This is a very common condition which occurs due to the ageing of muscles that make up the wall of the large bowel. Small bulges develop as the internal layer of the bowel pushes outwards through the weakened muscle to form pockets called diverticulae. In many people, this process causes no problems or symptoms at all, however one in four people will develop symptoms from this condition.
The diverticulae (pockets) vary in size, and occasionally small amounts of faeces (stool) can get trapped in them. Over time the bowel wall becomes inflamed and this condition is called diverticulitis. The inflammation can flare up and subside without any medical intervention, however if the diverticulitis becomes more severe, treatment in hospital with antibiotics may be necessary, but this is rare.
Who gets diverticular disease?
50% of people aged 50 years
70% of people aged 80 years
Symptoms of diverticular disease
Left sided abdominal pain
Prevention of diverticular disease
It is thought that a high-fibre diet can help the large bowel function more efficiently. Regular light to moderate exercise can also keep your bowel functioning normally. It is recommended that an otherwise healthy person drinks two to three litres of water over the course of a day.
Treatment and management of diverticular disease
Traditional advice was to eat a high-fibre diet. However, it is now thought that a low-fibre or low-residue diet can ease the symptoms when there is a flare up or suspected inflammation. This reduces the likelihood of waste matter brushing against and irritating the affected bowel wall.
Regular doses of paracetamol can be used to relieve pain. Avoid products containing codeine or opiates, as these cause constipation. Where you must take these for other painful conditions, your doctor may prescribe laxatives to help you open your bowels.
Symptoms of diverticulitis
- Feeling generally unwell (flu-like symptoms)
- High temperature (above 38oC)
- Acute tenderness and pain in the abdomen (tummy)
- Rectal bleeding
- Nausea and vomiting
- Becoming pale and clammy
- Palpitations, feeling that your heart is beating very fast
- Generalized weakness and fatigue
If these symptoms develop and you feel acutely unwell, go immediately to your nearest Accident & Emergency department or call an ambulance.
Is there a link with bowel cancer?
There is no proven link between bowel cancer and diverticular disease. Diverticular disease makes the colon more rigid, and this may make the process of diagnosing bowel cancer through colonoscopy more challenging. If this is the case, another form of test may be used.
If you are experiencing any of the symptoms of diverticular disease for three weeks or more, our advice is to talk to your GP. The symptoms of diverticular disease and bowel cancer can be very similar, so symptoms need to be fully investigated before a diagnosis of diverticular disease can be accepted. Investigations may include bowel imaging, which could be flexible sigmoidoscopy, colonoscopy, CT colonography or a combination of these tests. Please see Tests and Investigations for more information about these procedures.
There is more advice at NHS Choices.