Diverticular Disease

Diverticular Disease

WHAT IS DIVERTICULAR DISEASE?

Diverticular disease is a condition that commonly affects the sigmoid colon (in the left lower quadrant of the abdomen). It is characterized by the development of outpouchings or pockets (diverticula) in the wall of the colon. The presence of diverticula is also referred to as diverticulosis. When those diverticula get infected, the condition becomes acute diverticulitis.  

WHAT ARE THE SYMPTOMS OF DIVERTICULAR DISEASE?

Commonly, diverticulosis has no symptoms. When symptomatic, diverticulosis may cause intestinal bleeding. When the condition is acute diverticulitis, symptoms may include:

• Lower abdominal pain
• Fever and chills
• Constipation
• Nausea
• Vomiting

WHAT CAUSES DIVERTICULAR DISEASE?

While experts are not sure what causes diverticular disease, there is evidence to support the possibility of these factors playing a role:

• Genetics
• Aging
• Certain medicines
• Lifestyle habits: lack of exercise, obesity, low fiber diets, smoking

WHAT ARE THE MYTHS ABOUT DIVERTICULAR DISEASE?

A common myth about diverticular disease is that it can be caused by eating nuts, seeds and popcorn. The truth is that a healthy diet, including nuts and seeds, is the best medicine against diverticulitis.

HOW IS DIVERTICULAR DISEASE DIAGNOSED?

Diverticular disease is usually diagnosed by reviewing your history, as well as doing a physical exam. At Loma Linda University Health, we may also conduct a CT scan of your abdomen and tailbone areas. It may also be diagnosed at the time of a colonoscopy.

HOW IS DIVERTICULAR DISEASE TREATED?

The first course of treatment for diverticular disease is normally oral antibiotics. Your doctor may also tell you to change to a low fiber or liquid diet for a short period of time. Symptoms typically improve in about 48 hours.

When symptoms are  severe or do not respond to antibiotics taken by mouth, intravenous antibiotics may be given. You may also be told not to eat or drink anything to allow you to heal. In this situation, hospital admission is required.

If a patient does improve after these treatments, or there is a perforation or blockage of the bowel, surgery to remove the sigmoid colon (sigmoid colectomy) may be necessary. At Loma Linda University Health, this procedure can be performed laparoscopically or robotically.

When severe infection, swelling, or leakage of stool has occurred, the surgeon may also need to perform a colostomy (a surgically-created opening of the colon that has been brought through the abdominal wall to allow for evacuation of intestinal waste). The colostomy may be temporary and reversible via a second operation performed about six months after the original operation. Your physician will discuss with you if a colostomy is/was necessary and whether or not a reversal is possible in the future.

WHAT ARE THE COMPLICATIONS OF DIVERTICULAR DISEASE?  

If diverticular disease isn’t treated, serious complications can develop. These include:

• Painful, damaging inflammation of the gut
• Necrosis, which is when a portion of the gut or intestines begin to die
• Loss of gut or intestinal wall integrity, which invites bacteria and fungal invasion
• A hole or perforation in the gut  
• Abscesses inside the gut
• Pylephlebitis (inflamed thrombosis)
• Bowel obstruction
• Bleeding
• Fistula

NEXT STEPS

Make healthy choices. Lifestyle may play a role in the prevention of diverticular disease. If you are at risk because of any of the lifestyle factors listed here, take steps to change those habits immediately.

Seek medical intervention. If you are experiencing symptoms of diverticular disease, seek medical attention right away. Being proactive is important, and it starts with a physician evaluation. To request an evaluation at Loma Linda University Health, contact your provider or schedule the appointment through MyChart.