Diverticulitis and diverticular disease, rupture and incidents

Fiber helps to soften stool and relieve constipation allowing smooth movement through the colon

Diverticulitis, diverticular disease, rupture and incidents

What is Diverticular Disease and Diverticulitis

Diverticular Disease and Diverticulitis are related digestive disorders of the large bowel or colon.

But before we venture much further, it may help to take a look at the colon.

The Colon

The colon is the last part of the digestive system also known as the large intestine. It consists of a layer of flexible tissue on the inside covered by a tougher layer of muscle and is approximately six feet long.

The colon plays a significant role in the absorption of water and some electrolytes into the circulation before elimination and helps to move waste material from the small intestine into the rectum and out through the anus as feces.

Diverticular

Diverticular is a medical term used to describe pouches or sacs that can form in the colon protruding and bulging out through the muscle wall. Diverticular disease is rare in parts of the world where the diet contains large intake of fruits and vegetables, and low in red meat.

Diverticular disease is related to aging occurring in approximately 70% of people by the age of 80.

The cause of the formation of pouches or sacs are unknown; however, according to experts, eating a low-fiber diet is one of the most likely causes. Diverticular disease is common in the United States and Europe where a high percent of the food consumed are processed and low in fibre. The result is the formation of hard stool and constipation that increases the pressure in the colon leading to the formation of pouches.

In certain conditions such as Multiple Sclerosis where constipation is a common complication, the bowel function needs to be managed to prevent diverticulitis in cases with diverticular disease.

However, with education, people have become much more aware and are making informed choices about the right diet and lifestyle to reduce the incident of diverticular disease and diverticulitis.

The majority of people with diverticula, will not exhibit symptoms, but 1 in 4 will experience abdominal pain and diarrhoea, these are said to have diverticular disease.

The pouches in the colon can become infected and inflamed, forming areas of empyema, when this occurs, the condition is known as diverticulitis.

Risk Factors Include:

  • A low fiber diet
  • Alcohol. Excessive consumption may increase the possibility of diverticulitis by 2-3 times higher when compared to the general population.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may increase the risk of diverticular disease.
  • A Suppressed Immune system.
  • Age. Under the age of 30, approximately 1 to 2% of people will have diverticula disease. However, the condition is found in more than 40% of the population over the age of 60. The total number of diverticula increases with age.
  • Gender. Women appear to experience complications from diverticula disease at an older age than men.

Diverticulitis

The symptoms of diverticulitis are more severe than that of diverticular disease, which usually presents symptoms of lower abdominal pain and a feeling of bloating. With diverticulitis, the stomach pain is severe and is accompanied by a high fever with temperature more than 38 degree Celsius, nausea, vomiting and loss of appetite.

There is a risk that the infection may cause the colon to rupture and spread fecal matter into the sterile area of the abdomen, resulting in peritonitis. Infection can lead to the formation of a fistula, which is an abnormal channel, connecting to other regions causing a wider spread of the infection and further complications that will require surgical intervention.

Diverticulitis can be simple or complicated:

Simple diverticulitis occurs in around 75% of cases with no complications and responds to medical treatment without the need for surgery.

Complicated diverticulitis occurs in 25% of cases and often requires surgery. Complication such as abscess, fistula, obstruction, peritonitis and sepsis can occur.

Treatment for Diverticulitis

The treatment for diverticulitis largely depends on the severity of the symptoms; Treatment can be in a hospital or at home.

Treatment

  • To reduce the pain, the doctor may suggest bed rest and the use of heat pads, applied to the abdomen.
  • Pain medication may be indicated and prescribe by your doctor or health care provider; this may include paracetamol and antispasmodics, avoid aspirin and ibuprofen as they may cause internal bleeding. Your doctor will be aware of your medical history and can give advice appropriate to your individual need. Always read the information leaflet that comes with the medication and if in doubt, discuss with your pharmacists.
  • Take only fluids for the first twenty-four to forty-eight hours. In a hospital, fluids and energy may be given through an intravenous drip, this allows the bowel to rest and recover, before moving on to thicker liquids then progressing to solid foods.
  • Your doctor may prescribe antibiotics.

