Definition

Diverticulosis is the presence of pockets (diverticula) that develop on the wall of the large intestine or colon. They occur at weak areas in the bowel wall and are usually found on the left side (called the sigmoid colon), but they can be found anywhere throughout the colon.

Causes

Diverticula occur gradually over time and are due to excessive pressure or spasms within the bowel. The amount of fiber and fluid intake affects what kind of action occurs in the bowel. The American diet is high in processed foods with natural fiber being removed. When fiber and fluid are lacking, the stool becomes hard and dry; the muscles in the wall of the colon need to squeeze with greater force, causing a bulge to form in the colon wall, which eventually becomes a pocket or diverticulum.

Symptoms

Most people with diverticulosis have no symptoms. If they do, possible symptoms include left lower abdominal pain, diarrhea, cramps, and change in bowel habits. Some patients with diverticulosis can have severe rectal bleeding. These symptoms can also be the result of other conditions. An examination is necessary to make the correct diagnosis.

Diagnosis & Treatment

The prevention of diverticulosis and treatment of its symptoms are managed in the same way– with diet, and occasionally with medication. Dietary fiber should be increased to 25 grams daily and liquid intake to 8-10 glasses daily. High-fiber foods and commercial fiber products add bulk to the diet, which helps achieve regular bowel habits. Fiber holds water, which helps to soften stool; soft stool requires less pressure to move it through the colon, which may reduce or even stop diverticula formation.

High-fiber foods can be found in most food groups:

    • Legumes–The bean family excels in fiber, especially the soluble, cholesterol- lowering type. They include kidney, pinto, navy, lima, and baked beans.
    • Whole grains–Wheat bran and oat bran are present in a variety of cereals and breads. The label should say that the bread contains whole wheat or whole grain. Plain wheat bread may lack fiber. One cannot always tell by the color. Some manufacturers artificially color bread brown to make it look more wholesome.
    • Whole fresh fruits– Valuable pectin fiber is found in the skin and pulp. Figs, prunes, and raspberries have the highest fiber content.
    • Cooked or stewed fruits–Prunes and applesauce are good choices.
    • Green leafy vegetables–Lettuce, spinach, celery, and broccoli are good examples.
    • Root vegetables–Potatoes, turnips, and carrots are excellent sources.

Since fiber can cause rumbling intestinal gas and even some mild cramping, the amount taken should be increased gradually. The goal should be 25 to 35 grams of fiber each day, which will usually produce one to two soft, formed stools a day.

Visit the American Society of Colon & Rectal Surgeons website for more information