Diverticulosis is actually quite common in people aged 40 and above. However, only a small number of those with
diverticulosis will ever experience symptoms from their condition, and an even smaller number would require surgery
to treat it. Only when the diverticuli causes problems does the condition become known as diverticular disease and
start requiring treatment.
Inflammation or infection at the area of the diverticuli is a common problem
associated with diverticular disease
This may cause fever and pain over the area of the inflammation, as well as loose stools or diarrhoea. In severe
cases, the infection may even cause perforation and abscesses that require hospitalisation and even surgery. There
are occasions where the perforation from the colon extends into surrounding organs like the bladder, resulting in a
fistula forming between the colon and bladder.
Another possible complication resulting from diverticular disease is internal bleeding of the colon, a problem that
occurs more commonly in asian populations (as compared to Western populations). This happens when blood vessels at the
edge of the diverticulum breaks and bleeds, causing either dark red blood or blood clots to be passed out along with
stools. This differs from bleeding from more
common conditions such as hemorrhoids
in which the blood is fresh and
While it is not immediately clear what causes diverticular disease, it has been postulated that inadequate fibre in the
diet causes a build-up of pressure in the colon, which then causes diverticuli to form in the colon. Once they form,
taking a high-fibre diet does not reverse the condition, but such a diet may prevent more diverticuli from forming.
While infections resulting from diverticular disease may be treated with antibiotics in an outpatient setting - or, if
the infection is more severe, with hospitalisation, bowel rest, intravenous drip and antibiotics - if the colon has been
perforated, emergency surgery to remove that segment of the colon may be required. Surgery may also be necessary for
people with recurrent episodes of diverticulitis or other complications that occur after an attack.
When surgery is performed, the segment of the colon affected by diverticular disease is removed while sparing the
rectum. The colon is then joined back and the continuity of the intestines is restored. It is very unusual for a stoma
(an artificial opening in the abdominal wall for faeces to pass out) to be required; it is likely that the patient will
retain most of his/her bowel functions.