Many people have small pouches in their
colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called
diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis.
When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 percent to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.
Although not proven, the dominant theory is that a low-fiber diet is the main cause of diverticulitis. Diverticulitis was first noticed in the United States in the early 1900s. At about the same time, processed foods were introduced into the American diet. Many processed foods contain refined, low-fiber flour. Unlike whole-wheat flour, refined flour has no wheat bran.
Diverticulitis is common in developed or industrialized countries -- particularly the United States, England, and Australia -- where low-fiber diets are common. The disease is rare in countries of Asia and Africa, where people eat high-fiber vegetable diets.
Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Some fiber dissolves easily in water (soluble fiber). It takes on a soft, jelly-like texture in the intestines. Some fiber passes almost unchanged through the intestines (insoluble fiber). Both kinds of fiber help make stools soft and easy to pass. Fiber also prevents
constipation.
Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. This excess pressure might cause the weak spots in the colon to bulge out and become diverticula.
Diverticulitis occurs when diverticula become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning.
Diagnosing Diverticulitis
To diagnose diverticular disease, the doctor will likely do the following things:
- Ask about your medical history
- Perform a physical exam
- Perform one or more diagnostic tests.
Because most people do not have symptoms of diverticulitis,
diverticulosis is often found through tests ordered for another ailment.
When taking a medical history, the doctor may ask about bowel habits, symptoms, pain, diet, and medications. The physical exam usually involves a digital rectal exam. To perform this test, the doctor inserts a gloved, lubricated finger into the rectum to detect tenderness, blockage, or blood. The doctor may check stool for signs of bleeding and test blood for signs of infection; he or she may also order x-rays or other tests.
Facts About Diverticular Disease and Diverticulitis
Key information about diverticulosis and diverticulitis includes:
- Diverticulosis occurs when small pouches, called diverticula, bulge outward through weak spots in the colon (large intestine). The pouches form when pressure inside the colon builds, usually because of constipation.
- Most people with diverticulosis never have any discomfort or symptoms.
(Click Diverticulitis Symptoms for more information.)
- The most likely cause of diverticulosis is a low-fiber diet because it increases constipation and pressure inside the colon.
- For most people with diverticulosis, eating a high-fiber diet is the only treatment needed. You can increase your fiber intake by eating these foods: whole grain breads and cereals; fruit like apples and peaches; vegetables like broccoli, cabbage, spinach, carrots, asparagus, and squash; and starchy vegetables like kidney beans and lima beans.
(Click Diverticulitis Diet for more information.)
- Diverticulitis occurs when the pouches become infected or inflamed and cause pain and tenderness around the left side of the lower abdomen.
