Diverticula (bowel pouches)
Many people over the age of 50 have diverticula in their colon (lower bowel). A diverticulum is a small pocket, or pouch, of intestine that bulges through the layers of muscle that line our bowels, rather like the way the inside of a tyre might bulge through a weak area on its surface.
Diverticula usually cause no serious problems. However one in five people with them will experience some symptoms, in which case they are classified as having diverticular disease.
An affected person may have just one or 2 of these little pouches, or much larger numbers.
It is generally believed that the main cause of diverticula is the modern Western diet. The condition is rare in people who eat a predominantly vegetarian diet, with high amounts of fibre. People whose diet is low in fibre tend to develop higher pressures inside the bowel, which may be increased when they strain to pass a motion. It is easy to see how this increased pressure can cause areas of bowel to ‘pop’ through the muscle lining.
Diverticular disease can produce symptoms of pain (usually in the lower left side of the abdomen), wind, altered bowel habit and sometimes quite dramatic bleeding. If infection develops in a diverticulum the condition is called diverticulitis. The affected person may be quite seriously ill with severe pain and a high temperature. If the infected diverticulum bursts, life-threatening peritonitis can occur. Treatment with antibiotics is necessary when diverticulitis occurs.
The main treatment for simple diverticular disease is strict attention to the diet, with an emphasis on plenty of fibre, and avoiding constipation. If someone gets recurrent attacks of diverticulitis, and their diverticula are localised to a particular section of bowel, surgery to remove the offending area can help greatly.
The diagnosis of diverticular disease is made either by X-ray (barium enema) or direct examination through a flexible telescope-like instrument known as a colonoscope. These tests are vitally important because the symptoms of diverticular disease closely resemble those of bowel cancer, which is more serious and becomes increasingly common with age.
Last Reviewed: 26 February 2002
