Diverticular Diseases

More and more frequently, people suffer from diverticular diseases. In most cases, the sac-shaped protrusions of the intestinal wall do not cause any symptoms – but if they do, those affected should seek medical help immediately. A diet rich in fiber prevents the formation of diverticula as well as more severe consequences of this disease. The number of diverticular diseases has increased steadily in Western industrialized countries in recent decades. An incidence rate of 7 to 12 percent is assumed for 40- to 60-year-olds, while 40 to 50 percent of those over 60 are affected. This makes diverticulosis one of the most common colon diseases.

Definition: what are diverticula?

Diverticulum in Latin means deviation, deviation. Diverticula are small, sac-like projections. They can occur in a variety of organs. If no more specific information is given, it generally refers to outpouchings of the colon wall. If these protrusions do not occur in isolated cases but in larger numbers, they are referred to as diverticulosis. If the diverticula become inflamed, it is diverticulitis.

Causes: How do diverticula develop?

The exact cause of the protrusions has not yet been clarified. However, it is assumed that the comparatively low-fiber diet in the Western world plays an important role. For example, vegetarians consume much more fiber than “meat eaters” – and are much less likely to be affected by diverticulosis.

Symptoms: What kind of symptoms can occur?

Not all diverticulosis automatically causes symptoms – 80 percent of those affected have no symptoms at all. Often, the outpouchings are discovered by chance during a colonoscopy. Only 20 percent of sufferers experience health problems, for example flatulence, abdominal pain, especially in the left lower abdomen, or constipation alternating with diarrhea. Serious complications are rare, but require immediate medical attention, for example if there is blood in the stool. If the diverticula become inflamed, diverticulitis occurs. In this case, the symptoms are similar to those of appendicitis:

  • Cramp-like pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Usually also fever

Diverticula in the esophagus

Outpouchings of the mucosa can appear in other places in the body – the best known are diverticula of the esophagus. This is because the latter has bottlenecks in three places:

  • The first is strictly speaking in front of the actual beginning of the esophagus: where the trachea and esophagus emerge from the pharynx. Here, the musculature surrounding the mucosa is relatively thin, so that a diverticulum can quickly bulge out. This diverticulum is called a Zenker diverticulum. Typical complaints are food residues, which are found in the morning undigested back in the mouth, sometimes a feeling of tightness in the throat.
  • Other diverticula are often found in the area where the two main bronchi depart from the trachea.
  • Diverticula can also occur just before the end of the esophagus, where it leaves the chest cavity and passes through the diaphragm.

All diverticula can be removed in laparoscopic surgery if the symptoms are severe.

The right diet for diverticular disease.

Existing diverticula do not regress on their own. However, a diet rich in fiber prevents complications as well as the formation of further diverticula in the intestine and is therefore recommended for prevention and for symptom-free affected persons. For the daily diet this means:

  • Whole grain products and vegetables and fruits should be abundant on the menu
  • Animal products such as meat, sausage or eggs should be reduced

So that the intestine can slowly get used to such a diet, the change should be gradual and slow. In addition, very important: drink plenty of fluids, so that the dietary fiber has enough. The daily intake of wheat bran can further increase the fiber content of the diet.

Surgery and other forms of treatment

When diverticulitis is present, your doctor will take steps to treat it in order to contain the inflammation and thus avoid surgery (OR). These include requiring affected individuals to abstain from solid foods until the inflammation subsides, feeding them with IV fluids usually as part of a hospital stay, and giving them antibiotics.If the section of bowel has to be removed because it keeps getting inflamed, this can usually be done in a laparoscopic operation – only in the case of severe inflammation and a complication such as a bowel rupture is immediate open emergency surgery sometimes necessary.