I Have Diverticulosis. What Now?

Diverticulosis is a fairly common condition that we encounter in gastroenterology. This problem occurs in the colon and increases in frequency with age. It is uncommon before age 40, but by age 85 about 65% of patients will have diverticuli. These are small pockets or projections that extend out from the colon, and most experts think that they develop as a result of a diet low in fiber. However, individuals with irritable bowel syndrome or spastic colon may also be vulnerable to developing them. It appears that low fiber diets and irritable bowel lead to increased pressure in the colon, which increases the risk of developing this condition.

Approximately 70% of people with diverticuli never have problems with them. Bloating, cramps and increased gas are commonly reported, but may be related to underlying irritable bowel rather than diverticulosis. About 20% can develop acute diverticulitis, which is an infection usually treated fairly readily with antibiotics. Bleeding can occur in 10% of patients, but this usually resolves without specific treatment. Diverticuli are generally diagnosed with colonoscopy, a procedure that can also lead to assurance that no other disease such as colon cancer is present. Diverticuli can also be seen on CAT scan, but other diseases cannot be ruled out with confidence without performing a colonoscopy.

Treatment includes increasing fiber in the diet, which helps to relieve the pressure on the diverticulosis. Anti-spasm medication may help in some cases. For many years, physicians told patients that they must avoid seeds, pits, nuts, and popcorn, but recent studies now show that all these things are safe and will not worsen this condition. For the unfortunate patient who has recurrent attacks of infection, pain or bleeding, surgery to remove the affected part of the colon can be considered. Fortunately, this condition is easily controlled with diet and medication in the vast majority of patients.

As Gastroenterologists, we commonly deal with diverticulosis as well as other bowel problems, and our specialized training has prepared us to diagnose both minor and serious conditions of the intestines. A colonoscopy is still the most common procedure used to diagnose many intestinal symptoms, and is most reliable when performed by a trained gastroenterologist.