Diverticulosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Diverticulosis is a common condition that affects the large intestine (colon). Diverticula form in the lining of the intestine and push through the wall of the intestine to cause diverticulitis. Diverticulitis is a condition where the pouches become inflamed or infected, causing severe abdominal pain, nausea, vomiting, and changes in bowel habits. These pouches are usually harmless and do not cause any symptoms. Occasionally, it can also lead to serious complications such as bleeding, abscesses, perforations, fistulas, or bowel obstructions.
Causes of Diverticulosis
The exact cause of diverticulosis is not known, but it is thought to be related to several factors, such as:
-
As people age, their colon weakens and is more likely to develop pouches, increasing the risk of diverticulosis. About 30% of people over 50, 50% of people over 60, and 75% of people over 80 have diverticulosis.
-
Overweight or obesity can increase the pressure in the colon and lead to diverticula formation.
-
Smoking damages blood vessels and tissues in the colon, impairing its function.
-
Constipation can be caused by lack of exercise, which can improve muscle tone and blood flow in the colon.
-
In addition to increasing the risk of diverticulosis, a diet that is high in animal fat and low in fiber softens the stool, making it easier to pass through the colon. A low-fiber diet can result in hard and dry stools that require more force to move along the colon, creating more pressure on the weak spots where diverticula can form.
Symptoms of Diverticulosis
Most people with diverticulosis do not have any symptoms and are unaware that they have the condition. However, some people may experience mild symptoms such as:
-
Gas or fluid accumulation in the abdomen can cause bloating.
-
Pain or spasms in the lower abdomen, especially on the left side, where most diverticula are located.
-
Diarrhea or constipation: Changes in bowel habits caused by irritation or inflammation of the colon.
-
Blood in stools or on toilet paper caused by a ruptured blood vessel in a diverticulum. It is usually painless and stops on its own, but it can indicate a serious problem.
Diagnosis of Diverticulosis
Diverticulosis is often detected incidentally during tests or procedures for other conditions. Some of the tests that can detect diverticulosis are:
-
During colonoscopy, a flexible tube with a camera and a light (colonoscope) is used to examine the inside of the colon and the rectum. Biopsies can also be taken for further analysis.
-
Similar to colonoscopy, sigmoidoscopy examines only the lower part of the colon (sigmoid colon), where most diverticula reside.
-
A barium enema involves filling the colon with a liquid containing barium (a contrast agent) and taking X-rays to show the outline of the colon and any abnormalities.
-
The CT scan uses X-rays and a computer to produce detailed images of the abdomen and pelvis. It can also detect inflammation, infection, or complications associated with diverticulosis.
Treatment of Diverticulosis
Diverticulosis treatment depends on the symptoms and complications present. For most people with asymptomatic diverticulosis, no specific treatment is necessary. However, certain general measures can help prevent or reduce symptoms, such as:
-
Fiber-rich foods, such as fruits, vegetables, whole grains, beans, nuts, and seeds, can soften the stool and reduce colon pressure. An adult should consume 25-30 grams of fiber daily.
-
Water is the best fluid to drink, but other fluids such as juices, soups, and herbal teas can also be beneficial. Staying hydrated can help prevent constipation and dehydration, which can worsen diverticulosis symptoms.
-
Moderate physical activity for at least 30 minutes a day can improve blood circulation and muscle tone in the colon and prevent constipation.
-
Quitting smoking may help reduce inflammation and damage in the colon and reduce the risk of diverticulosis complications.
-
Some medications can alter colon function and increase the risk of diverticulosis and diverticulitis. Steroids, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, and some antibiotics are among them. Only use these drugs as prescribed and for a short period of time.
Prevention of Diverticulosis
You can prevent diverticulosis by following a healthy lifestyle that includes eating well, staying hydrated, exercising regularly, and not smoking. Taking these measures can also help slow or prevent diverticulosis progression to diverticulitis. Due to genetics or other factors, some people may still develop diverticulosis despite following these recommendations. A colonoscopy or sigmoidoscopy can help detect and monitor this condition and prevent serious complications.
