Diverticulosis is characterized by small sac-like protrusions (hernias) of inner intestinal tissue through the muscular wall of the large intestine (colon). These protrusions are called diverticula and may occur in any part of the colon, but most frequently are found in the lowest part (sigmoid).
Diverticulosis is characterized by small sac-like bodies (diverticula) that protrude through the wall of the colon. The diverticular wall consists of a thin layer of mucous membrane tissue. Diverticula can vary in size from 0.1 inch to larger than 1 inch in diameter.
In most cases, individuals with diverticulosis exhibit no symptoms of the disorder (asymptomatic) other than the development of diverticula. However, in rare cases, diverticulosis may cause abdominal pain, constipation, diarrhea, an uncomfortable feeling after eating (dyspepsia), and/or bleeding from a portion of the large intestine (rectum).
In some cases, the diverticula may become inflamed or infected (diverticulitis). (For more information on this disorder, see the Related Disorders section of the report.)
Diverticulosis may be caused by a highly refined diet lacking sufficient fiber and bulk. The lack of bulk may cause muscle spasms of the colon, especially in the lower section called the sigmoid. Pressure inside the colon builds up and the mucous tissue eventually pushes through the muscular coat of the colon, usually where the blood vessels pierce the muscle. Ulceration of the diverticulum may occur causing rectal bleeding. Chronic constipation may also cause diverticulosis. If the sacs become infected, diverticulosis becomes diverticulitis. (For more information, see the Related Disorders section of this report.)
Diverticulosis is a common disorder affecting 30 to 40% of persons over age 50. The incidence increases with each subsequent decade of life. It affects males and females in equal numbers. Diverticulitis is less common than diverticulosis.
The diagnosis of diverticulosis is usually confirmed by the presence of diverticula on CAT-scan or x-ray images. Examination of the diverticula can also be done directly by inserting a very thin, flexible tube through the rectum into the colon. This tube i. equipped with a tiny, powerful camera that helps the doctor determine if inflammation is present in the diverticula.
In some cases, especially in people over 50, a diagnosis of diverticulosis may be suspected if the individual is overweight, exhibits signs of thickening of the inner layers of the walls of certain arteries (atherosclerosis), and experiences abdominal pain or rectal bleeding.
Some cases of diverticulosis are treated by antibiotics and a few days of liquid diet followed by a diet high in fiber (e.g., whole wheat bread, bran cereal, etc.) Application of heat, adequate rest, a diet with substantial bulk and medication usually relieve symptoms. Small doses of barbiturates, or muscle relaxant, as well as antispasmodic agents may also relieve abdominal distress. Rectal bleeding may be treated by a clear liquid diet, blood transfusions, repair of coagulation defects, and/or the administration of fluids through the veins (intravenously).
Treatment options depend upon the severity of the bleeding. If severe bleeding persists or recurs, surgical intervention may be necessary.
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