IMPROVING DIGESTIVE HEALTH THROUGH Understanding Diverticulosis EXCELLENCE IN ENDOSCOPY exam for polyps. Gastroenterologists can directly visualize the diverticula What is diverticulosis? (more than one pouch, or diverticulum) Diverticulosis is a condition in which there are small pouches or pockets in the colon during a procedure that in the wall or lining of any portion of the digestive tract. These pockets uses a small camera attached to a occur when the inner layer of the digestive tract pushes through weak spots lighted, flexible tube inserted through in the outer layer. A single pouch is called a the rectum. One of these procedures diverticulum. is a sigmoidoscopy, which uses a short The pouches associated with tube to examine only the rectum and diverticulosis are most often located DIVERTICULUM lower part of the colon. A colonoscopy in the lower part of the large uses a longer tube to examine the entire intestine (the colon). Some people colon. Diverticulosis can also be seen may have only several small using other imaging tests, for example pouches on the left side of the by computed tomography (CT) scan or colon, while others may have barium x-ray. involvement in most of What is the treatment for the colon. diverticulosis? Diverticulosis is a common condition in the United States Once diverticula form, they do not that affects half of all people disappear by themselves. Fortunately, over 60 years of age and nearly most patients with diverticulosis do not everyone by the age of 80. have symptoms and, therefore, do not need treatment. When diverticulosis is accompanied Who gets diverticulosis? What are the symptoms by abdominal pain, bloating or of diverticulosis? constipation, your doctor may Diverticulosis is a common condition recommend a high-fiber diet to help in the United States that affects half Most people who have diverticulosis make stools softer and easier to pass. of all people over 60 years of age and are unaware that they have the While it is recommended that we nearly everyone by the age of 80. As a condition because it usually does consume 20 to 35 grams of fiber daily, person gets older, the pouches in the not cause symptoms. It is possible most people only get about half that digestive tract become more prominent. that some people with diverticulosis amount. The easiest way to increase Diverticulosis is unusual in people experience bloating, abdominal cramps fiber intake is to eat more fruits, under 40 years of age. In addition, it is or constipation due to difficulty in stool vegetables and grains. Apples, pears, uncommon in certain parts of the world, passage through the affected region of broccoli, carrots, squash, baked beans, such as Asia and Africa. the colon. kidney beans, and lima beans are a few examples of high-fiber foods. What causes diverticulosis? How is the diagnosis of diverticulosis made? As an alternative, your doctor Because diverticulosis is uncommon may recommend a supplemental in regions of the world where diets Because most people do not have fiber product such as psyllium, are high in fiber and rich in grains, symptoms, diverticulosis is often found methylcellulose, or poly-carbophil. fruits and vegetables, most doctors incidentally during evaluation for These products come in various forms believe this condition is due in part another condition or during a screening including pills, powders and wafers. to a diet low in fiber. A low-fiber diet Supplemental fiber products help to leads to constipation, which increases bulk up and soften the stool, which Most people who have pressure within the digestive tract with makes bowel movements easier to straining during bowel movements. The diverticulosis are unaware that they have the condition because pass. Your doctor may also prescribe combination of pressure and straining medications to help relax spasms in the over many years likely leads it usually does not cause symptoms. If left untreated, colon that cause abdominal cramping to diverticulosis. diverticulitis may lead to an or discomfort. abscess outside the colon wall or an infection in the lining of the abdominal cavity. Are there complications diverticulitis may lead to a collection blood through the rectum. Most from diverticulosis? of pus (called an abscess) outside the diverticular bleeding stops on its own; colon wall or a generalized infection however, if it does not, a colonoscopy Diverticulosis may lead to several in the lining of the abdominal cavity, may be required for evaluation. complications including inflammation, a condition referred to as . infection, bleeding or intestinal peritonitis If bleeding is severe or persists, a Usually a CT scan is required to blockage. Fortunately, diverticulosis hospital stay is usually required to diagnose an abscess, and treatment does not lead to cancer. administer intravenous fluids or usually requires a hospital stay, possibly blood transfusions. In addition, Diverticulitis occurs when the pouches antibiotics administered through a vein a colonoscopy may be required to become infected or inflamed. This and possibly drainage of the abscess. determine the cause of bleeding and to condition usually produces localized Repeated attacks of diverticulitis may treat the bleeding. Occasionally, surgery abdominal pain, tenderness to touch require surgery to remove the affected or other procedures may be necessary to and fever. A person with diverticulitis portion of the colon. stop bleeding that cannot be stopped by may also experience nausea, vomiting, other methods. shaking, chills or constipation. Your Bleeding in the colon may occur from a doctor may order a CT scan to confirm diverticulum and is called diverticular Intestinal blockage may occur in a diagnosis of diverticulitis. Minor cases bleeding. This is the most common the colon from repeated attacks of of infection are usually treated with oral cause of major colonic bleeding in diverticulitis. In this case, surgery may antibiotics and do not require admission patients over 40 years old and is usually be necessary to remove the involved to the hospital. If left untreated, noticed as passage of red or maroon area of the colon. Bleeding in the colon may occur from a diverticulum. Intestinal blockage may occur in the colon from repeated attacks of diverticulitis. In this case, surgery may be f.y.i. necessary to remove the involved area of the colon. Diverticulosis is uncommon in regions of the world where diets are high in fiber and rich TRANSVERSE COLON in grains, fruits and vegetables. Most doctors believe this condition is due in part to a diet low in fiber. The easiest way to increase fiber intake is to eat more ASCENDING COLON fruits,vegetables and SIGMOID DESCENDING grains. COLON COLON CECUM RECTUM Important Reminder: This information is intended only to ANUS provide general guidance. It does not provide definitive medical advice. It is very APPENDIX important that you consult your doctor about your specific condition. Since its founding in 1941, ASGE has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. This information is the opinion of and provided by the American Society for Gastrointestinal Endoscopy. Gastrointestinal endoscopy helps patients through screening, diagnosis and treatment of digestive diseases. Visit www.asge.org to learn how you can support GI endoscopic research, education and public outreach through a donation to the ASGE Foundation. For more information, visit www.asge.org or www.screen4coloncancer.org Copyright © 2014 American Society for Gastrointestinal Endoscopy PEB15.