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Many people have small bulging pockets of tissue (sacs) in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. This small bulging sac is called a diverticulum. Multiple bulging sacs, or diverticulum, are referred to as diverticula. Diverticula can occur throughout the colon but are most common near the end of the left colon called the sigmoid colon. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis with the condition becoming more common as people age. About half of all Americans age 60 to 80, and almost everyone over age 80, have diverticulosis.
When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease. Diverticular disease is common in the Western world but is extremely rare in areas such as Asia and Africa.
Most people with diverticulosis do not experience any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other conditions such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis. You should visit your doctor if you have these troubling symptoms.
The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.
Although not proven, it is believed that a low-fiber diet is the primary cause of diverticular disease. The disease was first identified in the United States in the early 1900s. At about the same time, processed foods were introduced into the American diet. Many processed foods contain refined, low-fiber flour. Unlike whole-wheat flour, refined flour has no wheat bran.
Diverticular disease is common in developed or industrialized countries--particularly the United States, England, and Australia--where low-fiber diets are common. The disease is rare in countries of Asia and Africa, where people eat high-fiber vegetable diets.
Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Some fiber dissolves easily in water (soluble fiber). It takes on a soft, jelly-like texture in the intestines. Some fiber passes almost unchanged through the intestines (insoluble fiber). Both kinds of fiber help make stools soft and easy to pass. Fiber also prevents constipation.
Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. The excess pressure causes the weak spots in the colon to bulge out and become diverticula.
Treatment depends on the severity of the disease. Treatment for diverticulosis generally includes a high fiber diet and pain medications. Treatment for diverticulitis includes antibiotics to treat the infection, a liquid diet to allow the colon to rest and pain medications. Treatment for diverticulitis may also include hospitalization and surgery.
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