Colonic Diverticular Disease

Causes and Risk Factors

While the exact cause of diverticular disease is not fully understood, it is thought to be related to the following factors:

• Diet: A diet low in fibre may contribute to constipation, which increases pressure in the colon and may lead to the formation of diverticula.

• Age: The likelihood of developing diverticular disease increases with age. It is more common in individuals over 40 years old.

• Genetics: A family history of diverticular disease may increase your risk.

• Lifestyle: Lack of physical activity and smoking can also contribute to the development of diverticular disease.

• Obesity: Being overweight or obese increases the risk of developing diverticular disease.

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Stages of Colonic Diverticular Disease

1. Diverticulosis: This is the condition in which diverticula form in the colon but do not cause symptoms. Many people with diverticulosis do not experience any problems and may never know they have the condition.

2. Diverticular Disease: This occurs when the diverticulae cause symptoms such as pain, bleeding or a change in bowel habit

3. Diverticulitis: This occurs when one or more of the diverticula become inflamed or infected. Diverticulitis can lead to symptoms such as abdominal pain, fever, and changes in bowel habits. It can be a more serious condition requiring medical attention.

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Symptoms

• Diverticulosis: Often, diverticulosis does not cause any noticeable symptoms. In some cases, mild abdominal discomfort, bloating, or irregular bowel movements may occur.

• Diverticulitis: When diverticulitis occurs, the symptoms are more pronounced and may include:

  • Severe abdominal pain, typically on the lower left side

  • Fever

  • Nausea and vomiting

  • Changes in bowel habits, such as constipation or diarrhea

  • Bloating or gas

  • Painful urination or rectal bleeding (in severe cases)

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Diagnosis

Mr Ferguson will typically use a combination of the following methods to diagnose colonic diverticular disease:

• Medical History and Physical Examination

• Imaging Tests: A CT scan (computed tomography) is often used to diagnose diverticulitis, especially if there is concern about complications.

• Colonoscopy or flexible sigmoidoscopy: This procedure allows the doctor to look inside the colon using a flexible tube with a camera. It is often used to diagnose diverticulosis or to rule out other conditions.

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Treatment

Treatment for diverticular disease varies depending on whether you have diverticulosis or diverticulitis.

• Diverticulosis: If you have diverticulosis but no symptoms, you may not need any treatment. If you have mild symptoms, increasing your fiber intake (through diet or supplements) can help prevent constipation and reduce pressure on the colon. Drinking plenty of fluids and staying active can also improve overall digestive health.

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• Diverticulitis: If you develop diverticulitis, treatment may include:

  • Antibiotics: To treat infection if diverticulitis is present.

  • Pain Relief: Over-the-counter pain relievers or prescribed medications may be used to alleviate discomfort.

  • Hospitalisation: Severe cases of diverticulitis may require hospitalization, especially if there is fever, severe pain, or complications like abscesses, perforation, or bleeding.

  • Surgery: In rare cases, if diverticulitis does not improve with medication or if complications arise, surgery to remove the affected part of the colon may be necessary.

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Complications of Diverticular Disease

While most people with diverticular disease do not experience serious complications, untreated diverticulitis or complications can occur, including:

• Perforation: A tear in the colon wall caused by severe inflammation or infection.

• Abscesses: Pockets of infection that may form in or around the colon.

• Fistulas: Abnormal connections between the colon and nearby organs, such as the bladder or small intestine.

• Bowel Obstruction: Scar tissue from repeated episodes of diverticulitis may lead to blockages in the intestines.

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Prevention

While diverticulosis cannot always be prevented, the following lifestyle changes can help reduce your risk of developing the condition or complications from diverticulitis:

• Increase Fibre Intake: Eating a high-fibre diet helps to keep stools soft, reducing pressure on the colon. Foods rich in fibre include fruits, vegetables, whole grains, and legumes.

• Stay Hydrated: Drinking plenty of fluids helps keep the digestive system working efficiently.

• Exercise Regularly: Physical activity promotes healthy digestion and bowel regularity.

• Avoid Smoking: Smoking is a risk factor for diverticular disease and other digestive problems.

• Maintain a Healthy Weight: Being overweight can increase the risk of diverticular disease, so maintaining a healthy weight is important.

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Colonic diverticular disease, while common, is manageable with proper lifestyle adjustments and medical care. Increasing fiber intake, staying hydrated, and maintaining an active lifestyle can significantly reduce the risk of developing complications. If you have symptoms of diverticulitis or diverticulosis, consult Mr Ferguson for a proper diagnosis and treatment plan.

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