Symptoms of diverticulosis Diverticulosis is usually asymptomatic has no symptoms. However, when many diverticula pouches are present, the normal smooth working of the bowel can be affected.
This may cause a range of symptoms including: abdominal pain and bloating constipation and diarrhoea flatulence blood in the faeces — this is usually minor, but bleeding can sometimes be heavy if a diverticulum gets inflamed or is near a blood vessel anaemia from repeated bleeding may occur.
Many of these symptoms are similar to those of bowel cancer. Diverticulosis is more common, so these symptoms may be more likely to be due to diverticulosis than cancer. However, a specialist will usually assess these symptoms — your doctor will refer you. Symptoms of diverticulitis Symptoms of diverticulitis include: sharp pain, often located at a specific point — for example, in the lower left half of the abdomen fever distension bloating of the abdomen nausea and vomiting. Complications of diverticular disease Some of the possible complications of diverticular disease include: Abscess — untreated, diverticulitis may lead to an abscess a ball of pus.
Perforation — a weakened pocket of bowel wall may rupture. The contents of the bowel can then seep into the abdominal cavity. Symptoms include pain, high fever and chills.
A perforated bowel is a medical emergency. Peritonitis — perforation can lead to peritonitis infection of the membranes that line the abdominal cavity and abdominal organs. This complication is potentially life threatening. Haemorrhage — diverticula can be the source of haemorrhage.
When bleeding occurs, it is important to exclude other causes. A person with diverticulosis can also get cancer. Diagnosis of diverticular disease Since diverticulosis is often asymptomatic without symptoms , it tends to be discovered during examinations for other conditions such as colorectal cancer.
Diverticulitis is usually diagnosed during an acute attack. Tests to confirm the diagnosis of diverticular disease include: medical history — including dietary habits physical examination — including rectal examination colonoscopy — a slender flexible tube inserted into the anus so that the doctor can look at the entire length of the large intestine barium enema — a special contrasting dye flushed into the bowel via the anus and x-rays are taken CT scan — to detect abscesses outside the bowel lining blood tests — to check for signs of infection stool tests — to check for the presence of blood in the faeces or the presence of infections, which may mimic the symptoms of diverticulosis and diverticulitis.
Treatment for diverticulosis For a person with diverticulosis, there is no proven way to prevent the formation of new diverticula. Treatment revolves around the settling of symptoms. A gradual switch to a diet with increased soluble fibre green vegetables, oat bran and fibre supplements such as psyllium usually leads to an improvement in bowel habit and mild symptoms.
Some foods may make symptoms worse or even lead to diverticulitis. Nuts, seeds and pips are best avoided, while some people find avoiding legumes peas and beans and sweet corn also helps. Short-term use of laxatives to treat and prevent constipation may be advised. Rarely, elective surgery is performed to remove seriously affected bowel segments when symptoms are disabling.
Diverticulosis is quite common, especially as people age. Most people with diverticulosis will never develop symptoms or problems. Among people younger than age 50, diverticulitis is more common in men than in women. Research suggests that, in the United States, diverticulitis is more common in white Americans than in other groups, and diverticular bleeding is more common in Black Americans than in other groups. Some people with diverticular disease may develop serious complications.
For some people, complications may be the first sign of diverticular disease. Diverticular bleeding occurs when a small blood vessel within the wall of a diverticulum pouch bursts. Diverticular bleeding is a common cause of bleeding in the lower digestive tract.
The bleeding may be severe and life-threatening. After taking your medical history and listening to your symptoms, the GP may first want to rule out other conditions, such as irritable bowel syndrome IBS , coeliac disease or bowel cancer. This may involve blood tests.
If necessary, you'll be referred for a colonoscopy , a CT scan, or sometimes both. A colonoscopy is where a thin tube with a camera at the end a colonoscope is inserted into your bottom and guided up into your bowel. The doctor will then look for any diverticula or signs of diverticulitis.
You'll be given a laxative beforehand to clear out your bowels. You may be offered painkilling medicine and a sedative to make you feel more relaxed and reduce any discomfort. Sometimes you may need to have a CT scan. This might be done instead of a colonoscopy or in combination with one called a CT colonography or virtual colonoscopy. For a CT colonoscopy, the scan is done after you've had the laxative.
Eating a high-fibre diet may help ease the symptoms of diverticular disease and stop you developing diverticulitis. Good sources of fibre include fresh and dried fruits, vegetables, beans and pulses, nuts, cereals and starchy foods. Fibre supplements, usually in the form of sachets of powder that you mix with water, are also available from pharmacists and health food shops. Find out how to get more fibre in your diet.
Gradually increasing your fibre intake over a few weeks and drinking plenty of fluids can help prevent side effects associated with a high-fibre diet, such as bloating and farting.
Paracetamol can be used to relieve pain. Some painkillers, including aspirin and ibuprofen , should not be taken regularly as they can cause stomach upsets. Ask a pharmacist about this.
You may be prescribed a bulk-forming laxative to help ease any constipation or diarrhoea. If you have diverticulitis, a GP may recommend that you stick to a fluid-only diet for a few days until your symptoms improve. While you're recovering you should eat a very low-fibre diet to rest your digestive system.
Once the symptoms have gone, you can return to a higher-fibre diet, aiming to eat about 30g of fibre a day. Diverticulitis can usually be treated at home with antibiotics prescribed by a GP. You can take paracetamol to help relieve any pain. Talk to a GP if paracetamol alone is not working.
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