Diverticula are small, bulging pouches that can form in ...



Diverticuli are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon). Diverticuli are common, especially after age 40, and seldom cause problems. It becomes more common as people age. About half of all people over age 60 have diverticulosis. Some experts believe the main cause is a low-fiber diet however this is still largely theoretical. Most people with diverticulosis don't have symptoms. Diverticulosis is often found through tests ordered for something else. For example, it is often found during a colonoscopy to screen for cancer or during other exams such as a CatScan.

There are some theories that a low fiber diet can lead to diverticulosis however experts are still not sure, causes are likely multifactorial including genetic predisposition (family history) or possibly other environmental factors. A higher fiber diet may help prevent constipation and worsening of diverticular disease. Experts suggest eating 25-35 grams of fiber daily.

If the pouches become inflamed or infected, you have a condition called diverticulitis (die-vur-tik-yoo-LIE-tis). The most common symptom is abdominal pain, usually on the left side. Other symptoms that may occur include fever, nausea and a marked change in your bowel habits. Mild diverticulitis can be treated with bowel rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may rarely require surgery (see below). Experts are not sure what causes diverticulitis. No specific food item does (you do not need to avoid nuts, corn or seeds). There are some recent studies that indicate that frequent/ regular NSAID (aspirin/motrin/ibuprofen products) use can increase your risk.

Surgery is no longer routinely recommended even after multiple uncomplicated bouts of diverticulitis. Medical treatment is recommended. The risk of having another attack over a 10 year period is estimated form various studies to be anywhere from 10-25%. Most people only have a single recurrence while about 4% have repeated attacks over 10 years. Rarely after complications from diverticulitis such as an abscess, perforation, stricture or repeated episodes in a short period of time your doctor may talk to you about considering surgery. Current guidelines suggest that the approach to who should get surgery should be individualized based on the severity and responsiveness of the attack, general health of the patient, and the risk of surgery compared with the risk of a future attack. Risk of recurrent diverticulitis even after surgery is still between 2-10% based on studies.

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