When the condition has sufficiently improved, more fiber may be consumed to prevent further attacks. If bloating and gas persist, the amount of fiber can be reduced for a day or two.

Once formed, diverticula pouches remain for life, but by making a few dietary and lifestyle changes, diverticulitis may be kept at bay and prevented from returning. Some foods, however, can worsen the symptoms and should be avoided.

Food to Avoid

Beans and peas, dried fruits, coconut, popcorn, strawberries and coarse grains. Also, vegetables and fruits with skin on, tomatoes, pickles and cucumbers.

Doctors can advise individuals about eating nuts and seeds, medical opinion on eating nuts and seeds are changing, some experts say, it can complicate the condition of diverticular disease and increase the incidence of diverticulitis. Others say not.

Too much tea, coffee and alcohol can cause constipation that can aggravate the condition and worsen the symptoms. Eating five portions of fruits and vegetables per day, this will help to form soft, bulky stool.

© J Alexis- Hagues 21 November 2011

A section of the large bowel showing multiple diverticula  in the sigmoid colon
A section of the large bowel showing multiple diverticula in the sigmoid colon | Source

Glucomannan is an extract of the root of the konjac plant, rich in dietary fibre that attracts water and turns to gel during digestion. Study published in 2006

"Recent studies demonstrate a lesser role for aggressive antibiotics or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary." (Journal of the American Medical Association, January 15th, 2014)

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Comments 70 comments

tobusiness profile image

tobusiness 11 months ago from Bedfordshire, U.K Author

Sujaya, always a pleasure to see you. Thank you for stopping by.


sujaya venkatesh profile image

sujaya venkatesh 11 months ago

a very useful hub


tobusiness profile image

tobusiness 18 months ago from Bedfordshire, U.K Author

Robin, this one was written some time ago, it's probably in need of updating. Thank you again for taking the time, much appreciated.


RobinGrosswirth23 profile image

RobinGrosswirth23 18 months ago from New York

I always learn something new when reading your hubs. Thanks!


tobusiness profile image

tobusiness 20 months ago from Bedfordshire, U.K Author

Hi Mary, yes, some people do have diverticular disease without realizing it, the symptoms occurs when the pouches become infected and inflamed. We should all remember to add more fibre to our diet as a preventative measure. Thank you so much for the visit and insightful comment. Take care and my best to you.


aesta1 profile image

aesta1 20 months ago from Ontario, Canada

What worries me is that symptoms sometimes don't appear. More fiber in the diet. This is what I must remember.


tobusiness profile image

tobusiness 20 months ago from Bedfordshire, U.K Author

Catherine, sorry to learn that you have this condition, but it's good to know you're managing it and are symptoms free. Thank you for taking a look at the hub, I hope you found it useful. Take care and my best to you.


CatherineGiordano profile image

CatherineGiordano 20 months ago from Orlando Florida

Very interesting. I have diverticulosis, perhaps and early stage of diverticulitis. My symptom was constipation. Now I take a daily dose of MiraLax and all is well. I try to eat a high fiber diet.


tobusiness profile image

tobusiness 21 months ago from Bedfordshire, U.K Author

Hi Patricia, so sorry to learn about you friend's mum, diverticulitis can be difficult at the best of times, but complications such as abscesses can increase with age.I'm so glad you found the hub useful in filling some of the gaps. Appreciate you taking a look and commenting. My best always.


pstraubie48 profile image

pstraubie48 21 months ago from sunny Florida

My friend's Mom has diverticulitis and often is rushed to the hospital with complications. She had polio as a child and the effects have become quite problematic as she has aged.

This article certainly filled in many gaps in my knowledge of this disease.

Angels are on the way to you this afternoon ps


tobusiness profile image

tobusiness 22 months ago from Bedfordshire, U.K Author

Debra, doctors sometimes gets it wrong, especially back then. Take care now.


