Colonic Diverticula

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Colonic diverticula are a sac-like areas that bulge out (protrudes) in the wall of the large intestine known as the colon. The colon begins at the end of the small intestines and goes around to the rectum.

What causes colonic diverticulosis?

A lack of fiber in a person’s daily diet and eating too much refined and processed foods can lead to diverticulosis. During a bowel movement, stool needs to be pushed in the left colon. When a person becomes constipated there is more pressure put on the colon. Problems can develop in the left colon with the increased pressure or constipation in the bowel causing gas and spasms. Diverticulitis happens when a small, hard piece of stool is trapped in the diverticula (sac-like bulge). When this happens it becomes infected. An infection can cause acute abdominal infection (peritonitis) or compression of the colon (stricture), or can tunnel in to another organ (fistula) like the bladder, bowel or vagina.

Diverticulitis may feel like appendicitis, but instead of pain in the lower-right side of the abdomen, it is on the lower-left side. Symptoms can include lower-left abdominal pain, abdominal distension, an irregular bowel habit with pellet-like stools, or small quantities of blood passed during bowel movement. The pain is usually severe and sudden or it may be mild pain that becomes worse over several days. Abdominal tenderness, fever, nausea, and constipation or diarrhea may also be present.

How is colonic diverticulosis diagnosed?

Most patients suffering from diverticulosis have no symptoms. Bloating, diarrhea, constipation, and abdominal cramping are some of the most common signs of diverticulosis. Diverticular problems can be promptly diagnosed by a barium enema, colonoscopy, or MRI of the abdomen.

How is it treated?

For patients with no symptoms or mild disease, a high fiber diet is recommended. A stool laxative or medication that will help move the bowels is usually enough to treat this problem. If inflammation occurs, a short round of antibiotics and a bland diet will usually ease the symptoms in a couple of days. A serious attack would require admission to the hospital.