Diverticuli are pockets, sacs or projections extending out from the colon. It occurs gradually over a long period of time and occurs at weak points in the bowel wall. The sacs develop because of the pressure exerted within the contracting colon. Most diverticula develop within the lower third of the colon, the sigmoid colon. This area represents the highest pressure zone within the colon. These balloon-like projections can make the lining of the colon become thickened and narrowed, causing some bowel problems including abdominal discomfort, diarrhea and/or constipation. Most patients, however, with diverticulosis have no symptoms whatsoever. A low fiber diet contributes to the development of these projections within the colon.

Symptoms of Diverticulosis

As diverticula form, few symptoms are noticeable, except for intermittent spastic discomfort in the lower portion of the abdomen. Usually, there are not any symptoms at all.

When diverticulosis is far advanced, the lower colon may become very fixed, distorted and even narrowed. When this occurs, there may be thick or pellet-shaped stools, constipation and an occasional rush of diarrhea. The problem then becomes a mechanical or structural one.

Complications of Diverticulosis

Diverticulitis – once a sac becomes infected or inflamed, diverticulitis has occurred. The infection can be mild with only slight discomfort, or it can be quite extreme with severe pain, fever and chills. Treatment includes antibiotics and may require hospitalization if severe.

Bleeding – at times, bleeding can occur from a ruptured blood vessel in diverticuli. This may produce a large amount of blood.

Perforation – this is the most uncommon, but the most serious. The infection in the diverticuli have caused a hole in the colon. This requires immediate surgery.

Treatment of Diverticulosis

Diverticulosis cannot be cured once diagnosed, but it can be prevented from advancing if treated early. A diet high in fiber, bran and roughage is important. These foods add bulk to the stools, producing softer stools, and thus decreasing the pressure on the bowel. Fiber supplements are helpful for this. A daily fiber intake of 20 to 30 grams is recommended. Also, a daily intake of 8 glasses of water is recommended. Nuts, large seeds and popcorn may need to be avoided if indicated by your physician.

Surgery may be needed to remove the diseased portion of the colon if there are recurrent episodes of diverticulitis.