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Diverticulitis
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Diverticulitis

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DIGESTIVE SYSTEM
Diseases & Conditions  

Diverticulitis occurs in people with diverticulosis. It most commonly affects the sigmoid colon, which is the last part of the large intestine just before the rectum. Diverticulitis is more common in people older than 40. It can be severe in people of any age, although it is most serious in the elderly, especially those taking corticosteroids or other drugs that suppress the immune system and thus increase the hazards of infection.

One or more pouches in the colon may become inflamed or infected, causing severe abdominal pain, fever, nausea and a marked change in your bowel habits. When diverticula become infected, the condition is called diverticulitis.

Signs and symptoms

Diverticulitis can feel like appendicitis, except you'll generally have pain in the lower-left side of your abdomen, instead of the lower-right side. The pain is usually severe and comes on suddenly, but sometimes you may have mild pain that becomes worse over several days and fluctuates in intensity. You may also have abdominal tenderness, fever, nausea, and constipation or diarrhea.

Less common signs and symptoms of diverticulitis may include:

  • vomiting

  • Bloating

  • Bleeding from your rectum

  • Frequent urination

  • Difficulty or pain while urinating

Causes

Diverticula usually develop when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall. Pouches are most common in your sigmoid and descending colon — the lower portions of your large intestine just above your rectum — and often occur as a result of straining during bowel movements over a number of years. The pouches are small at first but become larger with time.

Sometimes a bit of stool may become lodged in one of the pouches, leading to infection. A small tear or perforation can also develop in an infected pouch, which in turn can cause an infection within your abdomen (peritonitis). If the infection is limited to an area around the wall of your colon where the diverticula are inflamed, you may develop a localized collection of pus known as an abscess.

Risk factors

These factors may increase the pressure on the wall of your colon:

  • Aging. As you age, the outer muscular wall of your colon thickens, causing the inside passageway to narrow. The narrowing increases pressure in your colon and makes it more likely that pouches will form. Thickening of the outer wall also makes it more difficult for your colon to move waste through to your rectum. This means waste stays in your colon longer, becoming harder and dryer and exerting additional pressure on weak areas when the muscles of your colon try to move it along.

  • Too little fiber. Diverticulitis is rare in countries where people eat a high-fiber diet that helps keep stools soft. But it's common in industrialized nations, where the average diet is high in refined carbohydrates and low in fiber. In fact, diverticular disease emerged after the introduction of steel rolling mills, which greatly reduced the fiber content of flour and other grains. The disease was first observed in the United States in the early 1900s, around the time processed foods became a mainstay of the American diet. Too little fiber contributes to small, hard stools that are difficult to pass, which increases pressure in your colon.

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