Diverticular disease is the condition of having (sac like) projections in the wall of the colon. The increased pressure in the bowel lumen results in mucosa projections through weaknesses of muscle layers in the colon wall. They look like the “blisters” on a car’s tire.
It usually occurs in people over 40 years old and is caused due to a diet low in fiber. Dietary fiber is not digested in the intestine. It also has the capacity to absorb water and thereby creating increased stool volume. This results to bowel movements that diffuse along the colon lumen, and feces to pass with greater ease.
The diverticula usually cause no symptoms. Some people may complain of abdominal cramps, bloating and constipation.
When a diverticulum ruptures due to the increased colonic pressure, fecal content exits the lumen thus creating inflammation.
This condition is called diverticulitis and clinically characterized by severe pain in the abdomen, which may be accompanied by fever, nausea, vomiting and changes in bowel habits.
If diverticulitis remains untreated, it can lead to sepsis, bleeding, abscess or fistula formation and bowel
The usual treatment is conservative. Fluids and antibiotics are administered intravenously.
The surgical treatment becomes necessary after:
- Repeated episodes of diverticulitis. The segment of the colon which carries the diverticula (usually the sigmoid colon or the right colon) is resected
- Complications of diverticulitis like fistula formation or lumen obstruction
The diagnosis of diverticulitis is established with abdominal CT scan
The diverticular disease can be diagnosed with colonoscopy , barium enema and CT scan.