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Diverticular disease: Treatment, symptoms, advice and help

About diverticular disease

Diverticular disease affects the digestive system, especially the colon which is part of the large intestine. It is characterised by the formation of small pockets or pouches in the colon and this disorder is termed as ‘diverticulosis’. Such intestinal pouches may get inflamed resulting in a condition called ‘diverticulitis’. Both diverticulosis and diverticulitis are part of the diverticular disease.

Diverticular disease: Incidence, age and sex

Diverticular disease is commonly seen in older adults especially above 60 years of age. It is very rare in children or young adults. It occurs with equal prevalence in both men and women.

Signs and symptoms of diverticular disease: Diagnosis

The clinical spectrum of diverticular disease is variable and differs from person to person. Some individuals present with severe clinical features and some may remain asymptomatic. The classical clinical features include vomiting, constipation or loose stools which are usually sudden in onset. Sometimes abdominal cramps or sensation of bloating may also be experienced. In severe or advanced cases, rectal bleeding may be complained of which is characteristically painless. Very rarely, the affected individual may notice reduced appetite or loss of weight which may occur in longstanding cases. The affected individual may complain of fever and intense pain in lower abdomen if the diverticular pouches get inflamed.

Diagnostic tests like blood and stool tests are required to support the diagnosis. Blood tests may reveal anaemia which results from blood loss from intestines. The diagnosis may be established by imaging tests like CT scan or barium studies. Sometimes, invasive diagnostic procedures like colonoscopy may be needed to confirm the diagnosis of diverticular disease. Colonoscopy is a process wherein a flexible tube is passed into the gastro-intestinal tract through the rectum to visualise the interior of the large intestine.

Causes and prevention of diverticular disease

The exact cause of diverticular disease is not very clear. However it is considered that a diet low in fibre content may predispose to this condition. Moreover persistent constipation or straining can also lead to diverticular disease. Certain dietary measure like increased consumption of fruits, vegetables and whole grains may help prevent diverticular disease.

Diverticular disease: Complications

Diverticular disease if left untreated, may result in serious complications like intestinal bleeding or superimposed bacterial intestinal infections. Moreover, diverticulosis may result in intestinal obstruction which is a medical emergency. Other complications like fistula formation or rupture of colon are rare but may be seen in longstanding cases.

Diverticular disease: Treatment

The management of diverticular disease depends upon the symptoms and severity. Surgical removal of the affected colon may be considered in individuals with severe disease. The part of the affected colon is surgically resected and removed and the ends sutured back. The individual needs adequate rest for weeks after the surgery. However, mild cases may be managed with medications only which include pain killers and antibiotics. Sometimes medications may be needed to control rectal bleeding and prevent blood loss and resulting anaemia. Moreover, it is advisable to consult a nutritionist to make dietary modifications which may help in controlling the disease and preventing further complications.