Diverticulosis is a common condition where small, bulging pouches, known as diverticula, form in the wall of the large intestine. These pouches typically develop in weak areas of the intestinal lining, often in the sigmoid colon. Once formed, diverticula are considered permanent and cannot be reversed through non-surgical means. However, various management strategies can help prevent complications and maintain intestinal health.
What is Diverticulosis
Diverticulosis occurs when the inner lining of the colon pushes outward through weak spots in the muscular wall, forming small, sac-like bulges. This process often happens gradually, influenced by factors like increased pressure within the colon. The large intestine experiences significant pressure as it moves and dehydrates waste, contributing to pouch formation.
The development of diverticula is strongly associated with advancing age, with prevalence increasing significantly in individuals over 50. For instance, about 50% of people over 60 and 75% of those over 80 in the U.S. have diverticulosis. Most individuals with diverticulosis do not experience symptoms, and the condition often remains undetected unless discovered incidentally during medical examinations.
Diverticulosis Versus Diverticulitis
It is important to distinguish between diverticulosis and diverticulitis. Diverticulosis refers to the presence of small pouches in the colon, which are often asymptomatic. Diverticulitis is an acute condition occurring when one or more diverticula become inflamed or infected. This inflammation typically arises if food particles or stool become trapped within a pouch, leading to bacterial overgrowth and irritation.
Diverticulitis can cause sudden and severe abdominal pain, often in the lower left side, accompanied by symptoms like fever, nausea, vomiting, and changes in bowel habits. Complications can include abscess formation, fistulas, intestinal obstruction, or even perforation leading to peritonitis. While acute episodes of diverticulitis can be resolved with medical intervention, the underlying diverticulosis remains.
Managing Diverticulosis Long-Term
While diverticula are generally permanent, individuals can adopt strategies to manage diverticulosis and reduce the likelihood of developing diverticulitis or other complications. A primary approach involves dietary adjustments, especially increasing fiber intake. Fiber, found in fruits, vegetables, and whole grains, helps soften stool and adds bulk, promoting easier passage through the colon and reducing pressure on intestinal walls. For adults, a daily fiber intake of 22 to 34 grams is often recommended, but it should be increased gradually to avoid discomfort.
Adequate hydration is also important, as drinking plenty of water helps fiber function effectively by keeping stool soft and preventing constipation. Regular physical activity contributes to healthy bowel function and can help prevent constipation, potentially reducing diverticulitis risk. Maintaining a healthy weight and avoiding straining during bowel movements are additional lifestyle measures that support colon health.
Historically, people with diverticulosis were advised to avoid nuts, seeds, and popcorn. However, current scientific evidence indicates these foods do not cause diverticulitis and can be safely included in a high-fiber diet. Medical supervision may be necessary for some individuals, especially with chronic symptoms or recurrent diverticulitis episodes. Following these lifestyle and dietary recommendations offers effective long-term management for diverticulosis.