Diverticuli are small outpouchings or pockets in the wall of the colon. The term diverticular disease, or diverticulosis, describes the presence of these diverticuli.
Most diverticuli are asymptomatic. Two common complications are:
- Infection (Diverticulitis)
- Increasing age
- Low fibre diet
Most patients with uncomplicated diverticulosis are asymptomatic, with the diverticuli detected incidentally during colonoscopy, barium enema or CT colonography.
In the presence of infection, or diverticulitis, the patient may complain of:
- abdominal pain
- change in bowel habits.
Diverticuli may also present with rectal bleeding.
Medical attention should be sought in the presence of symptoms such as:
- Abdominal pain
- Change in bowel habits
- Rectal bleeding
Uncomplicated and asymptomatic diverticuli do not need to be treated. An increase in dietary fibre may be useful.
Complications of diverticuli such as diverticulitis and diverticular bleeding need specialized treatment.
In mild cases, antibiotics, fluids and bowel rest will suffice. In complicated cases of diverticulitis, there may be abscess formation, and this will need to be drained. In very severe cases, there may be perforation of the colon and surgery will be required to deal with the perforation.
2. Diverticular bleeding
Most diverticular bleeding episodes are self limiting. However in severe cases, intervention may be necessary. One possible option is angioembolization, where special haemostatic agents are injected into the bleeding vessel to stop bleeding. If bleeding persists, surgery may be necessary to remove the segment of colon which is bleeding.