Diverticular Disease

What is Diverticular Disease?

Diverticular disease is a condition affecting the large intestine.  Diverticula are small bulges or sacs formed in the large intestine because of the weakness of the muscular layer of the large intestine.

The mere presence of diverticula may not give rise to symptoms. When there are no symptoms, it is called diverticulosis.

When the diverticula causes symptoms, such as lower abdominal pain, it is called diverticular disease.

When the diverticula becomes inflamed or infected, it is called diverticulitis. 

Diverticular disease is also a cause of bleeding.

 

SYMPTOMS

Symptoms of diverticular disease include:

  • Lower abdominal pain
  • Constipation and diarrhoea
  • Blood in stool


Symptoms of diverticulitis are more severe:

  • Constant, more severe abdominal pain
  • Fever
  • Diarrhoea or constipation
  • Mucus or blood in your stool
WHEN to See a Doctor

If you have abdominal pain and a change in bowel habits, you should see a specialist for a thorough check to ensure that you do not have any serious condition.

If you already had a thorough check and you are diagnosed with diverticulosis, mild abdominal pain can be treated by your family physician at home.

You should seek immediate medical attention if you have severe pain, fever or bleeding. You may need to be admitted to the hospital for investigation and treatment. Sometimes, antibiotics may be needed. In severe cases, surgery may be required.

CAUSES

The exact cause of diverticular disease is unknown. It seems to be linked to age, diet and genetics. The older you are, the more likely that you will have diverticulosis. Most people will have diverticulosis by the time they are 80 years old. 

Not taking enough fibre is thought to be linked to developing diverticular disease and diverticulitis. Other contributing factors are smoking, being overweight, constipation and regular use of NSAIDs (painkillers). 

If you have relatives that have diverticulosis, especially if they have it before the age of 50, your risk of having diverticulosis increases.

DIAGNOSIS

Diagnosis of diverticulosis, diverticular disease and diverticulitis require investigations such as blood tests, CT scasns and colonoscopy.

It is important to have a thorough investigation because other important diseases such as cancer or appendicitis may have similar symptoms.

CT scan can detect inflammation and mass in the abdomen. It is also very useful to assess solid organs such as the liver, kidneys and spleen.

Colonoscopy is a simple procedure using a thin tube with a camera to examine the inside of your large intestine. This is usually done with sedation so that you are very comfortable during the procedure.

TREATMENT

Treatment of diverticulitis is usually treated with painkillers and antibiotics. The more severe cases may need to be admitted to the hospital for treatment, where stronger painkillers and antibiotics may be used. 

Occasionally surgery may be needed to treat complications of severe diverticulitis. Part of the colon may be removed with surgery. 

Sometimes pockets of pus called abscesses may form and drainage maybe  required. This is usually done with a special thin tube inserted with radiological guidance.

A diverticular bleed may need radiological intervention to stop the bleeding. Sometimes therapeutic colonoscopy or surgery may be used to stop the bleeding.