At the age of fifty, about one in two people will be affected by the formation of diverticula, or small “pockets” along the walls of the colon. It is a benign and silent presence that can evolve in pathological conditions such as diverticular disease and diverticulitis, characterized by inflammation of the diverticula. However, it is possible to limit the risk of developing diverticular disease and diverticulitis by following some precautions, as Dr. Gionata Fiorino, gastroenterologist of the Research and Care Centre for Chronic Intestinal Inflammatory Diseases of Humanitas, explains.
The diverticulosis
With this term we simply indicate the presence of the diverticula, that is to say the small “hernias” of the mucous membrane of the colon, which more frequently affect the part of the colon just before the rectum. Among the risk factors associated with diverticulosis are sedentariness, cigarette smoking and adherence to a diet with low fiber intake resulting in constipation and evacuating effort.
The onset of diverticula is not symptomatic, however, if you should experience symptoms such as cramping and sudden abdominal pain, alteration of intestinal regularity or constipation, consult a specialist to assess the possible onset of diverticular disease.
Diverticulitis
Unlike diverticular disease, diverticulitis is a more serious condition that can even require surgery: abdominal pain is more intense, rectal bleeding can occur along with fever, vomiting and nausea.
What can be done in the presence of diverticular disease? “If diverticular disease is not affected by complications – says Dr. Fiorino – it can be managed with a proper diet and an appropriate lifestyle. Diverticula can ignite essentially because of an increase in pressure inside the colon, which is favored by constipation, hard stools, and evacuating efforts. Thus, drinking a lot, eating fruit and vegetables regularly and exercising in such a way to facilitate regular emptying every day helps to manage the disease”.
“There is no clear evidence on the use of medicines, such as antibiotics, to be used regularly, so – adds the specialist – prescription should be made on a case-by-case basis according to the risk factors for the progress of the disease”.
Can diverticular disease evolve into diverticulitis if it is not adequately treated or can diverticulitis occur directly in an acute manner? “Unfortunately diverticulitis is not predictable, as well as the severity of symptoms. Diet and constipation tips apply to everyone. It is important, in the case of a known diverticular disease, to assess any worsening of symptoms in order to consult a specialist in good time to assess the correct therapy.
If you suddenly experience high fever, rectal bleeding and/or severe abdominal pain, it is important that you are urgently assessed by, for example, the Emergency Department to rule out complications. In these cases, hydration and intravenous antibiotic therapy are often necessary and, in the event of complications, a surgical evaluation is also required,” concludes Dr. Fiorino.
