Diverticular Disease: Diverticulosis and Diverticulitis

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Diverticular Disease: Diverticulosis and Diverticulitis

Diverticular disease affects the diverticula of the colon. These are small pouches with narrow necks that protrude from the wall of the colon (Black & Hyde, 2006). They are mostly found on the rectum. The disease is common among old people, from fifty years and above (Black & Hyde, 2006). It occurs in three forms as diverticular bleed, diverticulosis and diverticulitis. Diverticular bleed is a condition experienced by a diverticular disease patient when a chronic injury occurs on the small blood vessels that are next to the diverticular (Stollman & Raskin, 2004). Diverticulosis is characterized by formation of many tiny pockets in the wall of the intestine, while diverticulitis is characterized by inflammation due to infection.

During a diverticulosis, many tiny diverticular form in the lining of the colon (Black & Hyde, 2006). The many diverticula result from an increase in pressure from the weak spots of the colon. The pressure is brought about by wastes, liquid or gas. Conditions that strain bowel movements, such as, constipation can also cause diverticular disease. The sigmoid part of the colon is the most affected. According to Stollman and Raskin (2004), more than fifty percent of people above sixty years suffer from the disease. Complications can occur in the form of rectal bleeding or infection. The infection occurs due to blockage of diverticula with waste matter. This leads to the other form of the disease, diverticulitis.

The etiology of the disease is associated with colonic motility, the role of fiber and the structure of the colonic wall (Hobson & Roberts, 2004). In regard to colonic wall structure and the etiology of the disease, the sigmoid part of the colon has a thicker circular muscle layer. The diverticula occur in the weak areas of the colon. Colonic motility, especially in the distal part has been found to be weaker than normal bowel motility. According to Hobson and Roberts (2004), colonic motility occurs in the form of segmentation. This creates a pulsion force that leads to the development of diverticula. Consumption of low fiber diet has been associated with diverticular disease. Hobson and Roberts (2004) argue that people who consume low-fiber foods have a higher incidence of diverticular disease. Some other factors associated with the development of diverticular disease. These are caffeine ingestion, smoking, consumption of non-steroidal anti-inflammatory drugs and limited physical activity.

The medical treatment of diverticular disease aims at reducing the pressure in the colon. This is achieved by eating fiber-rich foods and avoiding low fiber foods. The foods recommended are legumes, grains, vegetables, wheat bran, brown rice and whole-meal wheat flour. Fiber helps by softening the stool, as well as, making it bulky, hence reducing pressure on the colon (Stollman & Raskin, 2004). This eases bloating and pain, and also reduces constipation. The diet also prevents the formation of more outpouchings. Pain-killers can also be used to reduce pain. If an infection develops, the specific treatment for the infection is offered.

Surgical treatment in diverticular disease is indicated in severe disease with little response to medication, severe bleeding, recurrent disease episodes and complications (Black & Hyde, 2006). It involves removal of the diseased part. The remaining parts are then anastomosed to the rectum. Normal bowel function returns after a few weeks. Diverticular disease is also associated with some complications. These are obstruction of the colon, formation of an abscess, perforation of the bowel wall, and the development of a fistula, for example, bladder fistula. Prevention of the disease and early treatment are encouraged to prevent complications.

References

Black, P., & Hyde, C. (2006). Diverticular disease. Hoboken, NJ: John Wiley & Sons.

Hobson, G. K., & Roberts, L. P. (2004). Etiology and pathophysiology of diverticular disease. Clinics in Colon and Rectal Surgery, 17(3), 147-153.

Stollman, N., & Raskin, B. J. (2004). Diverticular disease of the colon. The Lancet, 363(9409), 631-639.