Brief overview
- Symptoms: Usually no symptoms, otherwise irritable bowel-like complaints
- Diagnosis: Usually an incidental finding during colonoscopy or X-ray imaging
- Treatment: Dietary measures such as a high-fiber, low-meat diet, sufficient fluid intake, physical activity
- Causes and risk factors: Recurrent constipation over many years, risk factors: Age, obesity, other illnesses
- Disease progression and prognosis: Sometimes progresses to diverticular disease or diverticulitis with symptoms, high-fibre diet and healthy lifestyle have a positive effect on prognosis
- Prevention: Consider treatment measures
What is diverticulosis?
Doctors refer to diverticulosis as the presence of several diverticula in the area of the large intestine that do not cause any symptoms. In Western countries, diverticulosis is now one of the so-called diseases of civilization.
Doctors assume that an increasingly low-fiber diet plays a particularly important role in diverticulosis: Too little fiber results in hard and firm stools, which initially manifests itself in frequent constipation in most sufferers.
Doctors basically distinguish between two forms of diverticula:
- The most common are so-called false diverticula or pseudodiverticula. Here, the intestinal mucosa protrudes outwards through a tiny gap in the muscular intestinal wall. Blood vessels that supply the intestine with blood often pass through the intestinal wall at these points.
- True diverticula, in which the muscular wall of the intestine also bulges outwards, are rarer. These diverticula are more often congenital than diet-related and are more common in people from Asian countries.
While true diverticula usually occur in the ascending area of the colon (ascending colon), false diverticula, which are much more common in Europe, mainly form in the descending colon (descending colon) and in the last area of the colon (sigmoid colon).
In the vast majority of cases, diverticula appear in the large intestine. However, it is generally possible for diverticula to occur in the entire digestive tract, for example in the esophagus or small intestine.
What is sigmoid diverticulosis?
Sigmoid diverticulosis refers to diverticula in a specific section of the large intestine. The name of this section of the intestine is the sigmoid colon or sigmoid loop.
The causes for the frequent occurrence of sigmoid diverticulosis are:
- This is where a particularly large number of blood vessels run, resulting in a weak point in the intestinal wall.
- In the sigmoid loop, the pressure on the intestinal walls is high.
- In addition, the normally undulating intestinal movements stop abruptly (bruise-like) in front of the rectum.
What symptoms does diverticulosis cause?
Diverticulosis usually shows no symptoms (asymptomatic). Pain and digestive complaints are initially absent for a long time. The diverticula themselves are also not painful. However, depending on the number, size and location of the protrusions, irritable bowel-like symptoms sometimes occur over time, such as
- Painful urge to defecate (tenesmus) and/or slight pain, especially in the left lower abdomen
- Stool irregularities, often alternating between constipation and diarrhea
- flatulence
In principle, diverticula do not cause illness, but if symptoms occur, this changes. Doctors then refer to diverticulosis as diverticular disease or diverticulitis. It is characterized by symptoms such as severe pain, blood in the stool or persistent constipation. This is usually caused by inflammation of the diverticula or other complications of diverticulitis.
How can diverticulosis be diagnosed?
Diverticulosis is often an incidental finding, as it remains symptom-free for a long time and therefore often goes undetected. It is usually discovered by doctors during a colonoscopy. In addition, diverticula can usually also be easily recognized on an X-ray with contrast medium in the bowel and can therefore be diagnosed by doctors.
You can find out more about the diagnosis of diverticulitis under: Diverticulitis.
How can diverticulosis be treated?
In most cases, diverticulosis is caused by a low-fiber diet, too little fluid and/or lack of exercise. These are all factors that encourage constipation and promote the formation of diverticula in the long term. In addition, diverticulosis is more likely to lead to complications such as diverticulitis or bleeding of the diverticula due to certain dietary errors.
Existing diverticulosis can usually be easily managed by changing your diet and other lifestyle habits. The most important thing is
- More exercise: Daily walks and regular endurance training (such as jogging, swimming) support bowel activity.
- Drink plenty: At least two liters of water or tea a day ensure that the stool remains “smooth”.
How does diverticulosis develop?
Increased internal intestinal pressure and weakened intestinal walls play a role in the development of diverticulosis. If the internal pressure in the intestine is repeatedly increased over years, for example due to constipation, the intestinal mucosa sometimes bulges outwards at certain points. Diverticula often develop in this way.
There are also other risk factors for the development of diverticulosis. Risk factors that can be influenced include diet and exercise:
- Obesity
- High consumption of red meat
- Smoking and excessive alcohol consumption
There are also factors that cannot be influenced. These include
- age
- Diseases such as high blood pressure, diabetes mellitus (diabetes), polycystic kidney disease or an underactive thyroid (hypothyroidism)
- Genetic diseases of the connective tissue, for example Marfan and Ehlers-Danlos syndrome
How does diverticulosis progress?
If you have diverticulosis, it is advisable to pay careful attention to your diet and other lifestyle habits. In this way, it is possible not only to minimize the risk factors, but also to positively influence the prognosis.
Can diverticulosis be prevented?
The best way to prevent diverticulosis is to reduce the risk factors that can be influenced. The main focus here is on a high-fiber, low-meat diet, sufficient fluid intake and physical activity. All of these measures ensure healthy bowel function and counteract constipation – and therefore the development of diverticula.
You can find more tips on nutrition for diverticulosis and diverticulitis here: Diverticulitis nutrition.
