Patient Information
Diverticulosis
What is diverticulosis?
Diverticulosis is the presence of small pouches or pockets in the bowel wall. A single pocket is called a diverticulum.
Causes:
Some cases of Diverticulosis are congenital (present at birth). However, more commonly, diverticulosis develops in later life. Constipation and straining to pass a bowel motion raises the pressure inside the bowel, forcing pouches of bowel lining through points of weakness in the bowel wall muscle layer. Diverticulosis increases as age increases.
Diverticulosis is very common in New Zealand, especially in people of European descent due to genetic and dietary factors.
Symptoms:
Many people with diverticulosis do not have any symptoms.
Common symptoms include altered bowel habit (often alternating constipation and diarrhoea) and abdominal discomfort.
What are the complications of diverticulosis?
Diverticulitis: Inflammation of a diverticulum due to bacterial infection. This causes localized abdominal pain and tenderness. It may also cause diarrhoea and bleeding. Treatment sometimes requires antibiotics.
Diverticular abscess: This is a localized collection of pus next to the bowel, starting from an infected diverticulum. Symptoms include pain and fever. Treatment is usually with antibiotics. Sometimes, the abscess needs to be drained by an x-ray guided procedure or an operation.
Peritonitis: This is caused by a perforation of a diverticulum, causing bowel contents to leak in to the abdomen, and may result in peritonitis (severe generalized abdominal pain and extreme abdominal tenderness) . An urgent operation is usually required. This may also involve a stoma bag being created.
Bleeding: Bleeding in to the bowel can occur with or without diverticulitis and occasionally can cause major blood loss in the bowel motions. Usually, the bleeding stops by itself, but surgery may be required, though this is rare.
Fistula: Perforation of a diverticulum into the bladder can cause recurrent urine infections and the passage of air bubbles in the urine. In women, a fistula to the vagina can also occur.
Treatment:
The aim is to reduce the progression of diverticulosis and development of more pockets. A high fibre diet (plenty of fruit, vegetables, whole meal bread, and cereals) creates bowel motions that are larger, softer, and easier for the bowel to pass without straining. A stool bulking agent such as Metamucil or Konsyl-D may be prescribed. Studies have shown that regular exercise such as walking and adequate fluid intake are other measure to prevent constipation.
If you develop severe abdominal pain, fever with abdominal discomfort, or large amounts of blood in your bowel motions, you should seek urgent medical attention.
