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Diverticulosis and Diverticulitis

What is diverticulosis?

Diverticulosis is a condition where small bulging pouches, called diverticula, form in the colon wall, and push out through weak spots in the colon. Diverticula usually form in the lowest part of the colon called the sigmoid colon.

It develops in older people who consume a low fiber diet.  It’s more common in people over 50 years old, and its prevalence increases with age. Up to 50% of people over age 60 have the condition. It usually causes no symptoms, but some people experience cramping, bloating and constipation.

Most cases are diagnosed during a colonoscopy which is a test to screen for colon cancer.  It is also more common in industrialized countries, where diets are typically high in processed foods and low in fiber. Treatment involves adoption of a high fiber diet and avoiding heavy, frequent use of NSAIDS (Motrin, Ibuprofen, Aleve, etc.)

Diverticulitis is a condition where the diverticula become inflamed and infected. It used to be believed that diverticulitis was caused by consumption of nuts, seeds, and popcorn that could become stuck in diverticula and become infected. But studies have shown that these foods do not cause diverticulitis. In fact, no food is known to trigger diverticulitis.

It is caused when diverticula tear or are blocked by feces causing inflammation and sometimes infection.

Risk factors include:

  • age
  • obesity
  • smoking
  • lack of exercise
  • a diet low in fiber
  • some medications such as steroids, opioids and NSAIDs

Symptoms of diverticulitis include abdominal pain and tenderness on the left side, constipation, cramping, fever, chills, nausea, and vomiting. About 25% of people with acute diverticulitis can develop serious complications:

  • abscesses when pus collects in the pockets
  • a bowel blockage
  • a fistula, an abnormal opening in the intestines that allows the contents to leak through the intestines to other areas of the intestines
  • peritonitis, when infected pouches rupture and spill the contents of the intestines into the abdominal cavity. Peritonitis is a medical emergency.

Your Gastroenterology Associates of Brooklyn doctor will review your medical history and your medications, ask about your symptoms, your diet and lifestyle, and your bowel habits. They will perform a physical exam, and order blood tests.  They may order a CT scan of your abdomen and pelvis which can show inflamed and infected diverticula and also determine the severity of the condition.

Treatment for diverticulitis depends on the severity of your condition. If the symptoms are mild, your clinician may recommend a liquid diet and antibiotics to treat any infection. For more severe cases, a hospital stay may be necessary and will likely include IV antibiotics and intravenous fluids. In some cases, surgery may be necessary.

Surgical options include resection of the colon to remove any damaged or infected tissue. If you have diverticulitis, it is important to follow your doctor’s instructions in order to prevent complications such as an abscess or fistula.

A high fiber diet can soften waste and help it pass easier. This also helps to reduce pressure in the colon which can also help reduce the risk of developing diverticulosis.

Contact Gastroenterology Associates of Brooklyn to schedule a consultation to receive the correct diagnosis and all your treatment options.