Diverticulitis

Diverticular disease (also diverticulosis) is a condition in which the bowel (large intestine) forms small pouches (diverticula) that bulge outward through the bowel wall. This typically develops due to increased pressure in the bowel, weakness of the bowel wall, or from straining during bowel movements. Many people with diverticular disease have no symptoms, or symptoms that are not very troublesome. Some people with diverticular disease experience constipation, diarrhea and low belly pain. More troublesome symptoms are sometimes the result of infection or inflammation in these pouches (diverticulitis). The symptoms of infection may come on quickly, and include blood in the stool and fever. Treatment is only required in people who experience symptoms. This may involve antibiotics or, rarely, surgery.

Many people with diverticular disease do not have symptoms until they develop diverticulitis. Typical symptoms include changes in bowel habits (alternating diarrhea and constipation), bloating, nausea, vomiting and belly pain. If the diverticula are infected and inflamed, they may cause fever, belly pain and blood and pus in the stool. Symptoms are due to inflammation, irritation and sometimes infections forming in the out-pouching of the bowel.

The diagnosis is usually made on the basis of medical history and physical examination. A computed tomography (CT) scan may be needed to identify the location of the inflammation in the bowel and confirm the diagnosis.

Treatment is based on the severity and stage of diverticular disease. Affected people with no symptoms usually do not need treatment. People who have diverticulitis (infection and inflammation of the pouches) may receive antibiotics to treat the infection. In severe or complicated cases, surgery might be needed to stop bleeding, drain pus, or even remove parts of the bowel. However this is very uncommon.

The risk of getting diverticular disease and diverticulitis increases with age, and most commonly affects people older than 60 years of age. Eating a low-fiber diet (a diet high in processed foods) has often been seen as a cause, although the link is not clear.

Many people with diverticular disease do not have symptoms and do not require any treatment. Diverticulitis (inflammation and infection of the pouches) is often treated with antibiotics and people recover well if there are no complications. Some people may experience recurrent episodes of diverticulitis. Younger people may have a higher risk of severe disease and recurrence.

Eating foods which are high in fiber may help prevent diverticular disease and episodes of inflammation of the pouches (diverticulitis).

• inflamed pockets in the lining of the large intestine