Diverticular disease or diverticulosis is a common condition that becomes increasingly common as people age. Over 1/3 of people will have diverticulosis by the age of 50 and more than 1/2 by the age of 70. Diverticula are pockets or pouches that protrude from the wall of the bowel. Diverticulosis can occur in any part of the bowel but is most common in the lower third of the colon (but not the rectum).
Diverticulosis runs in families and is more common in people who have less fibre in their diet. Diverticulosis is thought to arise from excessive pressure on the wall of the bowel over long periods of time causing the lining of the bowel to bulge out through gaps in the muscle layer. Diverticulosis usually causes no symptoms at all although people with diverticulosis may have symptoms of irritable bowel syndrome due to spasm in the muscles of the wall of the bowel and increased gas production.
A small proportion of people with diverticulosis will develop complications including bleeding from the diverticula, infection (diverticulitis) and rarely even perforation causing peritonitis. Diverticulitis usually causes acute abdominal pain often with fever and should not be confused with diverticulosis or diverticular disease itself.
Increasing dietary fibre or using fibre supplements may reduce symptoms of irritable bowel syndrome and cramping and bloating associated with diverticulosis. Over time increased dietary fibre may prevent diverticulosis from becoming more severe although we do not know if it prevents people from developing complications of diverticulosis. Acute episodes of diverticulitis should be treated with antibiotics. If attacks of diverticulitis are frequent or there are other severe complications of diverticular disease surgery may be an option to remove the affected segment of the bowel.