Diverticuli are small sacs or pouches on the wall of the colon (or large intestine), a condition known as diverticulosis. The sacs are caused by high pressures within the colon which occur when there is not enough fiber in the bowel movement (feces).

What is diverticulosis?

Diverticulitis is an inflammation of the little sacs (pouches) due to infection. It causes pain or tenderness to the touch. Doctors give antibiotics by vein in the hospital if the pain, tenderness and swelling are severe. In fact, swelling can cause a blockage of the colon. Infected diverticuli can rupture. Such a condition requires surgery.

Diverticula can form anywhere in the hollow digestive tract, but they primarily occur in the colon.

Diverticuli pouches seldom cause any problems. A patient may never have any indication that they have them.

What causes diverticulosis?

When the colon is relatively empty, normal contractions of the colon muscles cause very high pressures in isolated segments that are empty. These high pressures cause bulging to occur in certain weak spots of the colon, where blood vessels enter the wall from the outside. These sacs, or diverticuli, can get as large as 1/2 inch in size.

There are indications that a diet that is low in fiber may contribute to this condition.

Complications of diverticulosis?

Diverticuli do not empty well. Feces can be trapped in these sacs and then become infected, causing inflammation. This causes pain, irritation and scarring. Scarring may cause adhesions later which may twist (kink) the colon.

What are the symptoms of diverticulosis?

In about 95% of cases, the diverticuli do not cause any symptoms. Diverticuli are very common; perhaps 50% of people over age 60 have diverticuli.

What is treatment for diverticulosis?

Doctors recommend surgery after two attacks of diverticulitis requiring hospitalization with intravenous antibiotics. The operation is done through an abdominal incision and twelve to eighteen inches of the colon are removed.

Dietary restrictions used to be commonly prescribed for people with this condition, however, there does not seem to be any correlation between eating specific foods and complications arising from diverticulosis. However, patients who are experiencing a flare-up are asked to limit the amount of fiber they eat.

What are the complications of treatment for diverticulosis?

Less common complications of the diverticulosis are perforation (rupture) of the colon, blockage, and bleeding. If medicines do not cure these complications, then sometimes part of the colon must be removed.

Since diverticuli do not occur in the rectum, it is unusual to need a permanent colostomy for diverticulosis or its complications. With new techniques, surgeons can often avoid even a temporary colostomy. Special techniques clean out the colon during surgery so that even emergency surgery does not require a colostomy as it did a few years ago.

Diverticulosis is a condition that was first noticed in developed countries, where the diet of fast food became normal.