By William N. Segal, MD
So, you had your screening colonoscopy, and the results were negative. No cancerous or pre-cancerous growths.
But your doctor did tell you that you have a condition called diverticulosis.
You may not be familiar with this type of diagnosis.
Here’s what you need to know.
Common in the United States
Diverticulosis is a condition characterized by the formation of small pockets in the lining of your colon. These pockets are caused by increased stress on the lining of the bowel wall.
Diverticulosis is common in the United States, especially as people age. More than 30% of U.S. adults between the ages of 50 and 59 and more than 70% of those older than age 80 have diverticulosis, according to the National Institutes of Health (NIH).
Among people younger than age 50, diverticulosis is more common in men than in women, according to the NIH. After age 50, the condition is common in both men and women.
Doctors believe that in Western countries diverticulosis is typically linked to not eating enough fiber. Low-fiber diets cause stools to be harder and stress pockets to form. In parts of the world where diets are very high in fiber, there appears to be a lower incidence of diverticulosis.
Diverticulosis is usually diagnosed during a routine colonoscopy to screen for colorectal cancer or incidentally on a CT scan of the abdomen or pelvis.
Most people do not know they have diverticulosis unless they have one of these studies.
Complications
While in most cases diverticulosis does not cause any symptoms or complications, in some instances the pockets can become infected. When this occurs, it is called diverticulitis. In the United States each year, 200,000 people are hospitalized for diverticulitis and about 71,000 people are hospitalized for diverticular bleeding, according to the NIH.
Symptoms of diverticulitis can include:
• Abdominal pain, usually but not always on the left side of the abdomen.
• Fever.
• Changes in bowel habits.
Occasionally, the infection can cause an abscess (a pocket of infection) or a bowel perforation.
The other major problem that diverticulosis may cause is rectal bleeding. While there may be a significant amount of bleeding, it usually stops on its own.
If you have symptoms of diverticulitis or experience rectal bleeding, contact your physician.
Diagnosis and Treatment
Diverticulitis is typically diagnosed with a medical exam or by CT scan. Treatment is usually a one- to two-week course of antibiotics.
If a bowel perforation or an abscess occurs, surgery to treat the infection and repair the bowel may be necessary. Surgery may also be recommended for individuals who have frequent bouts of diverticulitis.
At Penn Medicine Princeton Health, minimally invasive colorectal surgery can often be performed with a robotic surgical system, which typically results in a faster recovery time, including a quicker return to regular bowel function.
In circumstances where rectal bleeding persists, treatment by an interventional radiologist, gastroenterologist, or a surgeon may be necessary to stop the bleeding.
Prevention
Once diverticulosis develops, it does not go away, though as the NIH notes, there are steps you can take to help prevent complications:
• Eat a diet high in fiber and low in red meat.
• Be physically active on a regular basis.
• Don’t smoke or quit smoking if you smoke.
• Reach and maintain a healthy weight.
If you are diagnosed with diverticulosis after a colonoscopy, remember, only a small minority of people with the condition will develop complications. However, if you do experience symptoms, contact your physician. Treatment is available.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
William N. Segal, MD, is a board certified gastroenterologist and a member of the medical staff at Penn Medicine Princeton Health.