Diverticulosis: A Scary Word, But A Manageable Condition

Many people have it, but few know it - until the day of their first colonoscopy. But the word they hear isn't "cancer." It isn't "polyp." Instead, the doctor may mention "pockets" and point to small, gray indentations in the images taken by the scope. The diagnosis: diverticulosis.

While it sounds a bit ominous, diverticulosis is quite common, especially in adults 50 and older who eat a Western diet (translate that as "a diet high in processed foods"). In fact, 50 percent of people over 60 and 75 percent of adults 80 and older will have this condition. Fortunately, most people have no symptoms or complications, but it's good to know if you have it and how to keep the condition from worsening.

Diverticulosis refers to the forming of small pouches or pockets inside the walls of the intestine, usually in the large intestine (colon), and usually in the lower portion called the sigmoid colon. These pockets are formed when the inside lining of the intestine pushes against weak places in the outer intestinal wall. When dense food waste passes through your intestines and pushes against these weak spots over and over again, pockets form, called diverticula.

Most people find out they have diverticulosis when they have a colonoscopy in their late 40s or later, which is usually the time when it develops.

"It's a surprise to most patients when I include diverticulosis in my report," said colorectal surgeon Tobi J. Reidy, DO, with Franciscan Physician Network Indiana Colon & Rectal Specialists. "But it is very common in this country, due to our low-fiber diets and poor hydration."

While there is no cure for diverticulosis, most physicians recommend patients increase the fiber in their diet to keep the condition from causing more serious issues, namely infections. For adults, 20 to 35 grams per day is recommended. (In contrast, most Americans consume only 10 to 15 grams.) Fiber can keep food waste passing more quickly through the intestine and less likely to "hang around" and cause more issues in the diverticula. Fiber also can help reduce constipation and ease elimination.

Keeping the colon clean between colonoscopies can keep diverticulosis from developing into a more serious condition called diverticulitis.

"Diverticulitis occurs when otherwise normal bacteria and feces become trapped in the diverticular pockets leading to microscopic perforations," said Dr. Reidy. "This can cause lower abdominal pain, nausea, fever and other symptoms."

This is the time to contact your doctor, she adds, before the infection becomes more serious. "Many times, we can treat diverticulitis with antibiotics, but in severe cases, surgery may be needed," said Dr. Reidy.

Most people with diverticulosis, however, will go through life without problems. Then again, it can be a wake-up call to get back to basic good practices, including:

• Eat a fiber-rich diet
• Exercise regularly
• Maintain a healthy weight
• Don't smoke