woman with stomachache

Everything you need to know about diverticulosis

Diverticulosis is the name for a very specific change in the intestine; bumps form on the intestinal wall, called diverticula. These in themselves are not painful or dangerous, but they can be injured and bleed.

The finding of “diverticulosis” initially only means that there are multiple diverticula.

What is diverticulosis?

Diverticula of the large intestine are among the diseases of civilization in western countries. Doctors believe that a low-fiber diet plays an important role in diverticulosis: too little fiber ensures a firm, hard stool, which most people initially experience as constipation.

The intestinal pressure increases, so it can happen over the years that the intestinal mucosa bulges outwards in certain places. This occurs more and more in older people, as the connective tissue of the intestine is no longer as firm as before.

It is also the case that diverticulosis is particularly common in old age. Approximately two-thirds of those over the age of 70 find diverticula in the intestinal mucosa. However, young people have been increasingly prone to diverticulosis in recent decades.

Basically there are two types of diverticula:

  • The most common is the so-called false diverticula or pseudodiverticulum. The intestinal mucosa is rotated outward through a small space in the muscular wall of the intestine. Blood vessels often pass through the intestinal wall at these points and supply blood to the intestine.
  • Real diverticula, in which the muscular wall of the intestine bulges outward, are less common. These diverticula are more congenial than nutritional and are more common in people in Asia.

Although the actual diverticula appear mainly in the ascending area of ​​the large intestine (ascending colon), the much more common false diverticula in Europe mainly form in the descending colon and the subsequent S-shaped transition to the rectum (sigma or sigmoid colon). 

gastric ulcer and diverticulosis

Symptoms and diagnosis

In diverticulosis, symptoms such as pain and indigestion are often absent for a long time. The diverticulum itself is not painful. However, depending on the number, size, and location, they can lead to irritable bowel symptoms over time:

  • Irregular bowel movements
  • Constipation
  • Diarrhea
  • Slight pain in the lower left abdomen

However, if symptoms such as severe painbloody stool, or visibly persistent constipation occur, this is usually a sign of inflammation, an injured diverticulum, or other complications.

Often, however, diverticulosis remains undetected and symptom-free (asymptomatic) for a long time and is a coincidental finding, for example, in the context of colonoscopy. Even on an X-ray with a contrast medium in the intestine, the doctor can usually recognize diverticula well and make the correct diagnosis.

A fiber diet is the best therapy

In most cases, diverticulosis is the result of a diet low in fibertoo little fluid, and/or lack of exercise. These are all factors that promote constipation and also promote the formation of diverticula in the long term. Furthermore, complications such as diverticulitis or diverticular bleeding also occur more easily with diverticulosis due to certain nutritional errors.

If you manage to change your diet and other lifestyle habits in the case of existing diverticulosis, you can generally expect a good prognosis. The most important is:

  • diet rich in fiber: fruits, vegetables, and products made from whole grains are ideal sources of fiber. Also, concentrated sources of fiber like oat bran or ground flaxseed can be helpful.
  • More exercise: Daily walks and regular resistance training (for example, joggingswimming ) support bowel movement.
  • Drink plenty of water: At least two liters of water or tea a day make sure that the stool remains “flexible” and counteracts diverticula.

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