Diverticula Problems

INTRODUCTION

The outer layer of the wall of the large intestine (colon) is weaker in some areas than others.  This allows small ‘pouches’ of the inner layers to be forced outwards through the outer layer.  The pouches are called diverticula (a single pouch is called diverticulum).  They vary in diameter from 3mm to 3cm.

Diverticula form because of the pressure on the colon over time (particularly from constipation caused by not having enough fibre in your diet) and as we get older.

About half of all the people over 50 and most people over 90 have diverticula in their colons and in most cases they do not cause problems or symptoms.  Some people have fairly mild symptoms that come and go.  These people are said to have diverticulosis or uncomplicated diverticular disease.

If faeces get trapped in a diverticulum, bacteria can grow around the blockage and cause infection and inflammation.  This is called diverticulitis and can be very serious.  One in ten people with diverticula in their colon get diverticulitis at some point in their life.  Treatment for diverticulitis is usually with antibiotics and often in hospital.

A common complication of diverticulitis is peritonitis.  This is caused by infected and inflamed diverticula perforating or rupturing.

CAUSES

Diverticulosis

Diverticulosis becomes more common with age.  It is due to pressure in the colon; some people have weaker colon walls than others and some people have had constipation for many years.  Not eating enough fibre means that the muscles in the colon have to work harder to push the stools out.  So, eating more fibre can help symptoms such as constipation.

Diverticulitis

This is usually caused by faeces getting trapped behind one of the pouches (diverticulum) and causing a build up or blockage in the colon.  Bacteria start to grow and multiply around the blockage causing infection and inflammation.

COMPLICATIONS

Complications of diverticular disease are rare, but include

  • The main risk with Diverticular diseases is that the bowel may perforate (split) or become blocked.
  • Peritonitis – when the lining of the abdomen becomes inflamed.  An abscess might form.
  • · A large obstruction might form in the colon that will need to be surgically removed.
  • · A fistula may occur – this is when the walls of the internal organs get damaged and start to stick together, it can happen with the bowel and the bladder, uterus or vagina.
  • · Bleeding from pouches – this is quite rare.

Approximately 1 in 100 people with a diverticular disease have to have surgery for a related complication at some point in their life.

PREVENTION

A high fibre diet will help diverticular disease.  This should be accompanied with drinking plenty of fluids (water) and regular exercise.

HIGH FIBRE FOODS

Apple, Apple juice, apricot, asparagus, avocado, banana, barley, green beans, beetroot, bitter melon, blackberries, blueberries, bread (chapatti) bread (naan), broccoli, cabbage, carrot (raw), cereal (all bran), cucumber, dried figs, wholemeal flour, grapes, kiwi fruit, lemon, lettuce, mango peeled, nuts – almonds, cashew, orange, peach, onion, pear with skin, peas (cooked), potato (baked with skin), sunflower seeds, tomato, whole wheat bread.

The above list is very handy in selecting high fibre foods to increase fibres in diet.  The fibres should be very important inclusion in your diet for controlling your cholesterol and preventing cancer.