Diverticulitis and diverticulosis symptoms, treatment and prevention
Diverticular disease is the result of the development of small sacs or pockets (diverticula) in the wall of the colon. Often these are present without causing any symptoms, a condition called diverticulosis.
When these bulges in the lining of the colon become inflamed or infected and cause symptoms such as abdominal pain and bloating it is called diverticular disease, and if they cause more severe pain and fever it is known as diverticulitis.
What are the symptoms of diverticulitis?
Symptoms of diverticulitis are:
- Severe, cramping abdominal pain that is usually worse on the left side
- Chills or fever
- Constipation, thin stools, or diarrhoea
- Pain in the lower left quadrant of the abdomen that increases when the area is touched
- Rectal bleeding (rare)
Seek medical advice if:
- You have a fever, chills, and abdominal pain or swelling, or are vomiting, or your abdomen becomes rigid and you experience pain when you move - you could have peritonitis, an infection of the membrane that lines the abdominal cavity. Get medical help immediately.
- Blood appears in stools - this indicates internal bleeding.
- You have a fever - you may have an infection that requires medication.
- Severe pain continues despite treatment - you may have another abdominal disorder.
How can I prevent diverticulitis?
The best preventive action you can take against diverticulitis, of course, is to keep from developing the small sacs called diverticula. You have a good chance of doing that simply by modifying your diet and lifestyle:
- Eat wholegrain breads, oatmeal, bran cereals, fibrous fresh fruits and vegetables to increase the bulk in your diet.
- Keep refined foods such as white flour, white rice, and other processed foods to a minimum.
- Regular exercise can help the muscles in your intestine retain their tone, which encourages regular bowel movements.
- Don't use suppositories for constipation on a long-term basis without seeking medical advice.
- Prunes, prune juice and psyllium seed may all help to keep the bowels functioning.
Risk factors for diverticulitis and making the diagnosis
Ageing and heredity are factors in the development of diverticulosis and diverticulitis, but diet is the main risk factor, specifically a lack of fibre in the diet. Eating a lot of low-fibre, refined foods can greatly increase the risk. Indeed, in Western societies, an estimated 10% of people over 40 eventually develop diverticulosis; the figure reaches 25% in people over 60, and 50% in those over 80. Diverticular disease will occur in about 1 in 4 of those with diverticulosis.
Factors that increase the risk of diverticular disease include constipation, smoking, being overweight, physical inactivity, and the use of anti-inflammatory medication. The reasons for why these risk factors increase the risk of diverticular disease are unclear.
It has been suggested that being constipated and usually straining at bowel movements may create enough pressure in the intestinal walls to weaken them and begin the development of diverticular pouches. If the diverticula then become filled with faecal material or with undigested food, they are vulnerable to bacterial infection, leading to the inflammation of diverticulitis.