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Diverticular disease refers to conditions that involve diverticula, which are small, bulging pouches that can form in the walls of the colon (large intestine). The two main conditions associated with diverticular disease are diverticulosis (the presence of these pouches) and diverticulitis (inflammation or infection of the pouches). Diverticulosis is common, especially in older adults, while diverticulitis occurs when one or more of the pouches become inflamed or infected, leading to more severe symptoms.

Diverticular Disease

Symptoms

Diverticulosis (pouch formation): Often has no symptoms. However, some individuals may experience:

  • Mild bloating or discomfort

  • Changes in bowel habits, such as alternating diarrhea and constipation

Diverticulitis (inflammation/infection):

  • Sudden, severe abdominal pain, often on the lower left side

  • Fever and chills

  • Nausea and vomiting

  • Tenderness in the abdomen

  • Changes in bowel movements, including constipation or diarrhea

  • Blood in the stool or rectal bleeding (in more severe cases)

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Causes/Risks

  • Aging: The risk of developing diverticulosis increases with age, especially after age 40.

  • Diet: A low-fiber diet, particularly one lacking in fruits, vegetables, and whole grains, can contribute to the formation of diverticula, as it leads to increased pressure in the colon.

  • Obesity: Being overweight increases the risk of diverticular disease.

  • Lack of physical activity: Inactivity can contribute to slower bowel movements and increased pressure in the colon.

  • Chronic constipation: Straining during bowel movements can increase the pressure in the colon and contribute to the formation of diverticula.

  • Smoking: Smoking has been identified as a risk factor for developing diverticular disease and complications.

Treatments

Diverticulosis (pouches without inflammation):

  • Dietary changes: A high-fiber diet is typically recommended to reduce symptoms and prevent complications. Fiber helps soften stool and reduce pressure in the colon.

  • Hydration: Drinking plenty of fluids to aid digestion and reduce constipation.

  • Medications: Laxatives or fiber supplements may be prescribed if constipation is present.

  • Regular exercise: Physical activity can help promote healthy digestion and reduce the risk of complications.

Diverticulitis (inflammation/infection):

  • Antibiotics: If the condition is caused by infection, antibiotics are commonly prescribed.

  • Pain management: Over-the-counter pain relievers, like acetaminophen, may be used, but NSAIDs (like ibuprofen) should generally be avoided.

  • Hospitalization: In severe cases, hospitalization may be needed for intravenous antibiotics, fluids, and monitoring.

  • Surgery: In cases of recurrent diverticulitis or complications (e.g., perforation, abscess), surgical intervention may be necessary to remove the affected portion of the colon.

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