In the United States, diverticulosis affects over 60% of people by age 60, with approximately 15-25% of those individuals developing diverticulitis at some point in their lives (1).
What is Diverticulitis?
Source: https://www.gleneagles.com.sg/conditions-diseases/diverticulosis-diverticulitis/symptoms-causes
Diverticulitis occurs when small pouches (diverticula) that form in the colon become inflamed or infected. These pouches are weak spots in the colon wall that can develop over time due to increased pressure within the colon.
Diverticulosis vs. Diverticulitis
Diverticulosis is the presence of these pouches without inflammation or infection. The pouches, also known as diverticula, are sac-like protrusions of the colonic mucosa through weak points in the muscular wall.
Most people with diverticulosis do not know they have it until they get a routine colonoscopy.
Diverticulitis refers to the inflammation or infection of these pouches. This occurs when there is thinning and breakdown of the diverticular wall. It may be caused by increased pressure within the colon or by hardened particles of stool, which can become lodged within the diverticulum.
How Common is Diverticulitis?
In the United States, diverticulosis affects over 60% of people by age 60, with approximately 15-25% developing diverticulitis at some point in their lives (1).
Symptoms of Diverticulitis
The symptoms of diverticulitis can vary but often include:
Abdominal pain, usually in the lower left side
Fever, nausea, vomiting
Changes in bowel habits, constipation or diarrhea (2)
Occasionally, urinary symptoms due to inflammation affecting nearby organs (2)
Risk Factors of Developing Diverticulosis
Risk factors for developing diverticulosis include:
Older age
Male gender
Genetic predisposition
Contrary to popular belief, low dietary fiber intake and constipation were NOT associated with increased risk of diverticulosis (3).
Dietary red meat, fat, alcohol consumption, and physical inactivity also do not appear to contribute to the risk of diverticulosis.
Complications of Diverticulitis
Complications of diverticulitis can include bowel obstruction, abscess formation, fistulas, or colon perforation. Approximately 12% of patients with acute diverticulitis may experience these complications.
Diagnosis and Treatment
Diagnosing diverticulitis often involves clinical evaluation, blood tests (including inflammatory markers like CRP), and imaging studies like CT scans. Treatment usually starts with dietary modifications, pain management, and sometimes antibiotics. Severe cases may require hospitalization or even surgical intervention.
Prevention
Preventing diverticulitis involves adopting a healthy lifestyle:
Dietary Changes: Increase fiber intake (aim for 14 grams of dietary fiber for every 1,000 calories consumed), consume more fruits, vegetables, whole grains, nuts, seeds, and beans. Limit red meat and processed meats (4,5).
Physical Activity: Regular exercise, especially vigorous activity, reduces the risk of diverticulitis (6).
Weight Management: Maintaining a healthy weight and avoiding obesity is crucial (7).
Smoking and Alcohol: Quit smoking and moderate alcohol consumption (8).
Medications: Higher vitamin D levels were associated with a reduced risk of hospitalization for diverticulitis (9).
Questions? Let us know below.
Citations:
Peery, Anne F et al. “Distribution and Characteristics of Colonic Diverticula in a United States Screening Population.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 14,7 (2016): 980-985.e1. doi:10.1016/j.cgh.2016.01.020
Textbook of Gastroenterology, Yamada T, Alpers DH, Kaplowitz N, et al (Eds), Lippincott Williams & Wilkins, Philadelphia, PA 2003.
Peery, Anne F et al. “Constipation and a low-fiber diet are not associated with diverticulosis.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 11,12 (2013): 1622-7. doi:10.1016/j.cgh.2013.06.033
Cao, Yin et al. “Meat intake and risk of diverticulitis among men.” Gut vol. 67,3 (2018): 466-472. doi:10.1136/gutjnl-2016-313082
Strate, Lisa L et al. “Nut, corn, and popcorn consumption and the incidence of diverticular disease.” JAMA vol. 300,8 (2008): 907-14. doi:10.1001/jama.300.8.907
Strate, Lisa L et al. “Physical activity decreases diverticular complications.” The American journal of gastroenterology vol. 104,5 (2009): 1221-30. doi:10.1038/ajg.2009.121
Strate, Lisa L et al. “Obesity increases the risks of diverticulitis and diverticular bleeding.” Gastroenterology vol. 136,1 (2009): 115-122.e1. doi:10.1053/j.gastro.2008.09.025
Hjern, F et al. “Smoking and the risk of diverticular disease in women.” The British journal of surgery vol. 98,7 (2011): 997-1002. doi:10.1002/bjs.7477
Maguire, Lillias H et al. “Higher serum levels of vitamin D are associated with a reduced risk of diverticulitis.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 11,12 (2013): 1631-5. doi:10.1016/j.cgh.2013.07.035
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