Diverticulosis: long name, bad condition
Lifestyle changes are the best medicine for this digestive tract issue
Key takeaways:
- Diverticular disease is a common problem involving bulges in the digestive tract.
- Lifestyle changes, including getting more fiber in your diet, are a common treatment. In severe cases, you may need treatment at the hospital.
The late Senator John McCain and Pope Francis are among the public figures who have dealt with diverticular disease. It’s a common problem in the digestive tract, but it’s one that can have serious complications if not treated properly.
Terminology
David Rzepczynski, MD, an OSF HealthCare gastroenterologist, says it’s important to first lay out some similar sounding terminology.
- Diverticulum (singular) or diverticula (plural): These are the bulges that form when an inner part of the colon sticks out through a weak spot in the colon wall.
- Diverticulosis: This is the name of the condition when the bulges occur.
- Diverticulitis: This describes when the bulges become inflamed.
Causes, symptoms and diagnosis
Dr. Rzepczynski says diverticulosis occurs when your colon is trying to push stool forward, and the organ is not as bulky as it should be. The diverticula bulges then form.
The condition has been more common in people over 60, but Dr. Rzepczynski says health care providers are seeing a rise in cases in people in their 40s and 50s.
Diverticulosis can run in families. It’s also tied to your lifestyle.
“A diet that has more red meat, less grain and less fiber might put you at a higher risk,” Dr. Rzepczynski says.
Smoking, excess alcohol and obesity are also risk factors.
Symptoms of diverticulosis include abdominal pain or constipation. But it often comes with no symptoms and is found during a colonoscopy.
Treatment
Dr. Rzepczynski says in mild cases, a provider may tell you to change your lifestyle, such as getting more fiber in your diet. This makes bowel movements smoother.
“Often, people will look to use fiber supplements,” Dr. Rzepczynski says. “The amount of fiber intake from supplements pales in comparison to what you can get from your diet.”
Also, eat a healthier diet overall. Dr. Rzepczynski says there used to be a myth that nuts, popcorn and seeds would get lodged in the colon bulges. He says studies have shown those foods are not a risk factor.
Other lifestyle tips: exercise and cut out tobacco and alcohol.
Dr. Rzepczynski says more serious cases of diverticulosis can come with two complications. One is bleeding.
“You could have a blood vessel on the outside of the diverticulum. If it ruptures into the diverticulum, it could cause sudden bleeding from the rectum,” Dr. Rzepczynski says.
Dr. Rzepczynski says bleeding from diverticulosis is not common. He ballparks it at around one in 2,000 cases. People on blood thinning medication who develop diverticulosis have a higher risk of bleeding.
While unpleasant, Dr. Rzepczynski says most bleeding cases resolve on their own.
The second, more serious complication is diverticulitis, or when the diverticula bulges become inflamed. This happens when there is a tear in the diverticulum, and bacteria from stool leaks. And it can lead to a host of other problems: pockets of pus known as abscesses, issues passing stool and a urinary tract infection.
Symptoms of diverticulitis include pain in the lower left abdominal area, abnormal bowel movements, nausea and vomiting. If you have these symptoms, it’s important to been seen by a health care provider quickly. A doctor may order a computed tomography scan (commonly called a CT scan) to diagnose diverticulitis.
Dr. Rzepczynski says it’s not common for diverticulosis to progress to diverticulitis, and most cases of diverticulitis can be treated at home with oral medication. But, he says 12 to 15% of diverticulitis patients spend time at the hospital. Treatments there include antibiotic medication through intravenous therapy (IV) and surgery. If surgery is necessary, a doctor will drain any abscesses then remove the inflamed area of the colon.
“They’ll try to reconnect the colon at that time,” Dr. Rzepczynski explains. “But if the surgery is done on an emergency basis, sometimes the person may have a colostomy where part of the colon is coming out through the skin. That’s a temporary measure.”
A colostomy comes with a bag on the outside of your body that collects the waste that would normally leave your body via a bowel movement.
Dr. Rzepczynski warns that surgery isn’t a permanent fix. He says around 15% of diverticulitis patients who have surgery end up with another bout. It reinforces the importance of lifestyle changes. You should also get on a colonoscopy schedule as advised by your health care provider.
Learn more
Read more about how to avoid diverticulosis on the OSF HealthCare website.