Diverticular disease encompasses two related conditions: diverticulosis and diverticulitis.
- Diverticulosis: This condition refers to the formation of small pouches (diverticula) in the lining of the colon. These pouches can develop over time as pressure increases inside the colon due to factors like low fibre intake and muscle weakness in the colon wall.
- Diverticulitis: When one or more of these pouches become inflamed or infected, it leads to diverticulitis. This condition can cause abdominal pain, fever, and changes in bowel habits.
Why Does Diverticular Disease Happen?
Diverticular disease is more common in older adults and is often associated with low-fibre diets:
- Low-fibre diet: A diet low in fibre can cause constipation and increased pressure in the colon, leading to the formation of diverticula. When stool becomes hard and difficult to pass, it can cause the walls of the colon to push out and form pouches.
- Genetic factors: There may be a hereditary component to the development of diverticula, although more research is needed to understand the genetic links fully.
- Increased pressure in the colon: Factors such as obesity, smoking, physical inactivity, and a diet high in red meat and low in fruits and vegetables can contribute to increased pressure in the colon and the formation of diverticula.
When Does Diverticular Disease Occur?
Diverticular disease is more common in:
- Older adults: The risk increases with age, especially after the age of 40, due to changes in the colon’s elasticity and muscle strength.
- Geographical variations: It is more common in Western countries where diets are often low in fibre and high in processed foods.
How to Treat Diverticular Disease
Treatment for diverticular disease varies depending on the severity of the condition:
- Mild diverticulosis:
- Dietary changes: Increasing fibre intake with foods like whole grains, fruits, vegetables, and legumes can help prevent constipation and reduce the risk of diverticulosis.
- Fluid intake: Drinking plenty of water can also help soften stools and prevent constipation.
- Regular exercise: Maintaining a healthy weight and regular physical activity can help reduce the risk of developing diverticulosis.
- Mild diverticulitis:
- Rest: Resting the digestive system by consuming a liquid or low-fibre diet temporarily may be recommended.
- Pain relief: Over-the-counter pain relievers such as paracetamol can help alleviate mild pain. In more severe cases, prescription medications may be required.
- Antibiotics: If an infection is present, antibiotics may be prescribed to clear the infection.
- Severe diverticulitis:
- Hospitalisation: In severe cases, hospitalisation may be required for treatment with intravenous fluids, antibiotics, and pain management.
- Surgery: Surgery may be necessary if complications arise, such as an abscess, perforation, or persistent inflammation. The type of surgery depends on the severity of the condition and may involve the removal of damaged sections of the colon.
- Lifestyle adjustments:
- Dietary changes: A high-fibre diet is recommended to prevent further complications. This includes consuming foods like whole grains, fruits, vegetables, and legumes.
- Avoid certain foods: Avoiding foods that can exacerbate symptoms, such as nuts, popcorn, and seeds, which can get stuck in the diverticula, may be necessary.
- Regular bowel movements: Establishing a routine for bowel movements can help prevent constipation and reduce the pressure in the colon.
- Long-term management:
- Ongoing monitoring: Regular follow-up visits with a healthcare provider are important to monitor for complications and assess the need for ongoing treatment.
- Colonoscopies: Periodic colonoscopies may be recommended to check for changes in the colon and to monitor the development of new diverticula.
- Education on symptom management: Understanding the symptoms of diverticulitis and seeking medical advice when symptoms worsen can help prevent complications.
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