Diverticulosis
Information about the causes, possible complications, and treatment of the bulging sacs that form inside the colon.
Symptoms and Causes
Diverticulosis is a condition that occurs when small protrusions or sacs (pouches of tissue) form inside the large intestine (diverticula). These small bulging sacs usually appear in the sigmoid colon, located just before the rectum. In rare cases, they may also develop in other parts of the intestine.
Diverticula typically measure between three and ten millimeters in diameter. In some cases, they may grow abnormally, for unknown reasons, and reach a size of about four centimeters in diameter (giant diverticula).
The prognosis for diverticulosis is good, as it is usually asymptomatic, and most patients live without complications throughout their lives. When the diverticula become inflamed, diverticulitis develops — a condition that causes various intestinal discomforts.
Symptoms
In general, diverticulosis does not cause symptoms. In some cases, it may cause:
- Abdominal pain in the form of cramps.
- Constipation.
- Excessive gas.
Causes
Diverticula form due to increased pressure in the colon. Over time, this pressure causes the inner layers of the colon to protrude through weaker areas of the intestinal wall.
Although the exact causes of this increased pressure are not fully known, it is believed to be related to:
- Thickening of the muscular layer of the colon.
- Spasms or irregular contractions of the intestinal muscles.
- Repeated straining during bowel movements, which increases intra-abdominal pressure.
Risk Factors
Several factors are associated with the development of diverticula, including:
- Advanced age – more common in people over 60.
- Constipation.
- Sedentary lifestyle.
- Obesity.
- Smoking.
- A diet low in fiber and high in animal fat.
- Anatomical abnormalities of the intestine.
- Family history.
Complications
Diverticulosis may lead to:
- Diverticulitis: inflammation of the diverticula.
- Abscesses: accumulation of pus around the diverticula.
- Peritonitis: if the infection spreads, it may cause inflammation of the tissue lining the inside of the abdominal cavity.
- Gastrointestinal bleeding: one or more diverticula may cause bleeding that exits through the anus. Although it often stops on its own, surgery may be required to control it.
Prevention
The best way to prevent diverticulosis is to follow these recommendations:
- Exercise regularly.
- Eat foods rich in fiber (fruits, vegetables, legumes, whole grains).
- Drink plenty of fluids.
Which specialist treats diverticulosis?
Diverticulosis is diagnosed and treated by specialists in gastroenterology or internal medicine. When complications such as diverticulitis occur, a general and digestive system surgery may also be involved in treatment.
Diagnosis
Diverticulosis is diagnosed through the following tests:
- Colonoscopy: a flexible tube is inserted through the anus. Once inside the colon, a camera at the tip allows visualization of the inner lining. If polyps or abnormal cells are observed, they are removed during the same procedure for biopsy in the laboratory.
- Barium enema: a barium enema is administered to coat the large intestine, making it visible on X-rays. The radiographs capture images of the colon’s inner tissue.
- Computed tomography (CT) scan: while the patient lies on a table, they are placed inside a scanner that takes X-ray images of the abdomen from multiple angles, creating a three-dimensional view of the intestine.
Treatment
The main treatment for diverticulosis usually involves dietary changes. Adopting a high-fiber diet helps relieve potential symptoms and prevent the condition from worsening.
If symptoms worsen or the risk of complications increases, additional measures may include:
- Fiber supplements.
- Laxatives.
- Antispasmodics to control colon contractions.
- Pain relievers to reduce pain and intestinal pressure.
- Colonoscopy: sometimes used to seal persistent bleeding through a minimally invasive procedure.
- Surgery: may be necessary when bleeding is severe or recurrent, or to remove large diverticula.
