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Most people with diverticulosis (diverticular disease) have few or no symptoms; however, symptoms that can occur with diverticulosis, which then may be called "diverticular disease" include abdominal pain constipation and diarrhea When diverticulosis is associated with inflammation and infection it is called "diverticulitis Diverticulitis as well as diverticular disease can be diagnosed with barium X-rays, sigmoidoscopy, colonoscopy, or CT scan. Most people with diverticulosis (diverticular disease) have few or no symptoms; however, symptoms that can occur with diverticulosis, which then may be called "diverticular disease" include Treatment of diverticulitis and diverticular disease can include high fiberdiet, and anti-spasmodic drugs. Foods to eat that may prevent diverticulitis flares include fruits and vegetables, legumes, and whole grains. It has been suggested that people with diverticulitis avoid eating seeds, nuts, and corn; however, there is little evidence to support this recommendation. When diverticulosis is associated with inflammation and infection the condition is called diverticulitis. Complications of diverticulosis and diverticulitis include rectal bleeding, abdominal infections, and colon obstruction. The colon (large intestine or large bowel) is a long tube-like structure approximately 6 feet in length that stores and then eliminates waste material left over after digestion of food in the small intestine takes place. It is thought that pressure within the colon causes bulging pockets of tissue (sacs) that push out from the colonic walls as a person ages. A small bulging sac pushing outward from the colon wall is called a diverticulum. More than one bulging sac is referred to in the plural as diverticula. Diverticula can occur throughout the colon but are most common near the end of the left colon, referred
to as the sigmoid colon, in Western countries. In Asia, the diverticula occur mostly on the right side of the colon. The condition of having these diverticula in the colon is called diverticulosis. Diverticula increase with age. They are uncommon before the age of 40, but are seen in more than 74% of people over the age of 80 years in the U.S. A person with diverticulosis usually has few or no symptoms. The most common symptoms associated with diverticulosis are abdominal pain, constipation, anddiarrhea. In some of these patients the symptoms may be due to the concomitant presence of irritable bowel syndrome (IBS) or abnormalities in the function of the muscles of the sigmoid colon (in which case it is referred to as diverticular disease); simple diverticula should cause no symptoms. Occasionally, bleeding originates from a diverticulum, and it is referred to as diverticular bleeding. When a diverticulum ruptures and infection sets in around the diverticulum, the condition is called diverticulitis. An individual suffering from diverticulitis often has abdominal pain, abdominal tenderness, colonic obstruction, and an elevated white blood cell count in the blood, and fever.
The muscular wall of the colon grows thicker with age, although the cause of this thickening is unclear. It may reflect the increasing pressures required by the colon to eliminate feces. For example, a diet low in fiber can lead to small,hard stools which are difficult to pass and which require increased pressure to pass. The lack of fiber and small stools also may allow segments of the colon to close off from the rest of the colon when the colonic muscle in the segment contracts. The pressure in these closed-off segments may become high since the increased pressure cannot dissipate to the rest of the colon. Over time, high pressures in the colon push the inner intestinal lining outward (herniation) through weak areas in the muscular walls. These pouches or sacs that develop are called diverticula. Lack of fiber in the diet has been thought to be the most likely cause of diverticula, and there is a good correlation among societies around the world between the amount of fiber in the diet and the prevalence of diverticula. Nevertheless, studies have not found similar correlations between fiber and diverticula within individual societies. Many people with diverticular disease have excessive thickening of the muscular wall of the colon where the diverticula form. The muscle also contracts more strongly. These abnormalities of the muscle may be contributing factors in the formation of diverticula. Microscopic examination of the edges of the diverticula show signs of inflammation, and it has been suggested that inflammation may be important for the formation of the diverticula and not just the result of them