Diverticulosis

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Diverticulosis

Topic Overview

What is diverticulosis?

Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the colon (large intestine). These pouches are usually very small (5 to 10 millimetres) in diameter but can be larger.

In diverticulosis, the pouches in the colon wall do not cause symptoms. Diverticulosis may not be discovered unless symptoms occur, such as in painful diverticular disease or in diverticulitis. As many as 80 out of 100 people who have diverticulosis never get diverticulitis.1 In many cases, diverticulosis is discovered only when tests are done to find the cause of a different medical problem or during a screening examination.

What causes diverticulosis?

The reason pouches (diverticula) form in the colon wall is not completely understood. Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall.

Normally, a diet with adequate fibre (also called roughage) produces stool that is bulky and can move easily through the colon. If a diet is low in fibre, the colon must exert more pressure than usual to move small, hard stool. A low-fibre diet also can increase the time stool remains in the bowel, adding to the high pressure.

Pouches may form when the high pressure pushes against weak spots in the colon where blood vessels pass through the muscle layer of the bowel wall to supply blood to the inner wall.

What are the symptoms?

Most people don't have symptoms. You may have had diverticulosis for years by the time symptoms occur (if they do). Over time, some people get an infection in the pouches (diverticulitis). For more information, see the topic Diverticulitis.

The symptoms of painful diverticular disease are the same as those of irritable bowel syndrome (IBS), including diarrhea and cramping abdominal pain, with no fever or other sign of an infection. For information on the symptoms of IBS, see the topic Irritable Bowel Syndrome (IBS).

How is diverticulosis diagnosed?

In many cases, diverticulosis is discovered only when tests, such as a barium enema X-ray or a colonoscopy, are done to find the cause of a different medical problem or during a screening examination.

How is it treated?

The best way to treat diverticulosis is to avoid constipation. Here are some ideas:

  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
  • Get some exercise every day. Try to do moderate to vigorous activity at least 2½ hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
  • Take a fibre supplement, such as Metamucil or Prodiem, every day if needed. Start with a small dose and very slowly increase the dose over a month or more.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.

This treatment may help reduce the formation of new pouches (diverticula) and lower the risk of developing diverticulitis.

Treatment for painful diverticular disease involves adding fibre to the diet and eliminating any foods that cause gas, pain, or other symptoms. Treatment is the same as that for irritable bowel syndrome (IBS), because many people who have this condition also have IBS. For information on the treatment of IBS, see the topic Irritable Bowel Syndrome (IBS).

Can diverticulosis be prevented?

Eating a high-fibre diet, getting plenty of fluid, and exercising regularly may help prevent diverticulosis.

Other Places To Get Help

Organizations

Canadian Association of Gastroenterology
1540 Cornwall Road
Suite 224
Oakville, ON  L6J 7W5
Phone: 1-888-780-0007
(905) 829-2504
Fax: (905) 829-0242
Email: general@cag-acg.org
Web Address: www.cag-acg.org
 

The Canadian Association of Gastroenterology (CAG) provides educational information and supports research about digestive health and disease.


Canadian Digestive Health Foundation
Web Address: www.cdhf.ca
 

The Canadian Digestive Health Foundation provides educational information about digestive diseases and supports research into their causes and treatment.


National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way
Bethesda, MD  20892-3570
Phone: 1-800-891-5389
Fax: (703) 738-4929
Email: nddic@info.niddk.nih.gov
Web Address: www.digestive.niddk.nih.gov
 

This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.


References

Citations

  1. Davis BR, Matthews JB (2006). Diverticular disease of the colon. In M Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 855–859. Philadelphia: Saunders Elsevier.

Other Works Consulted

  • Travis AC, Blumberg RS (2009). Diverticular disease of the colon. In NJ Greenberger et al., eds., Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy, pp. 243–255. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD - Gastroenterology
Last Revised November 18, 2010

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