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Andy Stein

Diverticular Disease: Causes, Symptoms, Treatment

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Diverticular Disease: Causes, Symptoms, Treatment

Here are 10 key facts about diverticular disease.

Surgery for diverticular disease | healthdirect  Diverticulae in lower left colon

1. Definition: Diverticular disease is a condition where small, bulging pouches (diverticula) develop in the digestive tract, most commonly in the sigmoid colon (lower left, see above).

Note. Having diverticulae is very common – and in fact, normal (see below). When they do not cause symptoms it is not a disease. It is better called diverticulosis.

2. Causes: The exact cause is unknown, but it’s thought to be related to a low-fibre diet, leading to increased pressure in the colon and formation of diverticula.

3. Risk Factors
  • Age (>50 years)
  • Low-fibre diet
  • Obesity
  • Lack of physical activity
  • Family history.

Age and Diverticulae (Diverticulosis)

  • Under 40: Diverticulosis is unusual in this age group
  • 40-60: The prevalence rises significantly, with 1/3 having the condition by age 60
  • Over 60: It is very common, affecting about 50% of people over 60
  • Over 80: 2/3 of people have it by this age.
4. Symptoms
  • Abdominal pain (often left lower quadrant, LLQ)
  • Change in bowel habit
  • Bloating and gas
  • Fever (in complicated cases).
5. Diagnosis
  • CT scan
  • Colonoscopy (elective, when stable)
  • Barium enema (not often done now).
6. Treatment
  • Mild cases: high-fiber diet, fluids, and antibiotics (e.g. ciprofloxacin and metronidazole)
  • Severe cases: IV antibiotics, bowel rest, and possible surgery.
7. Complications
  • Diverticulitis
  • Abscess formation
  • Perforation
  • Fistula formation
  • Obstruction.
8. Prognosis (outlook): Most patients have a good prognosis with prompt treatment, but recurrent episodes are common.

9. Prevention: A high-fibre diet, regular exercise, and maintaining a healthy weight can help prevent diverticular disease.

10. Referral: Refer all patients with complicated diverticulitis, recurrent episodes, or severe symptoms to a lower GI (gastrointestinal) surgeon (or gastroenterologist).

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