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Diverticular Disease

What Is Diverticular Disease?

Contributors to this article: 

Farid Naffah MD
Guy Slowik FRCS

Last updated on:
16/04/2013

Diverticular disease is a condition in which small pouches, called diverticula, develop in the wall of the colon, or large intestine.

The pouches develop at weak spots in the wall of the colon. These weak spots occur because of excess pressure in the colon, or existing weakness in the colon wall, that eventually bulge out to form pouches.

The increase in pressure in the colon is commonly caused by constipation due to lack of fiber in the diet.

Most pouches occur in the sigmoid colon-the lower left part of the large intestine that connects to the rectum.

The condition is common in older people, affecting about half of Americans by age 60 and nearly all by age 80. Only a small percentage of those with diverticula will have symptoms.

In a small number of people who develop diverticula, the diverticula become inflamed or infected. This condition is known as diverticulitis.

Need To Know:

  • A single pouch is called a diverticulum.
  • Many pouches are diverticula.
  • The name for the condition of having diverticula is actually diverticulosis.
  • If the pouches become inflamed or infected, causing symptoms, then you have diverticulitis ("itis" means inflammation).
  • Diverticular disease is a general term for the condition.

Diverticular disease was virtually unheard of before a hundred years ago. It has become common in western countries-especially the United States, England, and Australia-where the average diet consists of processed foods that are low in fiber.

The change in the way wheat was processed into flour at the turn of the century-from a crushing to a finer rolling process-accounts substantially for the depletion of fiber in our diets.

The condition is far less widespread in Asian and African countries, where diets still include large amounts of fiber. However, with economic development and changes in diet, the incidence of diverticular disease is increasing in African countries.

Need To Know:

What is Fiber?

Fiber is the cell walls of plants. It is found mainly in the outer layers of plants - the parts of plant cells that are not digested in the intestine. It is a special type of carbohydrate that passes through the human digestive system virtually unchanged, without being broken down into nutrients.

Carbohydrates are the main source of energy for all body functions, especially brain functions. Cereals, vegetables, fruits, rice, potatoes, legumes, and flour products are major sources of carbohydrates.

There are two main types of fiber, and they have different effects on the body:

  • Insoluble fiber is mainly made up of plant cell walls, and it cannot be dissolved in water. It has a good laxative action.
  • Soluble fiber is made up of polysaccharides (carbohydrates that contain three or more molecules of simple carbohydrates), and it does dissolve in water. It has a beneficial effect on body chemistry, such as lowering blood cholesterol and blood sugar levels.

Fiber has an influence on the digestion process from start to finish:

  • Because foods containing fiber need to be more thoroughly chewed, fiber slows down the eating process and helps contribute to a feeling of being full, which in turn can help prevent obesity from overeating.
  • Fiber makes food more satisfying, probably because the contents of the stomach are bulkier and stay there longer.
  • Fiber slows digestion and absorption so that glucose (sugar) in food enters the bloodstream more slowly, which keeps blood sugar on a more even level.
  • Fiber is broken down in the colon by bacteria (a process called fermentation), and the simple organic acids produced by this breakdown helps to nourish the lining of the colon.
  • These acids also provide fuel for the rest of the body, especially the liver, and may have an important role in metabolism

The following are good sources of fiber:

  • Whole grains (bran has the highest fiber content, about 25 to 45 percent)
  • Nuts and seeds
  • Legumes
  • Fruits
  • Vegetables
  • A dietary supplement of fiber products such as Citrucel or Metamucil

For further information about fiber, go to Fiber: Its Importance In Your Diet.

Facts about diverticular disease

  • Doctors estimate that half of all Americans between ages 60 and 80 have diverticular disease, and that almost everyone over 80 has the condition. It is rarely found in those younger than 40.
  • Western societies consume only about 10% of the fiber that they did 100 years ago.
  • Diverticular disease and its complications affect men and women equally.
  • The vast majority of those affected never develops symptoms and remains unaware that they have the condition.
  • In about 10 to 25 percent of the people who have diverticula (small pouches in the wall of the colon), the diverticula become inflamed and infected. This causes diverticulitis.

 

Edited by Guy Slowik MD FRCS.