Diverticula are small pouches that stick out from the large intestine. Although around half the population will have diverticula by the time they are 50, 3 in 4 will never experience any related symptoms. However, the other 1 in 4 may experience abdominal pain and diarrhoea, which is known as having diverticular disease. Diverticulitis can also occur, which is when the diverticula become inflamed or infected.
Diverticular disease may be characterised by a change in normal bowel habits, such as constipation or diarrhoea, bloating, or bleeding from the rectum. Pain in the abdomen (stomach) will often be intermittent and felt on the lower left-hand side. Symptoms of diverticulitis also include abdominal pain, constipation and bleeding; but may also encompass nausea, vomiting, frequent and painful urinating, and a high temperature. Complications arising from diverticulitis have been known to include abscesses and fistulas.
Both diverticular disease and diverticulitis can be caused by a lack of fibre in the diet, as this is what is thought to cause the development of diverticula. Fibre makes stools softer and easier to push out. Straining to push out harder stools can weaken the muscle: this allows the inner layer of the colon to push through, thus creating the diverticula. Risk of diverticular disease may be increased by smoking, being overweight, lack of physical activity, and having a history of constipation. Infections causing diverticulitis may occur when a hard stool gets stuck in one of the pouches, giving bacteria a chance to multiply and spread.
As many conditions have similar symptoms to diverticular disease and diverticulitis, GPs may recommend blood tests as a way of ruling out these other conditions. A colonoscopy, whereby a tube with a camera on the end is inserted up your rectum and into the colon, can confirm the presence of diverticula. Alternatively, a barium enema X-ray can be undertaken, which involves squirting barium liquid up a tube into your rectum.
Diverticular disease can generally be treated with painkillers such as paracetamol, although ibuprofen and aspirin are not recommended as they may upset your stomach. A high fibre diet may also help manage the symptoms, however in cases where blood loss is severe, a blood transfusion in hospital may be necessary. Diverticulitis may also be treated at home, with antibiotics to combat the infection and paracetamol to address the pain. In more serious cases, for example where your GP suspects complications or you are dehydrated, treatment may be administered in hospital. This will involve antibiotic injections and being hydrated and nourished through a drip. Surgery is rarely recommended, however if it were to be undertaken it would involve removing the affected area of the colon.
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