Diverticular Disease
What is diverticular disease?
Diverticular disease refers to the presence of small pouches or sacs, known as diverticula, that can develop in the lining of the digestive system, particularly in the large bowel. These pouches usually form when weak spots in the muscular wall of the large bowel herniate under pressure.
What is diverticulitis?
Diverticulitis occurs when one or more diverticula become inflamed or infected. Symptoms may include abdominal pain (usually in the lower left side), fever, nausea, vomiting and changes in bowel habits.
In severe cases, diverticulitis can lead to complications such as abscess formation, perforation of the colon, or development of fistulas (abnormal collection between colon and other structures).
What causes diverticular disease?
The exact cause of diverticular disease is not fully understood, but it is believed to be related to a combination of factors, including low-fiber diet, aging and genetic predisposition. A diet low in fiber can lead to harder stools, increased pressure in the colon during bowel movements, and a higher risk of diverticula formation.
How is diverticulitis diagnosed?
Diverticulitis is a clinical diagnosis and the combination of symptoms; clinical exam findings and diagnostic tests helps confirm the presence of the condition. Blood tests are performed to check for signs of infection or inflammation. Imaging tests such as a CT scan can show inflamed diverticula, abscesses or complications.
A colonoscopy may be recommended to rule out other conditions and to directly visualise the colon. However, it is typically not performed during an acute episode of diverticulitis due to the risk of perforation.
How is diverticulitis treated?
The treatment of diverticulitis depends on the severity of the condition. Mild cases are managed with conservative measures, while more severe cases may require hospitalisation and, in some instances, surgical intervention.
Mild diverticulitis may be managed with antibiotics and clear liquid diet to allow the inflamed bowel to rest.
More severe cases may require hospitalisation for close monitoring, intravenous antibiotics, pain management and/or surgical intervention.
If appropriate, patients with recurrent episodes of diverticulitis can also be considered for surgery.