or persistent gastrointestinal symptoms.
– Get colonoscopies on schedule to check for complications like bleeding or cancer.
– Tell your doctor about any family history of colon issues. More frequent screening may be recommended.
– Avoid nuts, seeds, popcorn and other foods that you find trigger symptoms.
– Consider probiotic supplements to support digestive health. Talk to your doctor first.
– Manage stress levels, which may aggravate symptoms. Try techniques like meditation, yoga or tai chi.
– Stay active with regular, moderate exercise most days of the week.
– Maintain a healthy weight. Excess pounds put pressure on the colon.
– Stay hydrated and aim to have a bowel movement every day to keep the colon moving.
– Use fiber supplements if recommended by your doctor, and be sure to increase your fluid intake when increasing fiber.
When to see a doctor
Contact your doctor if you experience:
– Persistent or severe abdominal pain
– Blood in your stool or black/tarry stools
– Fever over 101°F, chills or vomiting
– Bowel changes lasting more than a few days
– Inability to have a bowel movement or pass gas
These can indicate an acute complication like infection, blockage or perforation that requires prompt medical care. Call 911 or have someone drive you to the ER if you have severe, unrelenting belly pain.
Conclusion
Diverticulosis affects over half of adults over 60 but usually causes no symptoms. Eating a high-fiber diet, exercising, maintaining a healthy weight and managing stress can help prevent complications. Seek prompt medical care for any severe or persistent abdominal symptoms, which could indicate diverticulitis, obstruction or other serious issues. With proper lifestyle management and monitoring, most people with diverticulosis can enjoy normal, active lives.