The title is a little misleading. Diverticulosis is a condition in which a person has developed diverticula – small pouch-like structures – in the digestive system. Normally, they’re harmless and may persist for long periods, even a lifetime. It’s only when they become infected or inflamed that diverticulitis, the actual illness, occurs, generally to about 15% of those with diverticulosis.
The symptoms include abdominal pain, fever, nausea, and a radical change in bowel habits. The pain is often severe and may come on suddenly, usually in the lower left side of the abdomen. Vomiting is possible and constipation and/or diarrhea are common.
Those symptoms result when those marble-sized pouches rupture or become infected. The causes of the change are not known but several factors that make it more or less likely have received careful study. Simple aging is one risk factor, since it tends to produce both a weakening in portions of the intestine as well as changes in elasticity of the bowel. However, there are several risk factors that are within our control.
Lack of exercise and the often associated obesity contribute to the chances of developing diverticula, and for them to change in a harmful way. But the major cause is thought to be diet, in particular too low an intake of fiber. Fiber helps lend bulk to stools while at the same time absorbing water to keep them soft.
When the condition is allowed to develop, there are several secondary complications that may result from diverticulitis. A blockage may occur, caused by scarring. Abscesses are possible when pus collects in the pouch. But the most common and most serious, at least when the condition progresses, is peritonitis.
If a diverticulum ruptures, the contents of the digestive system spill into the abdominal cavity, which is lined with tissue called a peritoneum. The resulting inflammation is called peritonitis. When this happens, immediate care is a must, usually surgery. The toxins can poison the body in a short period, marked by symptoms such as spike in the white cells and an associated high fever.
Fortunately, that is far from a foregone conclusion. Changes to the diet – the addition of fiber mentioned above – are the simplest method of prevention and ‘treatment’. A temporary liquid diet, typically only for a few days, is another effective alternative. Antibiotics may be recommended to prevent or treat infection.
In more severe or advanced cases, corrective surgery may be required. In some cases that involves what is known as a primary bowel resection, a procedure in which the affected area is removed and the bowel sewn back together, minus that part.
What is required can, of course, only be determined by a professional diagnosis. That is typically as painless (and harmless) as having a CT (computer tomography) scan. A radiologist directs a series of computer-controlled X-ray bursts at the abdomen and the results are recorded and analyzed. A CT scan may also be performed as part of treatment, in order to guide a physician to drain any abscess that has occurred.
To head all that off, be sure to exercise regularly in an age-appropriate way, eat plenty of fiber, and drink plenty of fluids. Fiber supplements (such as Metamucil or Citrucel), properly used, are also beneficial.