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Diverticular Disease
Diverticular disease is a condition that affects the large intestine (colon). A normal colon is strong and relatively smooth. Sometimes small pouches or sacs – called diverticula – form along the inner lining of the intestine. These diverticula may push through the outer colon wall in weakened areas. The presence of these pouches on the colon wall is called diverticulosis. Although diverticulosis can occur anywhere in the colon, most of the time it is found in the lower left side (sigmoid colon) because the colon is narrowest and the inner pressure is highest at this point. Inflammation or infection of these diverticula is called diverticulitis. The inflammation or infection is due to a very small perforation of diverticula. If not treated, it can lead to an abscess, peritonitis, or other severe complications. Diverticulosis and diverticulitis are the two forms of diverticular disease.
Symptoms
Some people with diverticulosis experience no symptoms. Others might feel a cramping pain in the abdomen or tenderness in the left side. If there are a large number of diverticular pouches and they cause a thickening and narrowing of the sigmoid colon, it may cause more painful cramping.
Symptoms of diverticulitis range from mild or slight discomfort in the left lower abdomen to severe tenderness, fever, and bleeding. Occasionally, the affected part of the colon may obstruct the intestine or create a new pathway, called a fistula that may cause matter in the intestine to pass into other organs.
Rectal bleeding occurs when a blood vessel ruptures in one of the diverticular pouches. This may produce a gush of red blood from the rectum or maroon-colored stools. The bleeding usually stops on its own, but requires careful evaluation. Occasionally, emergency surgery is necessary to stop the loss of blood.
Diagnosis
Diverticular disease is diagnosed by performing tests such as barium enema X-rays, flexible sigmoidoscopy, or colonoscopy. The latter two tests are performed by passing a slender, lighted, tube-like instrument (scope) through the rectum and into the intestines to examine the interior of the colon and locate and evaluate problem areas. When a sigmoidoscopy is performed, only the sigmoid colon (lower colon) is viewed. A colonoscopy is performed to view the entire colon.
Causes
The most common theory is that contractions of the muscles surrounding the colon constrict the colon causing pressure to the colon wall and creating diverticula in the weak areas.
Treatment
A fiber-rich diet is advisable. Mild cases of diverticulitis are treated with simple bowel rest and antibiotics. More severe cases might require hospitalization and intravenous antibiotics or, occasionally surgery is required to remove the affected portion of the colon. The most common reason for surgery is to stop repeated episodes of pain, bleeding or diverticulitis.
Information
Courtesy of
The American College of Gastroenterology |
