Colonic diverticular disease - What is it?

Lots of people have small pouches of tissue that bulge outwards from their gut wall. Doctors call these pouches diverticula. Usually these pouches don't cause any symptoms, so many people never know they have them. But if the pouches do make you ill, your doctor may say you have diverticular disease.

Diverticula are a bit like an inner tube that pokes through weak places in a tyre.[1] You can have just one of these pouches (when it would be called a diverticulum). But most people have more than one. Some people have hundreds.[2]

Diverticula are pouches that bulge out of your bowel. Diverticula are usually quite small. Most measure half to 1 centimetre (about a quarter to half an inch) across. But some can be more than 2 centimetres (an inch) across.

You can get these pouches anywhere in your gastrointestinal tract, including in your throat (in your oesophagus, the tube that connects your mouth to your stomach), in your stomach and in your small intestine (the part of your gut just after your stomach, also called your small bowel).

But most happen in the last part of your large bowel (your large bowel is also called your colon). This part of your large bowel joins onto your rectum and is where stools stay before you go to the toilet. It's called the sigmoid colon, and it is on the left side of your abdomen.[1] But if you’re Asian you are more likely to get diverticula higher up in your colon.[2]

No one knows exactly why people get diverticula. But you may be more likely to get them if you don’t eat enough fibre.[3] Fibre is the part of fruits, vegetables and grains that your body can’t digest.

Without enough fibre you can get constipated. Your stools become hard and difficult to pass. If you strain to pass these stools, you put pressure on the inside surface of your colon. Doctors think this can cause diverticula.[2]

Your chances of getting diverticular disease increase as you get older. Men and women are equally likely to get it.[2] But men are more likely than women to get it before the age of 40.[2]

The names for conditions that can happen in diverticula can be confusing. Here are some that you may hear about.

Diverticulosis: If you’ve got diverticula but you don’t have any symptoms your doctor may say you have diverticulosis. About 7 in 10 to 8 in 10 people with diverticula have diverticulosis. Doctors may find out about the pouches during tests you’re having for another reason: for example, during a screening test for bowel cancer.[1]
Symptomatic diverticulosis (also called diverticular disease): If you get symptoms from diverticula your doctor may say you have symptomatic diverticulosis or diverticular disease.[1] [2]
Diverticulitis: In about 10 in 100 to 25 in 100 people with diverticular disease, the diverticula get inflamed or infected at some time in their life. This is called diverticulitis. This usually clears up in a few days with treatment that involves taking antibiotics. But sometimes, you may need an operation to remove the affected part of your colon.[4] If you have diverticulitis you may get serious complications, such as a ball of infected pus (called an abscess) or a blockage in your bowel so that you can’t pass stools.[4] To learn more, see What will happen to me?

References

National Institute of Diabetes and Digestive and Kidney Diseases. Diverticulosis and diverticulitis. October 2005. Available at http://digestive.niddk.nih.gov (accessed on 26 September 2007).
Stollman N, Raskin J. Diverticular disease of the colon. Lancet. 2004; 363: 631-639.
Painter NS, Burkett DP. Diverticular disease of the colon: a 20th century problem. Clinical Gastroenterology. 1975; 4: 3-21.
Salzman H, Lillie D. Diverticular disease: diagnosis and treatment. American Family Physician. 2005; 72: 1229-1234.

Glossary

gastrointestinal: Relating to the parts of the body that take food from the mouth to the anus including the oesophagus, stomach, and small and large intestines.
colon: Your colon is the first 2 metres (6 feet) of your large intestine. During digestion, food travels from your stomach to your small intestine and then to your large intestine. What's not digested then leaves your body as a bowel movement.
fibre: Fibre is all the parts of food that the body can't absorb. This is why foods that are high in fibre make you have more bowel movements. When your body can't absorb something, it leaves your body in your stools. Foods high in fibre include wholemeal bread and cereals, root vegetables and fruits.
constipated: When you're constipated, you have difficulty passing stools (faeces). Your bowel movements may be dry and hard. You may have fewer bowel movements than usual, and it may be a strain when you try to go.
inflammation: Inflammation is when your skin or some other part of your body becomes red, swollen, hot and sore. Inflammation happens because your body is trying to protect you from germs, from something that's in your body and could harm you (like a splinter) or from things that cause allergies (these things are called allergens). Inflammation is one of the ways in which your body heals an infection or an injury.
infection: You get an infection when an organism, such as a bacterium, a fungus or a virus gets into a part of your body where it shouldn't be. For example, an infection in your nose and airways causes the common cold. An infection in your skin can cause rashes such as athlete's foot. The organisms that cause infections are so tiny that you can't see them without a microscope.
antibiotics: These medicines are used to help the fight infection. There are a number of different types of antibiotics that work in different ways to get rid of bacteria, parasites and other infectious agents. Antibiotics do not work against viruses.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.