Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon). Diverticula are common, especially after age 40, and seldom cause problems.
For many years, diverticulosis was considered an old patient's disease with an incidence of 5% in patients younger than 50 years of age[13]. Recently, the incidence of diverticulosis in younger patients has increased and has been reported to range from 18% to 34%[17,19,21,27].
While previous reports demonstrated a low incidence, between 2% and 5%, in populations younger than 40 years old, this new study found that 54% were younger than 50 years, and 21% were younger than 40 years.
Diverticulitis is caused by an infection of one or more of the diverticula. It is thought an infection develops when a hard piece of stool or undigested food gets trapped in one of the pouches. This gives bacteria in the stool the chance to multiply and spread, triggering an infection.
In about 95 out of 100 people, uncomplicated diverticulitis goes away on its own within a week. In about 5 out of 100 people, the symptoms stay and treatment is needed. Surgery is only rarely necessary.
Most people with diverticulitis recover completely. But, at its most severe, a pouch can burst open, spilling fecal matter directly into a person's bloodstream. This results in an immediate risk of developing a blood infection called sepsis, which can be life-threatening.
It is possible that stress plays a role in the development of diverticulitis as it is estimated that in 60 percent of cases the condition occurs due to environmental causes. Stress on the digestive system commonly experienced because of low fiber diets. Diets high in fat may also cause diverticulitis.
Symptoms of diverticulitis are more severe and often start suddenly, but they may become worse over a few days. They include: Tenderness, usually in the left lower part of the abdomen. Bloating or gas.
Risk factors for diverticulitis include heredity, being age 60 or older, having a BMI over 30, smoking, and regular use of NSAIDs such as aspirin.
Probiotics combined with mesalazine have also emerged as an alternative potential therapeutic strategy in preventing recurrent attacks of diverticulitis. One series reported that treatment with mesalazine and/or lactobacillus casei induced remission in 88% of their patients at a median follow-up of 2 years.
Diverticulitis is treated using diet modifications, antibiotics, and possibly surgery. Mild diverticulitis infection may be treated with bed rest, stool softeners, a liquid diet, antibiotics to fight the infection, and possibly antispasmodic drugs.
How long does a diverticulitis flare-up typically last? After starting treatment, most people should start to feel better in two or three days. If symptoms don't start to get better by then, it's time to call a healthcare provider and get instructions on what to do next.
You have about five feet of colon, and most patients can live a normal, healthy life without the sigmoid section, which is about one foot long.
CAUSES. The most commonly accepted theory for the formation of diverticulosis is related to high pressure within the colon, which causes weak areas of the colon wall to bulge out and form the sacs. A diet low in fiber and high in red meat may also play a role.
The prevalence of diverticulitis and diverticular bleeding has also been increasing[4]. Diverticulosis of the colon is often diagnosed during routine screening colonoscopy.
A CT scan, which can identify inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment.
The doctor also may suggest taking a fiber product, such as Citrucel® or Metamucil®, once a day. Your doctor may recommend a low- or high-fiber diet depending on your condition. Listed below are high-fiber food options for diverticulosis and low-fiber food options for diverticulitis.
Percutaneous therapy
However according to the American Society of Colon and Rectal Surgeons (ASCRS) radiologically guided percutaneous drainage is usually the most appropriate treatment for patients with a large diverticular abscess as it avoids the need for emergency surgery and possibility of a colostomy34.
The risk of a repeat attack after an initial attack of uncomplicated diverticulitis is low, with rates ranging widely from 1.4% to 18%. The risk of a repeat attack increases with each subsequent attack.
If you don't treat it, diverticulitis can lead to serious complications that require surgery: Abscesses, collections of pus from the infection, may form around the infected diverticula. If these go through the intestinal wall, you could get peritonitis. This infection can be fatal.
A minor risk factor for colorectal cancer is diverticulitis. Colorectal cancer has a 1.9% one-year incidence rate in patients with diverticulitis.