Diverticular disease is characterised by the formation of small bulges or sacs, termed diverticula, in the wall of the large intestine. These sacs vary in shape and size, appearing either individually or in clusters.
Types of Diverticular Conditions:
- Diverticulosis: This refers to the mere presence of diverticula without any associated complications.
- Diverticulitis: This condition arises when diverticula become infected or inflamed.
Causes of Diverticular Disease
While the exact causes remain unidentified, recent studies suggest that a diet low in fibre could be a significant risk factor. A diet lacking fibre can lead to constipation, producing harder stools that require increased pressure to move along the colon. Over time, this heightened pressure may result in sac formation.
Symptoms of Diverticular Disease
Many individuals with diverticular disease do not exhibit symptoms, particularly in uncomplicated cases. However, some may experience:
- Bloating
- Constipation or diarrhoea
- Lower abdominal cramps
The condition might be detected unexpectedly during medical tests like barium enema, sigmoidoscopy, or colonoscopy. Notably, most asymptomatic patients remain so, with only 15-25% encountering bleeding from pocketed vessels.
In contrast, diverticulitis can present with:
- Abdominal pain (typically on the lower left side)
- Nausea and vomiting
- Constipation or diarrhoea
- Fever and chills
Fortunately, appropriate diagnosis and antibiotics effectively treat most cases, although a minority might develop complications.
Potential Complications
- Abscesses
- Fistulas (tracts connecting to another organ or the skin)
- Colon blockage
- Inflammation of the abdominal lining
- Sepsis
- Bloody or dark stools
Such complications might necessitate more intricate treatments.
Diagnosis
Diverticular disease can often go undetected. Common diagnostic methods include:
- Barium enema
- Sigmoidoscopy
- Colonoscopy
- CT scans
Treatment Approaches
- Diverticulosis: Usually requires no treatment. However, adopting a high-fibre diet can soften stools and mitigate complications.
- Diverticulitis: Treatment depends on the severity. Mild cases might benefit from oral medications, while severe instances may call for hospitalisation, IV medications, or surgical intervention. Notably, while most bleeding cases resolve on their own, some might require colonoscopic intervention or surgery.
