Diverticular disease

What is diverticular disease?

A diverticulum is the name given to a small bulge or pouch which occurs on the bowel. If there are a number of these, this is called diverticular disease. The pouches usually occur on the large bowel (colon).

Is that different from diverticulitis?

Diverticulitis is when an area of bowel affected by diverticular disease becomes inflamed and infected.

How common is diverticular disease?

It is very common in the Western world but usually causes very few problems and most people are unaware that they have it. It can however cause problems with the bowels, most commonly

A change in bowel habit (either constipation or diarrhoea)
Colicky abdominal pain (often left sided)

Less commonly it can cause

Severe abdominal pain when the pouches become inflamed. This is diverticulitis
Bleeding - this should be reported to your doctor the first time it happens.

What causes diverticular disease?

We are not absolutely sure about the cause. It is very common in the West where we have low amounts of fibre in the diet but is virtually unknown where there is a lot of fibre in the diet.

When there is very little fibre, the motions are firmer and the bowel has to work harder to move it along. This means it has to produce a higher pressure and so can cause bulges at the weak areas of the bowel. This does not happen immediately but is the result of a lifetime of low fibre intake. Diverticular disease is therefore a disease which is much more common in later life.

What treatment is there?

Once diverticular disease has developed it will not go away. Its symptoms can however often be controlled by simple measures.

Reassurance that it is nothing more serious
A high fibre diet and possibly fibre supplements as medicine. A high fibre diet works by adding bulk and softening the stool, reducing the work the bowel needs to do.

To increase fibre in the diet you need to increase your intake of

Breakfast cereals containing bran
Wholemeal bread
Fruit and vegetables
Pulses (ie beans)

And reduce your intake of

Refined food such as sugar and fat
White bread
Red meat

Are there any complications?

Diverticular disease very, very rarely causes complications but it can

Become inflamed (diverticulitis)
Bleed
Narrow the bowel (a stricture)
Perforate

So, if your symptoms have been stable for some time then begin to change you should see your doctor.