Diverticular disease and diverticulitis

Diverticular disease and diverticulitis are two related digestive conditions. Symptoms of diverticular disease include:

• lower abdominal (stomach) pain
• feeling bloated

Symptoms of diverticulitis include:

• severe abdominal pain
• high temperature (fever) of 38C (100.4F) or above

Diverticula, diverticular disease, and diverticulitis

Diverticula is the medical term that is used to describe the small pouches that stick out of the side of the large intestine (colon). Diverticula are very common and associated with aging. It is estimated that 50% of people have diverticula by the time they are 50 years of age, and 70% of people have them by the time they are 80 years of age.

The majority of people with diverticula will not experience any symptoms. However, 1 in 4 people with diverticula will experience symptoms, such as abdominal pain and diarrhoea. People who do experience symptoms are said to have diverticular disease.

The diverticula can also become infected and inflamed. Inflammation of the diverticula is known as diverticulitis. Diverticulitis causes more severe symptoms than diverticular disease, such as severe pain, and carries a risk of causing serious complications, such as the colon rupturing (splitting), which can lead to an infection of the lining of the abdomen (peritonitis).

How common are diverticular disease and diverticulitis?

Diverticular disease is one of the most common digestive conditions. Like the diverticula, diverticular disease is associated with age. About 75% of people with diverticular disease will experience one or more episodes of diverticulitis.

It is estimated that 30% of people who are 60 years of age or over are affected by diverticular disease. This figure rises to 65% for people who are 80 years of age or over.

Both sexes are equally affected by diverticular disease and diverticulitis, although there are changes in the ages at which symptoms first begin, with the condition more likely to present at a younger age (under 50 years of age) in men than women.

Diverticular disease is often described as a ‘western disease’ because the rates are very high in western European and North American countries, and very low in African and Asian countries. Diet is thought to be the primary reason for this and, in particular, the fact that many people in western countries only eat a small amount of fibre. A low-fibre diet is known to be a significant risk factor for the condition.

Outlook

Generally, the outlook for diverticular disease is good because the symptoms can usually be controlled by including more fibre in your diet.

However, the outlook for diverticulitis is less favourable, as around 1 in 5 people will experience complications that will often require surgery to treat. In cases where no complications occur (uncomplicated diverticulitis) the recommended treatment is a short course of antibiotics.

If a person has repeated episodes of complicated diverticulitis, surgery to remove the affected section of the colon may also be recommended as a preventative measure.