What is diverticular disease?

Diverticular disease or diverticulosis is a common condition where there are small outpouchings or bubbles in the large bowel. This condition affects around 1/3 of people over 45. Low fibre intake is postulated to be the main risk factor which predisposes to constipation leading to excess straining and then increased intraluminal pressure which may lead to outpouchings in the bowel at areas of muscle weakness.

What are the symptoms of diverticulosis?

Most people with diverticulosis are asymptomatic. Some may have symptoms such as cramps, bloating, constipation or diarrhoea. These symptoms can mimic other conditions so it is important to seek medical advice.

How is diverticular disease diagnosed?

Diverticular disease can be detected on imaging with a CT scan and is routinely seen on colonoscopy as an incidental finding.

What are the complications of diverticular disease?

The complications of diverticular disease include infection and bleeding. Diverticulitis occurs when the outpouching becomes blocked, leading to abdominal pain and fever. This can be diagnosed with a CT scan and treated with antibiotics. If left untreated an abscess can develop outside the bowel requiring surgical intervention. Repeat attacks of diverticulitis or severe diverticular disease can cause a narrowing or stricture to form. Low grade inflammation can also occur at the site of diverticular disease and mimic ulcerative colitis. Diverticular bleeding can occur and will usually settle spontaneously. Rarely surgical intervention or embolisation is required.

What are the treatment options for diverticular disease

Once diverticula form they will remain. Most patients are asymptomatic. Treatment involves weight loss and increased fibre. Rarely, if complications occur, surgery is required.