Diverticulitis

Diverticulosis occurs when small defects in the muscle of the wall of the large intestine or colon allow small pockets or pouches (diverticula) to form. Diverticulitis is infection or inflammation of these abnormal pouches. Together, these conditions are called diverticular disease.

Diverticulosis is extremely common. Old age and diet may be the most important risk factors. More than half of all adults over the age of 70 have the condition. Most of these people are unaware that they have diverticulosis.

Diverticulosis is less common in people under 50. Studies appear to show that diverticulosis became more common in the 20th century. It is also more common in ‘Western’ nations including North America, Europe and Australia. It is less common in Asia and very uncommon in Africa.

Diverticulitis seems to occur when a small puncture develops in the diverticular wall. This causes a small infection to develop, often forming an abscess.

Symptoms of diverticulitis include:

• Sharp pain, often located at a specific point – for example, in the lower left half of the abdomen
• Fever
• Distension (bloating) of the abdomen
• Nausea and vomiting

Complications of diverticular disease

Some of the possible complications of diverticular disease include:

• Abscess – untreated, diverticulitis may lead to an abscess (a ball of pus).
• Perforation – a weakened pocket of bowel wall may rupture. The contents of the bowel can then seep into the abdominal cavity. Symptoms include pain, high fever and chills. A perforated bowel is a medical emergency.
• Peritonitis – perforation can lead to peritonitis (infection of the membranes that line the abdominal cavity and abdominal organs). This complication is potentially life threatening.
• Haemorrhage – diverticula can be the source of haemorrhage. When bleeding occurs, it is important to exclude other causes. A person with diverticulosis can also get cancer.

Self-care suggestions

Suggestions include:

• Increase your daily intake of green vegetables. Introduce fibre gradually to avoid unpleasant symptoms such as flatulence.
• Consider using a fibre supplement (such as psyllium).
• Drink plenty of fluids to ensure your stools are soft, moist and easy to pass.
• Exercise regularly to encourage bowel function and peristalsis.

Where to get help

• Your doctor
• Gastroenterologist or specialist surgeon

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