Diverticular Disease Of The Colon

Diverticula of the colon occur due to our western diet, leading to constipation which increases the pressure needed to propel stool forward. The wall of the colon has weak areas where blood vessels penetrate the muscle layer of the colon. It is through these weak areas that the inner layer (mucosa) of the colon can herniate and form diverticula. With advancing age, most people will develop some degree of diverticular disease. Fortunately, in the majority of people, this condition is completely asymptomatic.

The following complications can, however, occur secondary to diverticular disease:

What are the symptoms of diverticular disease?

Majority of patients with diverticular disease will be completely asymptomatic. If symptoms develop they may include any of the symptoms described above.

How is diverticular disease treated?

Diverticular disease is very common, and when completely asymptomatic, it requires no treatment. Once complications occur, some form of treatment is usually indicated. Simple diverticulitis usually responds well to antibiotics (either as in- or outpatient). In recent years the treatment of diverticular abscess / peritonitis has moved away from aggressively resecting the involved segment of bowel (which led to high rates of colostomies) to a more conservative approach where drainage (percutaneous, laparoscopic or open) of the abscess or abdominal washout would first be attempted, and surgical resection of the colon (if still indicated) can then be delayed and a colostomy avoided. To treat fistulas or strictures, Dr Cooper may resect the diseased portion of bowel and perform a primary anastomosis to restore intestinal continuity. Bleeding complications from diverticular disease are, fortunately also uncommon. In the minority of cases it can be severe and Dr Cooper may recommend surgery to resect the affected part of the colon. In most other cases the bleeding will be self-limiting. The decision on when to intervene surgically in these cases can be difficult and will depend on many factors.