Diverticula are small sacs that sometimes form in the wall of the intestine. When these sacs become infected and inflamed, a condition known as diverticulitis results.
The term diverticulosis means the presence of many diverticula in the bowel. A person's diet is thought to play a role in the formation of diverticula. Diverticula do not usually cause symptoms. But if diverticula become inflamed, symptoms usually do occur.
Diverticulitis can only occur in people who have diverticulosis. Both conditions are more common in people older than 50.
Diverticulosis is more common in people who have a low intake of fiber in their diets. Diverticula usually occur in the left side of the large bowel or colon. This may be due to higher pressure in this part of the bowel.
Once a diverticulum has formed, it may become infected. This infection causes the inflammation and symptoms of diverticulitis.
Diverticulitis, which may be either mild or severe, can cause:
Diverticulitis is suspected after a history and physical examination. A history of lower, left-sided abdominal pain is a clue. The physical exam often reveals a tender abdomen. Tightness of the abdominal muscles, called abdominal rigidity, suggests serious infection. The white blood cell count is often elevated. A test called a CT scan may be used to confirm the diagnosis.
The key is to prevent the diverticulosis from developing. Eating a diet high in fiber and low in dietary fat is thought to decrease the risk of diverticulosis. Once diverticula form, there are no other ways known to prevent the disease.
Most people will recover without long-term health effects. However, because diverticulosis still exists, the disease can occur again. If it happens many times, surgery may be needed to remove part of the colon.
Severe cases may also lead to other serious complications, such as:
Death may also occur.
The disease is not catching and poses no risk to others.
Mild cases can be treated at home with a clear liquid diet and antibiotics for about a week. In more serious cases, the person must be treated in the hospital. In this setting, the bowel is allowed to rest. This means the person should not eat or drink anything. Fluids and antibiotics are given through an intravenous line called an IV. Surgery may be needed if the bowel has holes, blockages, or abscesses. Some people may need surgery to remove part of the bowel.
Antibiotics can cause many side effects, including rashes, stomach upset, and allergic reactions. Surgery carries a risk of bleeding and infection.
Most people will recover completely. More studies of the inside of the bowel, such as X-ray tests, may be done after recovery.
Some people have repeated attacks of diverticulitis. If a classic symptom such as left-sided abdominal pain reappears, the person should see a doctor right away. Blood tests and X-ray tests may be used to monitor the disease. Any new or worsening symptoms should always be reported to the doctor.
Author:Minot Cleveland, MD
Editor:Crist, Gayle P., MS, BA
Reviewer:Kathleen A. MacNaughton, RN, BSN
Harrison's Principles of Internal Medicine, 1998, Fauci et al, pp. 1648-1649.