Diverticulosis

What is Diverticulosis?

Diverticulosis is the presence of small pouches or pockets in the bowel wall.  A single pocket is called a diverticulum.

What causes Diverticulosis?

Some cases of diverticulosis are congenital (present at birth) but more commonly diverticulosis develops in later life.  Constipation and straining to pass a bowel motion raises the pressure inside the bowel forcing pouches of bowel lining through points of weakness in the bowel wall.

How common is Diverticulosis?

Diverticulosis is very common in New Zealand and the older you are the more likely you are to have diverticulosis.  Diverticulosis is more common in people of European descent due to genetic and dietary factors.

What are the symptoms of Diverticulosis?

Many people with diverticulosis do not have any symptoms, and go through life unaware of the condition.
Common symptoms include;

  • Change in bowel habit (often alternating constipation and diarrhoea)
  • Abdominal pain

What are the complications from Diverticulosis?

Most people with diverticulosis never develop complications but the following problems can occur;
Diverticulitis – Inflammation due to bacterial infection.  This causes localised abdominal pain and tenderness.  It may also cause diarrhoea and bleeding. Treatment is with antibiotics.
Diverticular abscess – This is a localised collection of pus next to the bowel starting from an infected diverticulum. Symptoms include pain and fever.  Treatment is with antibiotics.  Sometimes the abscess needs to be drained by an x-ray guided procedure or an operation.
Peritonitis – Bursting of a diverticulum causing bowel contents to leak in to the abdomen.  Symptoms are severe, generalised abdominal pain.  An urgent operation is usually required.
Bleeding – Bleeding into the bowel can occur with or without diverticulitis and occasionally can cause major blood loss in the bowel motions.  Usually the bleeding stops by itself but surgery may be required.
Fistula Perforation of a diverticulum into the bladder can cause urine infections and the passage of air bubbles in the urine.  In women, a fistula in the vagina can also occur.

What is the Treatment for Diverticulosis?

Once diverticulosis has developed, it is there to stay.  Treatment is aimed at preventing the progression of the condition and development of more pockets.
A high fibre diet (plenty of fruit, vegetables, whole meal bread, and cereals) creates bowel motions that are larger, softer, and easier for the bowel to pass without straining.  Your doctor may also prescribe fibre bulking agents.
Other measures to prevent constipation may be taken, including regular exercise and adequate fluid intake.
If you develop severe abdominal pain, fever with abdominal discomfort, or large amounts of blood in your bowel motions you should seek urgent medical attention.

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