Diverticular diseases stem from conditions related to diverticulosis. This is when pockets --doctors call them “diverticula” -- form in the walls of your digestive tract. Most often they appear in the colon, the lower part of the large intestine.
Pressure in the intestine causes the inner layer to push through weak spots in the outer lining. This makes the areas bulge out, and creates little pouches.
Diverticular disease grows more common with age. About 10% of people over age 40 will get diverticulosis, and 50% will get it after age 60. It affects nearly everyone over 80.
There are two main types of diverticular disease -- diverticulitis and diverticular bleeding.
Diverticulitis
This can happen when waste -- bacteria or small pieces of stool from bowel movements -- gets trapped in the pockets. A sac also can tear, or you can lose healthy bacteria in your colon while harmful bacteria increase.
All these factors can cause painful swelling, infection, or irritation in the area. You may need to see a gastroenterologist, a digestive system specialist.
Some of the main complications that can occur with diverticulitis include:
• Abscess (the pocket fills with pus)
• Rectal bleeding (blood passes through your anus)
• Stricture (your colon narrows so stool can’t pass easily)
• Fistula (a channel that forms to another organ, or the skin -- for example, from the colon to the bladder)
Most of these conditions require surgery.
Diverticular Bleeding
Blood vessels carry blood from the muscle layer of the lining to the inner wall. If one of the vessels leading to the pocket bursts, lots of bright, red clots might suddenly show up in your stool.
It’s not likely you’ll have any pain, but the sudden blood loss can make you feel woozy or weak.
The bleeding will probably stop on its own. But you’ll still need to see your doctor as soon as you notice blood. If the bleeding doesn’t stop, you might need:
- An IV
- Blood replacement (transfusion)
- Other medicine
- Surgery
If you take aspirin more than four times a week, you could have more chance of bleeding.
What Causes Diverticular Disease?
Doctors aren’t sure, but there might be several reasons, including:
- Muscle spasms or strain (during bowel movements, for instance) causing pressure to build up and push against the lining.
- Family history
- Not eating enough fiber-rich foods
Who’s At Risk?
You have higher odds of getting a more serious type of diverticular disease if you:
- Are obese, or seriously overweight
- Don’t exercise enough
- Eat too much food that’s high in animal fat and low in fiber
- Smoke cigarettes
- Take certain medicines, including opioids (like codeine and hydrocodone); steroids; or anti-inflammatory meds like ibuprofen and naproxen (Aleve)
- Have a family history of diverticulosis
How Is It Diagnosed?
Unless you have symptoms like pain or bleeding, you may not know you have it. Often it’s found when you have tests for another condition. If you do have symptoms, your doctor will first rule out other conditions by doing a physical exam and running a series of tests.
Can You Prevent It?
Diverticulosis can happen naturally as you age. The main goal is to keep the pockets from causing problems. Your doctor might suggest that you:
- Eat more high-fiber foods or take supplements such as Citrucel or Metamucil .
- Take medicines that ease your symptoms or cure an infection that shows up.
- See a specialist if your case keeps returning or needs more attention.