Lady Guinevere profile image

Lady Guinevere 22 months ago from West Virginia

Back in 1994 I had my last DVT and the doctor there seen that I also had Ulcerative Colitis. He gave me something to kill the virus, only I did not have the virus and he nearly killed me instead. Seriously. My bones hurt so bad that I cried so hard and then he did not come to me for 2 hours and told me that he didn't think that it was that bad...until he saw me.

Thank you for the hint. I will definitely try that. I love prunes!


tobusiness profile image

tobusiness 22 months ago from Bedfordshire, U.K Author

Lady Guinevere, unfortunately, there is some evidence linking inflammatory bowel disease and genetics, but aparently, viruses may also play a part. Some experts suggests that a decrease in the diversity of bacteria in the gut may be the culprit, while a new study linked IBS with an increase in the diversity of viruses. I'm glad to know that you are in remission and have been for some time. For the constipation, you can try a moderate amounts of foods higher in sorbitol such as dried plums and prune juice. Remember to drink sufficient amounts of water. Flaxseed ground can be added to salads and cooked vegs. I hope this helps, take care and my best as always.


Lady Guinevere profile image

Lady Guinevere 22 months ago from West Virginia

Thaks for explaining this disease. My Aunt has this and so did my father. I have Ulcerative Colitis though. I think stomach problems plague my father side of the family. I have had UC since I was 21. It is is remission and has stayed that way for years. Thank goodness for that!

I have found that too much fiber will block me up and certain pain killers (just noticed this a few weeks ago) with make me constipated. I hate that!!


tobusiness profile image

tobusiness 23 months ago from Bedfordshire, U.K Author

Hi Will, so sorry to learn that you suffer from diverticular disease, but you appears to be on top of it, that's good. Diet is important, a good understanding of the condition will help you to better manage it. According to the research, people aged 50 to 70 who eat a high fibre diet have a 40% lower chance of complications, compared to the same age group taking a lower amounts of dietary fibre. Yes, rupture can occur, sorry about your friends, sometimes a colectomy is necessary to treat sever diverticulitis. Keep up the good work and my very best to you.


WillStarr profile image

WillStarr 23 months ago from Phoenix, Arizona

I had bouts of cramping and bloating and thought it was my diet until undergoing a colonoscopy and learning I have diverticula. Now I take lots of fiber, and only occasionally have symptoms.

One of my classmates also has diverticular disease and suffered a rupture. Her recovery took almost half a year. And just this month, another, a much younger female friend underwent a colon resection for the same reason.

It's a serious disease.

Very good Hub, Jo!


Nell Rose profile image

Nell Rose 24 months ago from England

Thanks so much Jo, I really appreciate your help, yes my doctor or should I say doctors never tell me anything about it apart from what meds to take, so I will make another appointment, write down a few questions to ask as I always forget when I get in there, and see what help they can give me, once again, thanks so much, nell


tobusiness profile image

tobusiness 24 months ago from Bedfordshire, U.K Author

Nell, I'm glad to know you're feeling better, it's not much fun being unwell. I've added some more information to the site and will do a bit more tomorrow. The current approach to treating people who are experiencing recurrent diverticulitis, is to treat each person as an individual. what's best for you may not be appropriate for someone else, although they may have the same condition. Do have a chat with your doctor about the choice of treatment, I know some doctors are not very good at explaining, but the more you know about you treatment, the more proactive you can become. Look after yourself, my best always.


Nell Rose profile image

Nell Rose 24 months ago from England

Hi Jo, thanks for answering, yes I had a sigmoidoscopy, and they saw all the little pouches, I understand I just thought that they were supposed to give the antibiotics, but that's fine, I feel a little bit better today, thanks so much for answering my question, have a great evening, nell


tobusiness profile image

tobusiness 24 months ago from Bedfordshire, U.K Author

Hi Nell, I'm so sorry to learn that the condition have flared up again. Did the doctors actually diagnosed your condition as diverticulitis, I can't remember if you got a definitive diagnosis? I know they once thought that your symptoms may well have been due to IBS.

