Diverticulosis

Diverticular disease: From harmless pouches to painful inflammation

Do you experience recurring abdominal pain, or are you concerned about your bowel health? Diverticula (pouches in the large intestine) are a very common condition, especially with age. While many people live with them without any issues, they can develop into a painful and potentially serious inflammatory state.

In this post, we take a closer look at the difference between diverticulosis and diverticulitis, and why a thorough bowel examination is crucial for the correct diagnosis.

What are diverticulosis and diverticulitis?

It is important to distinguish between the two terms, as they require different management:

• Diverticulosis: The presence of small pouches (diverticula) in the wall of the colon. This is not a disease in itself and often produces no symptoms.
• Diverticulitis: A condition where inflammation or infection occurs in one or more of these pouches. This often requires medical treatment.

Symptoms you should not ignore

Many people only discover their diverticula when they become inflamed. Typical signs of diverticulitis include:

• Severe abdominal pain (most often in the lower left side).
• Changed bowel habits (constipation or diarrhoea).
• Fever and chills.
• Nausea and vomiting.

Why is a bowel examination necessary?

When experiencing persistent abdominal pain or changes in bowel habits, it is vital to obtain a professional assessment. The symptoms of diverticulitis can resemble other conditions, including irritable bowel syndrome (IBS) or, in worse cases, colorectal cancer.

Colonoscopy: The most accurate method

A colonoscopy is the "gold standard" for bowel examination. During this procedure, a thin, flexible tube with a camera is inserted into the colon.

1. Diagnosis: The doctor can visually confirm the presence of diverticula.
2. Exclusion: It is the most effective way to rule out polyps or cancer.
3. Precision: If there are signs of chronic irritation, the doctor can take tissue samples (biopsies).

Note: In cases of acute, severe diverticulitis, a colonoscopy is often postponed until the inflammation has subsided to reduce the risk of complications.

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How is it treated?

Treatment depends on the severity:

• Mild diverticulitis: Can often be managed with a light diet and rest.
• Moderate to severe diverticulitis: May require antibiotics or hospitalisation.
• Prevention: A high-fibre diet, plenty of fluids, and regular exercise are the best tools for keeping the bowels healthy and preventing new flare-ups.

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Summary

Diverticula are common, but they require attention. If you suffer from abdominal pain, you should contact your doctor for a bowel examination. A timely colonoscopy provides peace of mind and ensures you receive the correct treatment.

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References (PubMed-based format)

1. Strate LL, Morris AM. Epidemiology, Pathophysiology, and Treatment of Diverticular Disease. Gastroenterology. 2019;156(5):1282-1298. doi:10.1053/j.gastro.2018.12.033. [PMID: 30602032]
2. Peery AF, Shaukat A, Strate LL. AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterology. 2021;160(3):906-911.e1. doi:10.1053/j.gastro.2020.09.059. [PMID: 33279517]
3. Carabotti M, Annibale B, Severi C, Lahner E. Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review. Nutrients. 2017;9(2):161. doi:10.3390/nu9020161. [PMID: 28218632]
4. Tursi A, Scarpignato C, Strate LL, et al. Colonic diverticular disease. Nature Reviews Disease Primers. 2020;6(1):20. doi:10.1038/s41572-020-0153-5. [PMID: 32218442]

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See also

Diverticula - overview