Publication date Sep 14, 2007
Diverticular disease can lead to painful cramps in your abdomen. There's no cure for diverticular disease. But some doctors think eating more fibre might help. There are also some treatments that can help control the symptoms.
Lots of people have small pouches of tissue that bulge outwards from their gut wall. Doctors call these pouches diverticula. If you get symptoms from these pouches, your doctor may say you have diverticular disease.
Diverticula are a bit like an inner tube that pokes through weak places in a tyre. You can have just one of these pouches. But most people have more than one. Some people have hundreds.
You can also get these pouches in other places like your throat (oesophagus), your stomach and your small bowel. But most happen in the last part of your large bowel (your colon). That’s why this condition is also called colonic diverticular disease.
No one knows exactly why people get diverticula. But you may be more likely to get them if your diet is low in fibre. Fibre is the part of fruits, vegetables and grains that your body cannot digest.
The most common symptoms are painful cramps in the lower part of the abdomen, usually on the left side.
Your pain may come and go, or it may be constant. It often starts after you've had a meal and gets better when you pass wind or a stool.You may also feel bloated and notice a change in your bowel habits, with your stools getting looser or, more often, harder.
Most doctors recommend a test called colonoscopy for people who might have diverticular disease. During this test, your doctor will use a thin, flexible tube with a light and camera at the end (called a colonoscope) to look at the inside of your colon. The tube is put in through your back passage and slowly pushed into your colon.
Sometimes these pouches bleed. When this happens, you may see a lot of blood in your stools. But the bleeding usually stops by itself and doesn't need treatment. If you get blood in your stools, you should see your doctor. If the bleeding doesn't stop, you may need an operation.
If one or more pouches become inflamed or infected, doctors say you have diverticulitis. You may:
Your doctor will examine you and may test your blood for signs of infection. That may be enough to confirm the diagnosis and start treatment.
But if your doctor is not sure whether you have inflamed diverticula, you may be referred to hospital for more tests.
Antibiotics are the main treatment for diverticular disease. We know antibiotics work, even though there hasn’t been much research. They might be used if your symptoms are severe, or if you get inflammation or an infection (when it’s called diverticulitis).
If you have a serious infection you may need to be treated in hospital with antibiotics through a drip (intravenous antibiotics).
There hasn’t been as much research on these treatments as there has been on antibiotics. But they might help with some symptoms.
If you get a serious infection or a blockage in your colon you will probably need emergency surgery. This operation involves cutting away the damaged part of your colon and joining the healthy sections back together. It is called colonic resection.
Your symptoms may be mild and you may have long periods when you don’t have any problems. Or, your condition may be more severe, with symptoms almost constantly.
If one or more pouches become inflamed or infected (when it's called diverticulitis), you will need to be treated with antibiotics. If you are not too ill you probably can be treated at home. But if your symptoms are more severe you will need to be treated in hospital. You’ll probably be put on a liquid diet or fed through a tube to rest your colon.
Most people get better with this kind of care. But 15 to 30 in every 100 need an operation to remove the affected part of their colon. This is sometimes because the antibiotics haven't worked or because of complications. The most common complications are:
If you have had an attack of diverticulitis and didn't get complications, you have about a 1 in 3 chance of having a second attack. Second attacks are usually more serious than first attacks and more difficult to treat. After a second attack, you have a 1 in 2 chance of having a third one.
Because of this increased risk, some doctors recommend that people who have had two attacks should have an operation to remove the diseased part of their colon.
Some operations for diverticular disease can be done using laparoscopic surgery (also called keyhole surgery). This is when surgeons make very small cuts in the abdomen and use a narrow tube with a camera to see the colon. To remove the diverticula, the surgeon uses small operating tools through other small cuts in the abdomen. People who have this kind of surgery usually have less pain and recover more quickly than people who have surgery through a large cut in their abdomen. There’s no research to say whether surgery using large cuts is safer than keyhole surgery, using much smaller cuts.
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.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
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.