Based on recent studies, doctors are prescribing less antibiotics for recurrent attacks of diverticulitis. While antibiotics may relieve the pain, it doesn't particularly reduce incidence of recurrence and with the crisis with antibiotic resistance, we all have to rethink how we use these drugs. Doctors are no longer using antibiotics as aggressively as they once did for recurring diverticulitis. I'll try to add some more recent information to this hub that may help, so do stop by and have a look. I hope you'll feel better soon.


Nell Rose profile image

Nell Rose 24 months ago from England

Came back for another read as I have been suffering again, really bad bout this time, saw the doc, he didn't even give me any antibiotics! is that right? I am sure he should have, thanks Jo, nell


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

SheGetsCreative, thank you for taking a look, much appreciated. About the strawberries; while a high fibre diet is recommended, strawberries, cucumber and tomatoes were once discouraged because the experts believed that the small seeds can become lodged in the small pouches to cause inflammation and flares. However, there is no real evidence to support this. I suppose what works for one person doesn't necessarily work for all. It's a case of knowing your body. Good luck with the diet, you seem to be doing well. Take care and my best to you.


SheGetsCreative profile image

SheGetsCreative 2 years ago from Seattle, WA

Very informative - voted up. I knew about many of the foods to avoid, but didn't realize strawberries were on the list!


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

Pawpawwrites, watch out for those polyps and keep up the good work.

Thank you for taking a look. My best to you.


Pawpawwrites profile image

Pawpawwrites 2 years ago from Kansas

Haven't had a problem with mine yet. Except for a couple of polyps.


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

DreamerMeg, glad you've found this useful, I appreciate you taking a look, thank you for the kind comment.


DreamerMeg profile image

DreamerMeg 2 years ago from Northern Ireland

Very useful and interesting, thanks. I always love it when a hub has useful, clear diagrams!


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

Hi Jackie, this type of stomach problems can be pretty terrible indeed. thank you for stopping by, I was just on my way over to you. :)


Jackie Lynnley profile image

Jackie Lynnley 2 years ago from The Beautiful South

Stomach problems are just so horrible to have. Great info and advice, Jo. ^


Nell Rose profile image

Nell Rose 2 years ago from England

Thanks Jo, that's great! I will go and try the acidophilus probiotic and if it still plays me up I will go back and see the doc, thanks for all your help! have a great day, nell


tobusiness profile image

tobusiness 2 years ago from Bedfordshire, U.K Author

Hi Nell, lovely to see you, sorry about the abdo. pain.....diverticulitis can be difficult to diagnose just by the symptoms which are similar to a lot of other abdominal conditions like pelvic inflammatory disease, IBS and coeliac disease (an intolerance to gluten), and many more. Diverticulitis is usually diagnosed during an acute attack, it's often done by doing a Colonoscopy, where a small tube with a camera on the end is passed into the colon to show what is going on inside. They can also do a CT scan, this will give a 3D picture and can also show if there is a spread of infection to other parts of the abdomen or even other parts of the body. Other tests such as a Barium enema X-ray can also show what's happening in the abdomen.

Have you tried using acidophilus probiotic? Good luck with the doctor, if you've been having pain and spasm for a while they may decide to do one of the test I mentioned, but chances are it may well be IBS or a bowel infection, try the probiotic anyway. Good luck with the doctors, use the one you trust and find it easier to talk to. Take care and my very best to you.


Nell Rose profile image

Nell Rose 2 years ago from England

Hi, I came looking for you on this because I wanted to ask a question? I was seen by about 5 docs, all saying it was ibs, one saying I was making it up...long story! I have a lower back pain, they told me it was diverticulitis, but I get bowel spasm too, so darn painful, but they have never done anything else, they gave me antibiotics last time, that was from a good doc! because she gave me a blood test and it said I had an infection. just had this again, total pain, do you think I need more test? thanks!


