The colon, or large intestine, is where fibers and digested food are turned into stools. It has numerous sections, including the ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anus. Over time, small pouches called diverticula can develop in the lining of the gastrointestinal tract, especially on the left side of the large intestine, or descending and sigmoid colon. The condition of having these sacs in the colon is called diverticulosis.
Diverticula develop when weakened spots on the colon wall begin to bulge outward. This occurs when stools become hard due to constipation, requiring the colon to exert more effort to push the stools along. Eventually, this increased pressure makes the colon wall stick out and form small sacs. Both men and women can develop diverticulosis, which is most common in people over the age of 60. The exact cause of the condition is not known; however, a low-fiber diet is believed to play a role in the development of diverticulosis.
Most people with diverticulosis do not have any symptoms, but some individuals may experience cramps, constipation, bloating, or discomfort in the lower abdomen. Tests that may be done to diagnose the condition include a barium enema, colonoscopy, computed tomography scan or flexible sigmoidoscopy. Diverticulosis is often found through tests ordered to check for another ailment, such as a colonoscopy to screen for cancer or polyps. While diverticula do not go away after they have formed, the condition can be managed to prevent complications.
A high-fiber diet is generally recommended to improve symptoms of constipation and decrease the development of diverticulosis. Fiber is a part of food that is not digested by the body. It stays in the colon where it absorbs water, helps keep stools soft, and makes bowel movements easier. The American Dietetic Association recommends having 25 to 35 grams of fiber daily.
High-fiber foods include navy, kidney and black beans, whole-grain cereals, whole-wheat English muffins, apples, pears, raspberries, stewed prunes, winter squash, sweet potatoes, green peas, cauliflower, spinach and turnip greens. Taking a fiber product such as methylcellulose or psyllium one to three times a day also may provide necessary fiber. Eliminating certain foods from the diet is not required.
Approximately 10 to 25 percent of people with diverticulosis develop diverticulitis, which is an inflammation of the diverticula that can cause severe abdominal pain, fever, nausea, constipation and diarrhea. Eating high-fiber foods, following a liquid diet, and taking antibiotics can help treat the infection. For cases that do not respond to medical management, colon resection surgery might be necessary to remove the inflamed pouches as well as diseased portion of the colon. Other complications of diverticulosis may include rectal bleeding from diverticula, small tears called perforations, formation on an abscess (small collection of pus) on the wall of the colon, an abnormal connection between two organs called a fistula, or intestinal obstruction. For more information about diverticulosis and diverticulitis, talk with your doctor or visit the American College of Gastroenterology website at www.patients.gi.org.
Holly Mlodzinski is a registered dietitian and health promotions coordinator at Hilton Head Hospital.