Diverticular disease

What is diverticular disease?

Diverticular disease (diverticulosis) is a condition causing abnormal small pouches, also known as diverticula, to form in the wall of the large intestine. The formation of these pouches are a result of constant pressure to the bowel wall or weakened muscles. Although these pouches can form anywhere in the colon, they are most common in the sigmoid colon. Diverticula are different to polyps and are not cancerous.

 

Signs and symptoms of diverticular disease

Most people who have diverticulosis are unaware that they have the condition because it usually does not cause symptoms, however some common signs include:

Abdominal discomfort, pain, cramping and/or bloating

Changes in bowel motions

such as diarrhoea or constipation

Complications of the disease may include:

  • Diverticular bleeding – can present as painless rectal bleeding (bright red blood). Diverticular disease is one of the most common causes of acute lower gastrointestinal bleeding
  • Diverticulitis – occurs when there is an infection of the diverticulum (small pouches in the digestive tract). Symptoms include constant abdominal pain, localised tenderness in the abdomen, nausea, vomiting, constipation or diarrhoea, fever and leukocytosis. In severe cases, it may cause perforation or peritonitis.

Diagnosis

Diverticulosis is often found during examination for other conditions, such as during a colonoscopy, a barium enema or CT scan, as many people do not experience symptoms.

Diverticular disease diagnosis involves a number of tests. You may undergo a colonoscopy, a procedure which involves inserting a camera on a flexible tube into the rectum to examine the diverticulum and rule out malignancy; or a barium enema, which is a special x-ray used to identify diverticula in the intestines and colon and is used for patients where a colonoscopy can be difficult or dangerous.

A CT scan is the investigation of choice for patients who have acute diverticulitis or are experiencing complications.

Treatment

As most people with diverticulosis do not experience any symptoms, treatment is not required. Fiber supplements may be recommended to help bulk and soften the stool and make bowel movements easier to pass. Medications may be used to relax spasms in the colon that cause abdominal cramping or discomfort.

Surgical treatment will depend on the severity and frequency of complications from diverticular disease. Your specialist may treat the disease with antibiotics, fluid replacement, and in some cases blood transfusion.2

Frequently asked questions

What causes diverticular disease?

Certain contributing factors can play a role in the development of diverticular disease. These include:

  • Age – People aged 60 or above are more likely to develop diverticular disease
  • Diet – Consuming a low fibre diet may increase the formation of pouches in the intestines

References

For a full list of references, click here.
  1. Gastroenterological Society of Australia (2009). Diverticular disease. Accessed 15 November 2019 at https://cart.gesa.org.au/membes/files/Consumer%20Information/Diverticular%20Disease.pdf
  2. Mayo Clinic (2019). Diverticulitis. Access 15 November 2019 at https://www.mayoclinic.org/diseases-conditions/diverticulitis/diagnosis-treatment/drc-20371764

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