What are the symptoms and problems caused by diverticula?
It is common for no symptoms to develop - called 'diverticulosis'
In about 3 in 4 people who develop diverticula, the diverticula cause no harm or symptoms. The term 'diverticulosis' means that diverticula are present, but do not cause any symptoms or problems. In most cases the condition will not be known about as there are no symptoms, but sometimes diverticula are discovered as an incidental finding if you are having tests such as colonscopy or barium enema for other reasons.
Diverticular disease
This term is used when diverticula cause intermittent, lower abdominal pain or bloating (but where there is no inflammation or infection - which is discussed later). The pain is usually crampy and tends to come and go. The pain is most commonly in the lower left part of the abdomen. You may get ease from pain and bloating by going to the toilet to pass stools. Some people develop diarrhoea or constipation, and some people pass mucus with their stools. It is not clear how diverticula cause these symptoms.
Symptoms of diverticular disease can be similar to those that occur with a different condition called irritable bowel syndrome (IBS). However, IBS usually affects younger adults and so symptoms that first develop in a younger adult are more likely to be due to IBS. Likewise, symptoms that first develop in older people are more likely to be due to diverticular disease. However, in some cases it is difficult to tell if symptoms are due to diverticular disease or to IBS.
A diagnosis of 'diverticular disease' is usually made by confirming the presence of diverticula and by ruling out other causes of the symptoms. Note: the symptoms of diverticular disease, especially if they start in an older person, can also be similar to those of early bowel cancer. Therefore, tell a doctor if you get these symptoms as some tests may need to be arranged. For example, a test called colonoscopy may be advised. This is where a doctor uses a special 'telescope' to look into the bowel. This can confirm the presence of diverticula, and rule out bowel cancer.
Diverticulitis (infection)
Diverticulitis is a condition where one or more of the diverticula become inflamed and infected. This may occur if some faeces gets trapped and stagnates in a diverticulum. Bacteria (germs) in the trapped faeces may then multiply and cause infection. About 1 in 5 people with diverticula develop a bout of diverticulitis at some stage. Some people have recurring bouts of diverticulitis. Symptoms of diverticulitis include:
- A constant pain in the abdomen. It is most commonly in the lower left side of the abdomen, but can occur in any part of the abdomen.
- Fever (high temperature).
- Constipation or diarrhoea.
- You may have some blood mixed with your stools.
- You may feel sick or vomit.
Obstruction, abscess, fistula, and peritonitis
An infected diverticulum (diverticulitis) sometimes gets worse and causes complications. Possible complications include: a blockage (obstruction) of the colon; an abscess (a collection of pus) that may form in the abdomen; a channel (fistula) that may form to other organs such as the bladder; a perforation (hole) in the wall of the bowel that can lead to infection inside the abdomen (peritonitis). Surgery is usually needed to treat these serious but uncommon complications.
Bleeding
A diverticulum may occasionally bleed and you may pass some blood via your anus. The bleeding is usually abrupt and painless. The bleeding is due to a burst blood vessel that sometimes occurs in the wall of a diverticulum and so the amount of blood loss can be heavy. A very large bleed requiring an emergency blood transfusion occurs in some cases. However, the bleeding stops on its own in about 3 in 4 cases. Sometimes and operation is needed to stop the bleeding. Sometimes just a slight bleed occurs.
Note, always report bleeding from the bowel (via your anus) to a doctor. You should not assume bleeding is from a diverticulum. Other more serious conditions such as bowel cancer need to be ruled out.
By Rob Mansfield
Average rating:
