Comparing Diverticulosis and Diverticulitis: Key Factors to Understand
Diverticulitis is a common digestive condition characterised by inflammation in small pouches called diverticula that develop along the walls of the gastrointestinal tract, most commonly in the colon.
The main cause of diverticulitis inflammation is a tear or rupture in a diverticulum, leading to inflammation and sometimes infection. This can result from increased pressure inside the colon and changes in colonic structure and motility.
Risk factors for diverticulitis include both uncontrollable and controllable factors. Uncontrollable factors include age, genetics, and gender, while controllable factors include diet, weight, lifestyle habits, medication use, and other health conditions.
Age is a significant risk factor, with the risk increasing significantly after age 60 due to degenerative changes in the colon wall. Genetics can explain up to 40-50% of the risk, influencing colonic structure and motility. Males are more prone under age 50, while postmenopausal females see higher risk.
Controllable risk factors include a low-fiber diet, obesity, lack of physical activity, smoking, a diet high in red or animal meat/fat, the use of certain medications, and other health conditions such as hypertension, immunosuppression, and low vitamin D levels.
A high fiber diet (20-35 grams daily) and drinking plenty of fluids can help prevent diverticulitis and its associated symptoms. For acute diverticulitis, an abdominal and pelvis CT scan is used to detect which part of the colon is affected and the presence of abscesses, strictures, or fistula.
Diverticulitis occurs when one or more diverticulum pouches become inflamed. Symptoms associated with diverticulitis include lower abdominal pain, abdominal tenderness, fever, and pain in the lower left side of the abdomen that may radiate to other areas.
In cases of persistent bleeding or a giant diverticulum at risk of infection and rupture, a doctor may recommend treatments to stop bleeding, such as injection, coagulation, or mechanical devices. Diverticulosis, the outpatient diagnosis in the United States, occurs due to having a low fiber diet and higher pressure within the colon.
Diverticula can occur anywhere in the digestive tract, though they are most common in the sigmoid colon. A colonoscopy is typically used to identify the source of bleeding in the stool, while endoscopy is not ideal for diagnosing acute diverticulitis due to the risk of perforation.
Researchers are still investigating what causes diverticulum inflammation. In cases where diverticulosis is diagnosed, most bleeding associated with diverticulosis resolves spontaneously, but a doctor may recommend increasing fiber and fluid in the diet to prevent recurrence. An abdominal ultrasound can diagnose acute diverticulitis, but its effectiveness depends on the operator's skill.
Those with complications may present with long-term symptoms such as thin stools, constipation, dark, cloudy urine, and passing air with urine. Symptoms associated with diverticulosis include painless rectal bleeding, unexplained abdominal pain, abdominal cramping, and alterations in bowel function.
In conclusion, understanding the causes, risk factors, and treatment options for diverticulitis is essential for maintaining gut health and preventing complications. A high-fiber diet, regular exercise, and avoiding smoking and a high-fat diet can help reduce the risk of developing diverticulitis. If symptoms persist or worsen, seek medical advice promptly.
