Diverticulosis is a condition in which the colon suffers from the presence of diverticula, small, bulging sacs of tissue that press outward from the colon wall. Diverticula tend to form as a person ages and pressure built up in the colon causes the bulging of tissue. A person with diverticulosis may have few symptoms or no symptoms at all.
Diverticulosis alone is merely the presence of the bulging tissue sacs in the colon. However, someone with diverticulosis is said to have diverticular disease. Often confused with diverticulitis, diverticulosis can be present in the body with no complications.
Diverticulitis is an infection of the sacs, which may rupture, and typically carries symptoms including fever, abdominal pain, and swelling. In rare cases, there may be bleeding, which requires medical attention and occasionally surgery. Though extremely rare, if an infected diverticulum ruptures into the abdominal cavity, it can be life threatening.
Discovery of diverticulosis may occur during a routine colonoscopy, or the condition may be investigated if symptoms present themselves. Barium x-rays and abdominal ultrasounds can also detect the presence of diverticula. Changes in bowel habits, including constipation or diarrhea along with abdominal cramping and bloating, can signify diverticulosis. People experiencing persistent symptoms or passing blood or tarry, black stools should call their doctor, as complications like diverticulitis or another disease of the colon may be present. Proper diagnosis is necessary for successful treatment.
Diverticulitis is treated with antibiotics and in most cases, the infection responds. In cases of severe infection with high fever and pain, excessive bleeding, or a lack of response to antibiotics, surgery may be necessary. In the more frequent occurrence of diverticulosis, a patient can often go without specific treatment. Though the benefits are not proven, a diet high in fiber is often recommended to help regulate bowel function and, if necessary, bloating can be treated with anti-spasmodic drugs.
Most people with diverticulosis have few or no symptoms. Doctors refer to diverticulosis with no symptoms as asymptomatic diverticulosis. For people who experience symptoms, the condition is called symptomatic diverticulosis. Symptomatic diverticulosis is categorized into three types - painful diverticulosis, inflammatory diverticulitis (inflamed and infected diverticula) and bleeding diverticulosis (the blood vessel in the wall of the diverticulum ruptures).
Symptoms of painful diverticulosis are:
abdominal pain (usually located in the lower left abdomen) that subsides after a bowel movement or passing gas
constipation, followed by bouts of diarrhea
bloating
Symptoms of inflammatory diverticulitis are:
abdominal pain
constipation
fever
bloating
vomiting
Symptoms of bleeding diverticulosis are:
sudden, mild cramps
urge to have a bowel movement
bright red blood clots and maroon-colored stool
If sufficient blood is lost in a short amount of time, the person may experience:
increased thirst
dizziness
rapid heart beat
fainting
Most patients with diverticulosis have minimal or no symptoms, and do not require any specific treatment. A high fiber diet and fiber supplements are advisable to prevent constipation and perhaps prevent the formation of more diverticula.
Patients with mild symptoms of abdominal pain due to muscular spasm in the area of the diverticula may benefit from anti-spasmodic drugs such as:
chlordiazepoxide (Librax),
dicyclomine (Bentyl),
atropine, scopolamine, phenobarb (Donnatal), and
hyoscyamine (Levsin).
Some doctors also recommend avoidance of nuts, corn, and seeds to prevent complications of diverticulosis. Whether these dietary restrictions are beneficial is uncertain.
When diverticulitis occurs, antibiotics are usually needed. Oral antibiotics are sufficient when symptoms are mild. Some examples of commonly prescribed antibiotics include:
ciprofloxacin (Cipro),
metronidazole (Flagyl),
cephalexin (Keflex), and
doxycycline (Vibramycin).
Liquid or low fiber foods are advised during acute attacks of diverticulitis. This is done to reduce the amount of material that passes through the colon, which at least theoretically, may aggravate the diverticulitis. In severe diverticulitis with high fever and pain, patients are hospitalized and given intravenous antibiotics. Surgery is needed for patients with persistent bowel obstruction or abscess not responding to antibiotics.