What is diverticular disease?
Diverticula are pockets that develop in the
colon (bowel) wall, usually in the sigmoid or descending colon, but may
involve the entire colon.
Diverticulosis describes the presence of these pockets in the
bowel.
Diverticulitis describes the inflammation of these pockets.
Diverticulosis is very common in Australia effecting more than half the
population by the age of 80.
What causes diverticular disease?
The cause of diverticular disease is largely unknown. However, indications are that a diet low in fibre over the years creates increased colon (bowel) pressure. This pressure forces the mucosa (lining) of the bowel through the muscle wall resulting in pockets or diverticula.
Diverticulitis is inflammation of these pockets of bowel. The pockets become inflamed when pellets of faeces are retained within them. This can lead to an abscess in the wall of the colon which in turn can cause peritonitis, or compression of the colon causing a stricture or a communication between organs. This can occur between the colon, the bladder or the vagina and is called a fistula.
What are the signs and symptoms of diverticular disease?
Many people who have diverticular disease may not
display any symptoms.
Those experiencing symptoms may have:
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Abdominal pain and cramps - this may be caused by spasm or bowel obstruction
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Fever from the infection
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Rectal bleeding (uncommon)
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Altered bowel habits
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More intense symptoms are associated with serious complications such as perforation of the bowel or fistula formation
How is diverticular disease diagnosed?
Diverticular disease is diagnosed by:
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Barium Enema - this is an X-ray taken of your abdomen after an enema containing the contrast (barium) that can be seen via X-ray. This is performed in the X-ray department.
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Endoscopy (flexible sigmoidoscopy or colonoscopy) this is a tube containing a flexible telescope inserted via the rectum into the colon (bowel). The doctor is able to view the inside of your bowel during this test.
How is diverticular disease treated?
Mild disease
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Increased amounts of dietary fibre (grains, legumes, vegetables)
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Antibiotics for attacks of diverticulitis
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Stool softeners
Severe disease
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Requires hospitalisation for intravenous (drip) antibiotics
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Fasting or nil by mouth until symptoms resolve
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Surgery may be required with recurrent episodes or with complications such as a fistula or peritonitis
Surgery
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The diseased part of the bowel is removed and in a majority of cases the bowel is joined up again. In some cases patients may require a temporary ileostomy or colostomy. Normal bowel function and health should return after the operation.
Useful Contacts and Further Information
Concord Hospital has an internationally recognised Colorectal Unit and can be contacted on 97678360
Contact your General Practitioner
Or visit the following web sites
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