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Diverticular Disease


Major Spencer
Diverticulosis is a common condition, affecting roughly 35 percent of adults under age 50 in the United States, and more than half of adults over 60. When diverticulosis causes symptoms or problems, it's called diverticular disease. Dr. Jerman, can you tell us more about diverticulosis and diverticular disease?

Dr. Jerman
Absolutely, Major Spencer. Diverticulosis is a condition that occurs when small pouches, or sacs, form and push outward through weak spots in the wall of the intestines, similar to potholes in a road. One pouch is called a diverticulum, and multiple pouches are called diverticula. Diverticula are most commonly found in the lower part of the colon, called the sigmoid colon, but they can occur anywhere in the intestines. A special type of diverticulum, called a Meckle's diverticulum, is usually found in the lower part of the small intestine. For most people, diverticulosis does not cause any symptoms or problems.

Diverticular disease occurs when diverticulosis does cause symptoms, such as changes in bowel movement patterns or pain in the abdomen. Diverticula in the upper small intestine can cause bloating and nausea from bacterial overgrowth. Meckle's diverticula have an especially high risk of bleeding. Other problems that can result from diverticulosis include diverticular bleeding and diverticulitis.

Diverticular bleeding occurs when a small blood vessel within the wall of a diverticulum bursts. Diverticulitis occurs when one or more diverticula become inflamed. Although diverticulitis develops in less than five percent of people with diverticulosis, it can lead to other serious complications.

One potential complication of diverticulitis is the formation of an abscess, which is a painful, swollen, pus-filled pocket of infection. An abscess can cause nausea, vomiting, fever, and severe abdominal tenderness.

Diverticulitis can also cause a perforation, or a small tear or hole in a diverticulum. If pus and stool leak through a perforation, it can cause peritonitis, which is inflammation or infection of the lining of the abdomen.

A fistula is another potential complication of diverticulitis. A fistula is an abnormal passage between two organs or between an organ and the outside of the body. The most common types of fistula caused by diverticulitis occur between the colon and the bladder or between the colon and the vagina in women.

An intestinal obstruction, which is a partial or total blockage of the intestines, may also result from diverticulitis. The obstruction prevents food and stool from moving through the intestines.