When was diverticulosis discovered

Diverticulosis is a condition that develops when pouches diverticula form in the wall of the colon large intestine. These pouches are usually very small 5 to 10 millimetres in diameter but can be larger. In diverticulosis, the pouches in the colon wall do not cause symptoms.

Diverticulosis may not be discovered unless symptoms occur, such as in painful diverticular disease or in diverticulitis. As many as 80 out of people who have diverticulosis never get diverticulitis. The reason pouches diverticula form in the colon wall is not completely understood. Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall.

Normally, a diet with adequate fibre also called roughage produces stool that is bulky and can move easily through the colon. If a diet is low in fibre, the colon must exert more pressure than usual to move small, hard stool. A low-fibre diet also can increase the time stool remains in the bowel, adding to the high pressure.

Pouches may form when the high pressure pushes against weak spots in the colon where blood vessels pass through the muscle layer of the bowel wall to supply blood to the inner wall. Most people don't have symptoms. You may have had diverticulosis for years by the time symptoms occur if they do.

Over time, some people get an infection in the pouches diverticulitis. For more information, see the topic Diverticulitis. Your doctor may use the term painful diverticular disease.

It's likely that painful diverticular disease is caused by irritable bowel syndrome IBS. Symptoms include diarrhea and cramping abdominal belly pain, with no fever or other sign of an infection.

In many cases, diverticulosis is discovered only when tests, such as a barium enema X-ray or a colonoscopy , are done to find the cause of a different medical problem or during a screening exam. The best way to treat diverticulosis is to avoid constipation. The clinical findings vary. Most often, the clinical picture is one of fever, abdominal pain, a change in bowel habit, and localizing findings associated with leukocytosis. Computerized tomography scanning has become the procedure of choice to evaluate the symptoms since it is of less risk than a barium enema and obtains more information.

The differential diagnosis may be difficult but usually can be made with accuracy. Medical treatment is preferred with appropriate antibiotic therapy and variations in fiber intake. Also rarely, a severe attack of diverticulitis may cause a narrowing of the colon that causes an obstruction. It also rarely may cause a passage from one segment of the colon to the small bowel, bladder, vagina, or skin. The latter phenomenon is called a fistula. These complications are rare and should not concern those who have uncomplicated diverticula.

Diverticular hemorrhage — As described above, diverticula follow the paths of the arteries as they penetrate the muscle layer of the colon wall. Uncommonly, these same arteries can erode through the thin wall of the diverticulum and cause a major hemorrhage.

This usually occurs when a person is elderly. The earliest symptoms are faintness and the appearance of much bright red blood by rectum. Such a complication requires hospitalization and blood transfusion.

Colonoscopy is sometimes attempted to localize the site of the bleeding, but is technically difficult. Angiography may also be done. In this procedure dye that can be detected by x-ray is injected into the arteries of the intestines. If the bleeding is active, some dye may be seen leaking into the colon. While diverticulitis almost always involves the left or sigmoid colon, most diverticular bleeding occurs in the right side of the colon.

Fortunately, the bleeding usually stops spontaneously, but recurs in about one-quarter of cases. Infrequently, a surgeon must operate to remove the segment of the colon containing the bleeding diverticulum.

Those who have colonic diverticula and no symptoms can relax. Nothing is likely to happen because of them. Some physicians recommend a high fiber diet, or bran or psyllium supplements, in the belief that lack of fiber causes the diverticula and that such treatment may prevent complications.

The notion that nuts or seeds may lodge in the diverticula and provoke diverticulitis is probably untrue. If there are coexisting chronic abdominal pains, it is likely to be associated with IBS or a similar disorder.

This should be discussed with a physician. It is useful to know if diverticula are present. The information may help a doctor in the event of an attack of pain or bleeding that could result from these otherwise innocent little colonic outpouchings.

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If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation. This information is in no way intended to replace the guidance of your doctor. All Rights Reserved. International Foundation for Gastrointestinal Disorders. GI Disorders. Upper GI Disorders. Lower GI Disorders. Bowel incontinence Chronic constipation Chronic diarrhea Dyssynergic defecation. Other GI Disorders. Abdominal adhesions Acute Hepatic Porphyria Anal fistulas Celiac disease Clostridium difficile Congenital sucrase-isomaltase deficiency.