Diverticular disease of the colon is a common condition that affects mainly patients above the age of 40. Only a small percentage of those with diverticulosis have symptoms and even fewer will ever require surgery.

Diverticulosis/diverticulitis

Diverticula are pockets that develop in the colon wall. It may involve only part of the colon or the entire colon. Diverticulosis describes the presence of these pockets. Diverticulitis describes inflammation or complications of these pockets.

Many patients with diverticular disease have no symptoms at all. Some patients may have abdominal pain, diarrhoea, or change in the bowel habits. Occasionally, there may be bleeding. Diverticulitis -- an infection of the diverticula -- may cause pain, fever and change in bowel habits. More severe symptoms can occur with complications such as perforation, abscess, or fistula formation (connection between the large intestine with another organ).

Causes of diverticular disease

It is believed that inadequate fibre in the diet creates a high pressure in the colon. This pressure then causes pockets or diverticula of the colon.

Diverticulosis and diverticular disease are usually treated by changes in your diet and occasionally, some medicine to help control pain, cramps and changes in bowel habits. Increasing the amount of fibre (e.g. fruits and vegetables), reduces the pressures in the colon, and complications are less likely to occur. However, these measures do not get rid of the diverticula once they are formed.

Diverticulitis usually requires hospitalisation. Treatment usually consists of oral antibiotic or dietary restrictions and possibly stool softeners. Severe cases require injections of antibiotics and strict dietary restraints. Most attacks can be relieved with such methods. For mild cases, your doctor may treat you without hospitalisation.

Surgery is reserved for recurrent episodes, complications or severe attacks when there is little or no response to medication. Young patients and patients with a severe episode have a higher chance of recurrent attacks and may be advised surgery.

In surgery, usually part of the colon, commonly the left or sigmoid colon, is removed and the colon is joined to the rectum. Complete recovery can be expected. Normal bowel function usually resumes in about three weeks.