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Diverticular disease

Here are some essential insights on Diverticular disease

What is diverticular disease?

It is a term used for denoting the formation of small sacs (out-pouching called diverticuli) on the wall of the colon (large intestine). While such bulges can grow anywhere, these are generally more common on the left side (sigmoid colon) close to the rectum. Diverticular disease (also called diverticulosis) is very common in developed countries and is believed to be related to the intake of low-fiber diets rich in processed carbohydrates. Almost half of the population over 60 years old gets this.

Common symptoms

The majority of patients with diverticular disease actually do not have symptoms and these are often discovered accidentally during a scan for other conditions or a colonoscopy. However, others may have the following symptoms:

  • Constipation
  • Bloating
  • Abdominal pain and cramps

When these diverticuli get inflamed, the condition is known as diverticulitis. Such patients can then present with:

  • Severe pain
  • Fever
  • Nausea with vomiting
  • Bleeding

What causes diverticular disease?

While it is not well understood why some people get diverticular disease, pressure in the colon is believed to play a vital role causing the weak portions of the colon wall to form sacs. Genetics and low-fiber diets are also believed to contribute to the causation. As such, age is also associated a contributing factor for the development of diverticular disease.

How can it be diagnosed?

A detailed history of one’s health, the symptoms experienced, and physical examination to check if the abdomen is tender are fundamentals to diagnosing diverticular disease. When there are signs of diverticulitis, they are followed by a blood test and a CT scan of the abdomen, with antibiotics being a useful treatment. Usually, this is followed later by a colonoscopy once the pain and inflammation have settled, to ensure there are no other sinister conditions in the colon.

How it is treated?

Treatment for this disease depends on the severity of the condition.

People having diverticular disease without any complication do not require treatment. However, they should be on a diet where intake of fiber is moderated and not taken in excess, to prevent aggravation of the disease.

2 main complications can arise: infection and bleeding.

When infection occurs, pus can form which can lead to serious infections. In such cases, the doctor prescribes intravenous antibiotics and fluids. If the infection worsens, drainage of the pus will be required, either using CT-guidance or surgery.

When bleeding occurs, this will often stop spontaneously, although angiography is useful if the bleeding continues and becomes life threatening.

In the worst-case scenario, surgery will be required to remove the affected portion of colon.

  • Bowel resection with anastomosis: It involves the removal of the infected or bleeding part of the colon and re-attaching the healthy portions.
  • Bowel resection with colostomy: In this process, the affected colon is removed and the healthy sections are not reattached, but brought to the surface of the abdomen as a stoma (colostomy).

Open or key-hole (laparoscopic) surgery is possible for both of these procedures.

Home remedies for diverticular disease

Home remedies for diverticular diseases are mostly based on dietary changes. Taking a diet is with a moderate amount of fiber is recommended. One can take apples, pears, and raspberries. Asparagus, broccoli, cabbage, carrots, spinach, squash, etc are also great to add fiber. One should take cereals and grains as well. Remember to avoid taking too much as this will cause bloating and constipation and potentially worsen the situation!

Probiotics also work well to keep the got flora in balance.

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