Diverticulosis or Diverticulitis

Diverticulitis is a disease that affects the GI tract, primarily the colon. It increases with age, especially after age 40. There are many misnomers and misconceptions regarding this spectrum of disease and hopefully this helps to shed some light on them.
Little pouches spring out from the walls of the colon due to high pressure within. Each pouch, usually 5-10mm, is called a diverticulum. The almost always occur in batches, and then collectively are called diverticulae. People found to have diverticulae are said to have diverticulosis or diverticular disease. This is true for over 50% of folks in the U.S. over the age of 60. It is largely considered a “Western” disease mainly due to the nature of our diets. Insufficient fiber and low residue lead to higher intestinal pressure and more of these pouches.
Diverticular disease is a misnomer in that the presence of the little pouches by themselves cause no specific harm, and are usually without symptoms. Many people have them without realizing. However, they can cause disease in different ways. If they become inflamed due to the bacteria that lives nearby in the colon, it is called diverticulitis. This can vary in severity from very mild abdominal pain to fevers and possibly even colon rupture. At other times, the pouches can erode into nearby blood vessels and cause bleeding. This is classically painless but with significant amounts of blood mixed in with the stools. Less common problems include strictures or narrowing of areas of the colon, small abscess on the colon wall and chronic scarring. Diverticulae do not transform into colon cancer as some types of polyps do.
There are volumes more that can be written about these pesky little pouches, including how to detect, prevent, and treat. I will definitely address those later on in this series. For now, hopefully this helps to clarify some of the confusing jargon.
This column is sponsored by Heart of Florida
BIO: Dr. Seetahal is a board-certified general and bariatric surgeon. He has published over 20 scientific articles and book chapters. For questions related to surgical health, you can contact him at shiva.seetahal@heartofflorida.com, or call his office at 863-421-7626 to schedule an appointment.

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