Diverticulitis

What is diverticulitis?

Diverticulosis (where small pockets or pouches develop in the wall of the bowel) is a very common condition that affects the large intestine (bowel), mainly affecting those over 70 who have a low-fibre diet.

Diverticulosis usually has no symptoms, but it can lead to the very uncomfortable condition called diverticulitis (infection and inflammation of the diverticular pouches) – which causes abdominal pain, bloating and other symptoms. If you have diverticulosis, there are simple dietary changes you can make to avoid developing diverticulitis.

Diverticulosis is the formation of small muscle defects or pouches (diverticulum) forming in the large intestine or colon. Most people with diverticulosis will not experience any discomfort or symptoms. Yet, sometimes, the muscle defects can become inflamed or infected – which leads to a diagnosis of diverticulitis.

Diverticulosis is extremely common in older Australian people. In fact, it is estimated over half of the population 70 years and older have the condition. If you have diverticulosis, you can make some simple lifestyle changes to prevent a case of diverticulitis developing.

Symptoms for diverticulitis include bloating, abdominal cramping, fever and noticeable changes in your bowel habits, such as constipation or diarrhea. Treatment for diverticulitis includes rest, antibiotics and a liquid diet for a short period of time until you’re feeling well again. Occasionally antibiotics are required.

Causes of diverticulitis

Diverticulitis only appeared as an illness in the early twentieth century – a time when many North Americans, Europeans and Australians increased the amount of processed foods in their diets. This change led to a decrease of fibre and increased the chances of developing the disease.

Recently, there has been debate in the scientific community as to whether the decrease of fibre in the diet is the cause; or whether foods that contain small seeds – like tomatoes or strawberries – trigger a case of diverticulitis. There are also studies that suggest lack of exercise, smoking and some medications such as aspirin and steroids lead to the disease.

Symptoms of diverticulitis

There are a number of symptoms associated with diverticulitis and these can either appear suddenly or begin as mild symptoms and worsen over a number of days.

The most common symptom is a severe pain located in a specific area of the abdomen, usually around the lower left side. Other symptoms can also include:

• Fevers and chills
• Nausea
• Vomiting
• Change in bowel habits – diarrhea or constipation
• Bloating

If you experience any of these symptoms, visit your doctor for treatment immediately as the complications from diverticulitis are very serious. They can include a worsening infection, or, at worst, a perforated bowel, haemorrhaging or peritonitis – infection of the lower abdominal cavity – all of which can require surgery.

Diagnosis of Diverticulosis

As diverticulosis is usually asymptomatic, it is often only diagnosed when the bowel is being investigated for other things including cancer.

Diverticulitis is diagnosed during acute episodes through symptoms and physical examination. Stool tests and CT scans may also be used to rule out other causes whilst barium enema or colonoscopy can visualize the disease.

Treatment of diverticulitis

The treatment for diverticulitis is varied depending on the seriousness of the condition. A mild case can be treated at home and may include a high-fibre diet (studies have shown a high-fibre diet assists in preventing diverticulitis with those who have diverticulosis), dietary supplements, antibiotics or probiotics.

If the case is serious and admission to hospital is necessary the treatment includes:

• Intravenous fluids instead of food or drink
• IV Antibiotics
• Pain medication
• Surgery if the infected or weakened bowel walls are obstructed
• Temporary colostomy bag for 6 to 12 months

To prevent diverticulitis, you can increase the amount of green vegetables in your diet, drink plenty of fluids, introduce a fibre supplement such as psyllium and exercise regularly.

Further Information and sources

• Health Direct Australia
• Better Health Channel