What's your experience with diverticulosis

This helps when diverticula cause discomfort

Protuberances in the intestine

11/22/18 (ams). They are small, balloon-shaped and bulge outwards through weak points in the intestinal wall: the diverticula. In most cases they are harmless, but they can cause intestinal discomfort and pain. The good news is, "Diverticula that don't cause discomfort don't need treatment. And sometimes a change in diet can help ease digestive problems," says Dr. Julian Bleek, doctor in the AOK Federal Association.

Pain in the left lower abdomen, possibly a slight fever, constipation, diarrhea, gas, nausea, sometimes cramps: These symptoms can indicate problems with diverticula, a disease of the diverticulum. The symptoms often go away temporarily, but they can also be permanent. They are often stronger after eating, but weaker after a bowel movement.
Little is known that diverticula can lead to digestive problems and sometimes serious complications, although according to the Institute for Quality and Efficiency in Health Care (IQWiG) around half of people over the age of 70 have such protrusions. For those under 50, it is only one in ten.

Depending on the symptoms, such protrusions of the intestine can be further differentiated into diverticulosis, diverticular disease and diverkulitis. In diverticulosis, the inner wall of the intestine bulges outward in several places. However, the protuberances do not cause any discomfort. If the diverticula cause discomfort or complications, it is diverticular disease. If the protuberances become inflamed, one speaks of diverticulitis.

Weak bowel muscles

Diverticula arise in places where the intestinal muscles are weaker. They usually form in the sigma, a 40 to 45 centimeter long section of the large intestine. In this S-shaped area in front of the rectum, the pressure of the stool on the intestinal wall is highest. Some people are hereditary more prone to such protuberances. Weak connective tissue and disturbed bowel movements are further risk factors. Elderly and very overweight people are also more likely to have diverticulosis. In addition to genetic predisposition, lifestyle and diet can also play a role. For example, a low-fiber diet can lead to constipation and solid stools, which increase pressure on the intestinal walls. The consumption of a lot of red meat such as beef or pork as well as smoking and too little exercise are also possible. In order to rule out the possibility of another illness with similar symptoms, the doctor asks about previous illnesses and the use of medication, among other things, and carries out a physical examination. They also do blood and urine tests, and an ultrasound scan is often done. If the situation is unclear, computed tomography or a colonoscopy can also be performed.

In the case of mild, uncomplicated diverticulum disease, a change in diet and sufficient fluid intake often help to alleviate the digestive problems. The main focus is on high-fiber foods such as fruit, cereals, vegetables and legumes. It makes the stool softer, more voluminous and stimulates digestion. As a result, it gets through the intestines faster and the pressure on the intestinal wall decreases. Exercise also stimulates digestion; it is still unclear whether it can prevent complaints. If the diverticula become infected, regular medical check-ups are advisable in order to detect complications at an early stage. In the case of an uncomplicated course, antibiotic therapy can then be dispensed with.


Ready-to-broadcast radio o-tones with Dr. Julian Bleek, doctor in the AOK federal association

Breakthrough of the bowel is rare

If there are already accumulations of pus (abscesses) or if the inflammation continues to spread, antibiotics are necessary. If the antibiotics are unable to limit the inflammation, surgery may be necessary to avoid serious complications such as a perforation in the intestine or inflammation of the peritoneum (peritonitis). In rare cases, the intestine ruptures and an operation must then be performed immediately. In some people, the diverticula keep getting inflamed. Around every fifth person affected will develop it again at least once in the years after treatment.

However, the risk of complications is highest with the first diverticulitis. If the inflammation recurs, the risk drops significantly. The main consequences are chronic complaints such as irregular stool, flatulence and abdominal pain. However, colon cancer does not develop from diverticula. This arises from intestinal polyps. These are benign growths of the intestinal lining that can develop into a malignant tumor. It used to be assumed that residues of certain foods such as nuts, grains, corn or popcorn get stuck in the diverticula and promote inflammation. However, this could not be proven in studies.


Additional Information:


To the ams guide 11/18

© 2016 AOK Federal Association