Colonic diverticulosis is the condition whereby diverticula, or pockets, form from the lining of the colon. These protrusions of the colon lining occur at sites of weakness in the muscle wall possibly due to increased pressure from muscle contractions.
Diverticulitis is an inflammatory process that causes acute symptoms and may be associated with serious complications.
Potential risk factors include increasing age; diets low in fibre and high in red meat and refined carbohydrates; obesity.
There is no evidence that seeds or nuts cause diverticulitis.
Diverticulosis is often asymptomatic and found on investigation by colonoscopy or CT scanning. It may be associated with low abdominal cramping, bloating, or constipation. Diverticulitis, due to infection or inflammation of the diverticula, may cause localized lower left sided abdominal pain with either diarrhoea or constipation and fever.
Classically, this is a disease process that predominantly affects people over the age of 70 years and is more common in developed countries. It is however getting more common in younger people possibly related to obesity.
It is important to confirm the diagnosis as symptoms of colonic diverticulosis as symptoms may mimic colonic cancer or inflammatory bowel disease.
A colonoscopy enables the gastroenterologist to examine the lining of the colon to confirm diverticulosis and to exclude colon cancer or inflammatory bowel disease.
An abdominal CT scan is a radiological test used to diagnose diverticulitis and to look for complications.
A blood test may be performed to look for any signs of infection within the body.
Diverticulitis is usually treated with antibiotics.A recent placebo-controlled trial did not show, in the outpatient setting, that antibiotics were any better than placebo.
Patients with abscess (collection of pus) or perforation (a hole in the colon) require emergency admission to hospital; these last 2 complications may require urgent surgery.
Long-standing severe diverticulosis or following recurrent attacks of diverticulitis the colon may get narrowed (stricture formation) and surgery may be required to avoid obstruction.