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Suzette, your doctor was correct, colitis can be very serious. The hospital where I work is closely linked to a national and international referral center for intestinal and colorectal disorders. So of course, we see the worst cases. Take care of yourself and stay on top of it. Keep a close eye on the diet and stress levels, although I'm sure you are already doing just that. Thank you for reading this, I hope it was helpful.

Enjoy the weekend and my best to you.


suzettenaples profile image

suzettenaples 3 years ago from Taos, NM

Very informative article, Jo. My sister suffers from diverticulitis and it is not funny. It is very painful and discomforting. She does watch what she eats, but every once in a while will have an attack. I have had issues with colitis, but I too, watch my diet and haven't had a colitis attack in quite some time. They are scary and serious. Years ago when I was in the ER with a colitis attack, the doctors impressed on me that one can die from these attacks. So, I really watch my diet and try not to have too much stress going in my life. Thanks for sharing your knowledge with us on an important medical issue.


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Your great grandmother knew what she was talking about, a very sensible lady. Much appreciate!


CraftytotheCore profile image

CraftytotheCore 3 years ago

Very interesting. My great-grandmother suffered from this in her late 80s before passing away. I remember her telling me she was afraid to eat tomatoes because of the seeds.


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Suzette, thank you very much, I do appreciated your visit. Hope you're in good health; have a wonderful weekend.


suzettenaples profile image

suzettenaples 3 years ago from Taos, NM

Very interesting and informative article! These health problems run in my family and we have all suffered from this at some point in our lives. The key for me was diet change and making sure I intake enough fiber in my diet. Your suggestions and advice are spot on!


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Thank you again travel_man, always appreciated. Take care now.

JO.


travel_man1971 profile image

travel_man1971 3 years ago from Bicol, Philippines

A first-rate information. Yes, a change in diet will hamper the effects of diverticulitis. Thank you for the information. :)


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

DDE, you are very kind, thank you for reading this, and for the insightful comment. My best to you.


DDE profile image

DDE 3 years ago from Dubrovnik, Croatia

Brilliantly researched hub health information is very important to make note of. Thanks for sharing such valuable points


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Thank you lurana, yes this condition can be very confusing, it can be very unpleasant to live with, it is very important to know how to manage it. Sorry to hear about you family member, I hope the information is of so e help.


Lurana Brown 3 years ago

Thank you for the informative article! I have a family member who has suffered from this disease. It is so important to be aware of positive, simple lifestyle habits that can keep us healthy.


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Phoebe, you should visit more often! :) thank you so very much for this wonderful comment, much appreciated and best wishes to you.


Phoebe Pike 3 years ago

This hub is awesome. We need more informative hubs like this out there. Two thumbs way up from me.


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

Hi Doc, many thanks for taking a look, much appreciated.


lovedoctor926 3 years ago

Useful information. Thank you for raising awareness.


tobusiness profile image

tobusiness 3 years ago from Bedfordshire, U.K Author

pstrubie48, I'm sorry that your daughter suffers from this condition. I hope this hub has helped with understanding her condition a little better. Thank you for the visit and comment, and best wishes to both yourself and you daughter.


pstraubie48 profile image

pstraubie48 3 years ago from sunny Florida

My daughter suffers with this and it is indeed most unpleasant. Many have no idea about what it is so I appreciate the fact that you have shared this for all to read. ps :)


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Your most welcome.

Many thanks for dropping by.


Specialk3749 profile image

Specialk3749 4 years ago from Michigan

I have never heard of this disease. Thank you for educating me!!


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Peggy, thank you for the comment and for stopping by. I'm sorry to hear about your friend, I hope She will be able to get the colostomy reverse soon, I have a colleague who is in the same position. But I think people are generally more informed than they used to be and are making better choices. I hope articles like this will help.


Peggy W profile image

Peggy W 4 years ago from Houston, Texas

Good article about diverticulitis and disease stemming from it. I have a friend who recently had surgery and has a temporary colonoscopy which will hopefully be reversed in the next coming months after she fully recovers. Perhaps people will start to take more seriously the need to up our vegetable and fruit consumption and cut down on the overly processed foods. Up and useful votes and will share.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Hi Doc, thank you so much for the visit and comment, it was very illuminating, isn't language wonderful? Funny, I've just got home from work, my patient was a 36 years old man with diverticulitis and a perforated bowel.


