Many people have the pouches or bulges that are characteristic of diverticular disease without experiencing any symptoms. In fact, nearly everyone over age 50 has some pouches present in the colon (Diverticulosis). However, when these pouches become infected or inflamed, the result can be a painful and dangerous condition called Diverticulitis. We offer treatment that can both relieve pain and help you return to full health.
What is diverticular disease?
Diverticular disease refers to bulges or pouches along the intestine that form over time. They can form anywhere in the large or small intestine, but usually the Sigmoid colon (part of the large intestine in the left lower part of the abdomen) is the usual location where problems happen. They form as weak spots develop in the muscles that form the intestinal wall. These pouches are thin and easily damaged by sharp or bulky foods such as popcorn and nuts. When that happens bacteria can escape, causing infection and inflammation. Very minor infection can be treated with antibiotics and dietary modifications. But it can be much worse, causing abscesses and perforation. In these situations, hospitalization and surgery is often needed. Diverticulitis can happen in the same place more than once, and may require surgery to remove the diseased area. About 15% of people with diverticulosis will develop diverticulitis in their lifetime.
Causes of diverticular disease
Researchers believe that diverticular disease is caused by a low fiber diet. When individuals do not consume enough fiber on a daily basis, stool can become hard. This, in turn, makes it more difficult for the colon to form stool and move it along. The increased pressure exerted passing hard stools can cause small pouches, known as diverticuli to form along the walls of the colon.
Doctors do not know why some people develop diverticular disease while others do not. A family history of diverticulosis may also play a part, as can frequent use of NSAID medications.
Symptoms of diverticular disease
Many people who have diverticular disease never experience any symptoms. In other cases, symptoms can include:
- Abdominal pain.
- Nausea and vomiting.
- Loss of appetite.
- Diarrhea, or blood in the stool.
The symptoms above can be associated with a range of conditions. It is important to have your symptoms assessed by a doctor if they do not go away.
Diagnosing diverticular disease
If your doctor suspects that you have diverticular disease, they will perform a physical exam. Based on your symptoms, he or she may order tests to rule out other medical conditions. These may include a complete blood count, abdominal X-rays, and a CT scan.
Treating diverticular disease
The initial treatment for diverticular disease may involve antibiotics and painkillers to treat painful symptoms and clear infection. Your doctor will ask you to avoid foods that can cause diverticulitis, such as nuts and popcorn. If the inflammation is severe, hospitalization and IV antibiotics and IV nutrition may be needed.
Surgery might also be necessary if you have repeat attacks of diverticulitis that are not helped by changing your diet, or if the episode is severe and complicated by an abscess or perforation.
Ongoing treatment for diverticular disease may involve a special diet where fiber is gradually introduced and increased. You may be monitored through regular doctor visits to see how you are progressing. A barium enema X-ray or a colonoscopy may be performed about six weeks after symptoms are under control to evaluate the extent of disease.
If surgery is needed, it can usually be performed with Minimally Invasive Laparoscopic or Robotic technique, both of which are equally effective in treatment. If internal scarring or inflammation is too extensive, a regular incision might be needed. It is always better to have the surgery in a planned situation, without active infection, and after a bowel prep to empty the intestine of its contents. This allows the intestine to be safely reconnected at the time of the one and only procedure. When surgery is needed during an emergency situation (perforation or severe infection) then reconnecting the intestine is usually considered too dangerous, and a temporary bag colostomy may be necessary. This can be reversed at a later time after a patient has recovered from the severe initial infection. Because situations requiring a colostomy are undesirable and higher risk, your surgeon may recommend a planned operation before a severe episode has a chance to develop.
Diverticular disease can be painful, but is considered highly treatable. If you are suffering from repeat attacks of diverticulitis, please call so that one of our skilled and experienced surgeons can help determine the right treatment for your specific situation.