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Diverticulosis

A diverticulum is a small sac which bulges out from the wall of the lower intestine. It can be compared to a weak spot in the lining of a hose which has pouched out. The presence of multiple diverticula in the lower intestine (colon) is referred to as "diverticulosis." Diverticulosis is often a silent condition with no symptoms. However, if these diverticula rupture or become infected, "diverticulitis" occurs. Diverticulitis is similar to appendicitis in that acute abdominal pain, fever, and nausea are typical symptoms. Unlike appendicitis which causes right sided pain, the pain of diverticulitis usually occurs on the left side of the lower abdomen. Diverticulitis can usually be treated medically with antibiotics. At times surgery can be required.

Diverticula are thought to develop because of excessive pressure within the colon. A variety of factors contribute to development of excessive pressure in the colon, including: constipation, insufficient dietary fiber and fluid intake, straining during bowel movements, and lack of exercise. In less "developed" countries, where dietary fiber intake is high, diverticular problems are unusual. In the United States, however, the average diet contains less fiber and diverticulosis is quite common. Over 25% of the American population over the age of 50 have diverticula.

Often asymptomatic diverticula are discovered during flexible sigmoidoscopy which is an office procedure recommended by many experts every 5 years after age 50 as a screening procedure for the early detection of some cancers of the large intestine. This involves the insertion of a flexible scope into the rectum to view the inside of the lower portion of the colon. Ask your physician if he/she would recommend this procedure.

In order to prevent the development of additional diverticula, and also prevent "diverticulitis," it is important to:

• Avoid eating nuts or seeds (such as sesame seeds, popcorn, poppyseeds)
• Increase your intake of fluids to about 8 glasses of water a day
• Increase your intake of fiber-rich foods such as fresh fruits, vegetables, brans, whole grain cereals and breads
• Consider using a fiber supplement such as Metamucil (psyllium fiber), one rounded teaspoon a day on a regular basis
• Try to avoid straining during bowel movements. Wait until you feel the urge to have a bowel movement, and when you have this sensation, try to evacuate promptly.
• Contact your physician if you notice any significant change in your bowel habits, particularly if you are experiencing bleeding or pain.

...from the physicians at the Los Altos Center

Palo Alto Medical Foundation

(650-254-5200)

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