Docmo profile image

Docmo 4 years ago from UK

Useful info here tobusiness: you've really succinctly summarised the issue of diverticular disease and diverticulitis. thankfully having Diverticula itself is not a bad thing as more than three quarters of the populations will get it as we reach 80- its only like wrinkles inside the gut.

Did you know the name Diverticula comes from Latin for little smelly dark alleys off the main road where they sell shady stuff ?


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Integrity, So glad you found this useful.

Many thanks for the vote and for stopping by, all my best.


IntegrityYes 4 years ago

That is so useful. I voted way up.


tobusiness profile image

tobusiness 4 years ago from Bedfordshire, U.K Author

Snowdrops, you are very kind, I do hope people will find it useful, there are so many who are affected by this condition. Thank you very much for stopping by.


snowdrops profile image

snowdrops 4 years ago from The Second Star to the Right

Hi Jo. thank you for bringing this to attention. I can say that this is one great informative hub.


rambansal profile image

rambansal 5 years ago from India

very informative hub and an eye-opener on selecting a variety of natural foods... thanks, tobusiness, for sharing..


tobusiness profile image

tobusiness 5 years ago from Bedfordshire, U.K Author

Only to happy to help, I'm just looking to see what works thanks again jhamann.


jhamann profile image

jhamann 5 years ago from Reno NV

I have been considering doing a med-hub, or at least a medical science hub, you may have pushed me in the right direction. Thank you. Voted up!


tobusiness profile image

tobusiness 5 years ago from Bedfordshire, U.K Author

Moonlake, thank you for the comment, I do hope you aunt continues to get well, this type of illness can be pretty debilitating, but its manageable. thanks again for stopping by.


moonlake profile image

moonlake 5 years ago from America

Good hub my aunt just got out of the hospital with this. She was pretty sick.


tobusiness profile image

tobusiness 5 years ago from Bedfordshire, U.K Author

Hi Kat11, So glad I can help, its good to know this can be of use and informative, I hope your aunt is better,thanks for stopping by.


kat11 profile image

kat11 5 years ago from Illinois

I have aunts diagnosed with this but I was not sure what it was exactly. Thanks for the information it really cleared lot of things up. voted up


tobusiness profile image

tobusiness 5 years ago from Bedfordshire, U.K Author

Thank you for stopping by Mike, as I said, the Irish, got to love em


Frank Atanacio profile image

Frank Atanacio 5 years ago from Shelton

thanks for this Med-share.. useful and educational :)


mikeq107 5 years ago

Ok, ToBusiness :0)

That was appetizing!!!... just having my breakfast as I read this(: 0() LOL

However, I have been a good Leprechaun...about 10 months ago embarked on a colon cleanse...ten-day lemonade diet...amazing what lives up there!!.. after which lost the desire for meat...eat a lot of fish, veggies,,nuts...and lost a lot of weight...feel great...mentally and physically fit like I have been to the fountain of youth and I’m 49 again :0)

Yes the USA will not have to be invaded by anybody…they are eating themselves to death…the new property owners! Can just walk in and bury the bodies, as they will not decompose because of all the wonderful chemical preservatives ?

Great hub love your research…have a good one !!!!

Mike :0)

Ps ,I can just Imangine the boys in an Irish pub talking about this one....

"Sheamus,Did You Hear paddy`s got Diverticulitis and diverticular disease"

" what the hells that?"

"Emmm think it means he keeps going down one way streets cause he can't read Diversion signs"

" no wonder he can't find his way home to the miss`s"

" no,no mick you have it all wrong, He got it from his miss`s after she found out where he had been"

" that's it lads I,m goin home early"

" what Joe your not Married"

" I know but marys looking at me with that twiperated look in her eyes and she might be carrying

That bloody thing in her purse”

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