Diverticulosis is a common condition, often found in older populations, that can develop into diverticulitis. Both conditions together are referred to as diverticular disease. As many as 65% of Americans aged 65 and older may have diverticulosis1, and it becomes increasingly more common as someone ages. What is this condition, what are its symptoms, and how is it treated?
Diverticulosis is a condition in which one or more sac-like formations push outward on the inner wall of the colon. These formations, called diverticula (“diverticulum” in the singular), most commonly appear in the weak areas of the intestine’s outer lining. They are commonly found in the sigmoid colon, or the “S-shaped” final curve of the large intestine near the rectum. When these diverticula cause inflammation or tearing, the condition becomes diverticulitis.
Complications of diverticulosis include intestinal obstructions, abscesses, fistulas, peritonitis, and hemorrhage. Risk factors include a low-fiber diet, obesity, cigarette smoking, and overuse of nonsteroidal anti-inflammatory drugs. Diverticulosis risk can also be genetic2.
Approximately 80 percent of patients with diverticulosis never develop any symptoms3. However, symptoms may include chronic constipation or other bowel irregularities, nausea, and bloating, all of which can be managed through diet.
If diverticulosis develops into diverticulitis, this can have more painful symptoms. Symptoms of diverticulitis include pain in the lower left abdomen, fever, nausea, diarrhea, vomiting, and frequent urination urges.
Diverticulosis is diagnosed with an examination and medical questionnaire that rules out genetic factors, side effects of medications, and other conditions that may cause this condition. A doctor will ask about symptoms and if certain foods are easier to digest. During the medical visit, a doctor may push pressure points in the lower left abdomen and listen to the gut with a stethoscope to look for abnormalities. Additional exams such as a rectal exam, CT scan, colonoscopy, or a barium enema may be required to conclude if the condition is diverticulosis.
Oftentimes, a high-fiber supplement or diet will be suggested to reduce the chances of additional diverticula forming and becoming inflamed. However, if the condition is particularly problematic or begins to develop into diverticulitis, surgical intervention may be required.
Surgery for diverticulitis may be necessary following an abscess, fistulas, rectal bleeding, blockage, intestinal perforation, or hemorrhage. Surgery may involve removing parts of the colon. On rare, serious occasions, a colostomy may be required. Patients that need surgery may be candidates for laparoscopic surgery, which carries less risk than open surgery.
Although diverticulosis is common in people over the age of 65 years old in developed countries, it can be avoided. It’s important to eat a healthy, fiber-filled diet, drink water, and exercise regularly. These actions help to keep the digestive system as a whole in top shape.
Dr. Franklin joined the medical staff at Piedmont Fayette Hospital in January 2011. He was previously in private practice in Gadsden, Alabama for over five years. He is board certified in general surgery and a Fellow of the American College of Surgeons.
His practice includes the full range of General Surgery – hernia, colon resection, gallbladder surgery, and other diseases of the intestines and abdominal organs. He also does surgery on the thyroid, parathyroids, and skin. He has had a distinguished career in laparoscopic and robotic surgery. While in Alabama, he was the first surgeon in the state to complete a gallbladder removal with the da Vinci robot. After moving back to Georgia, he is the first surgeon in the Piedmont health system to complete gallbladder removal with the da Vinci robot, and also the first ever utilizing a single incision in the umbilicus. He is one of a very few surgeons in the US utilizing this technique. He has been involved in laparoscopic surgery for 20 years and over 12 years robotically.
He has published and given numerous presentations to include topics of advanced laparoscopic procedures, cellular behavior of cancers, trauma, multiple sclerosis, and intravascular ultrasound. He has most recently served as chairman of the department Surgery at Piedmont Fayette. He now serves on the medical executive committee and utilization review committee. He also is involved in research projects in the US and internationally.
Dr. Franklin believes that to plan the best possible operation, the surgeon must understand and listen to the patient. He can then plan and educate the patient in regards to their forward progress. He understands that operations are not without risk, and the patient must understand those risks along with its benefits, and the alternatives to treatment.Make an apppointment