Health Tips & Articles

Diverticulosis and Diverticulitis

by Steven M. Samuels, MD

Diverticula are small pockets or sacs which form in the wall of the colon (large intestine/large bowel).  They often look like little fingers.  The presence of diverticula is called diverticulosis.  They can occur anywhere in the colon, but they are most often present on the left side. Well over half of the adult population has at least some.  Sometimes there can be hundreds.

The cause of diverticulosis is unclear.  We do not know of any specific dietary cause.  Lack of a high fiber diet has been blamed, but this has certainly not been proved.  Diverticula can be present in very healthy people and can be completely absent in very ill people.  Once diverticula develop, they remain forever. There is simply nothing known that one can do to prevent them.  Often there is a family tendency to having them, so there is probably a genetic  tendency of some sort.  Diverticula cause virtually no symptoms unless they become infected.

Infection of these pockets, or diverticula, is called diverticulitis  (“itis” means infection or inflammation).  Diverticulitis is quite rare, compared to the number of people who have diverticulosis.  Again, we do not know the cause of this kind of infection.  It can occur in the elderly or in the very young.  Theories about causing it by getting food, popcorn or seeds in the diverticula have simply not panned out.  Like diverticulosis, diverticulitis also seems to sometimes run in families.  Persons with diverticulitis usually complain of lower abdominal pain (often on the left), and some have fever and a high white blood cell count.  The symptoms usually cause the patient to consult a physician. 

The best test for diverticulitis is the history and physical examination.  It can often be confirmed with a CAT scan of the abdomen.  The treatment is antibiotics.  Unfortunately, diverticulitis often recurs.  If it recurs several times, or if certain complications develop, then surgical consultation may be recommended.  The inflamed portion of the colon (usually just a small part) may be removed to help prevent further attacks.

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