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Understanding Diverticulitis

What You Need to Know About One of the Most Common GI Diseases

by Mary Beth TeSelle, Special to The Union
Regular vigorous exercise, along with weight reduction and not smoking, can help toprevent diverticulitis, one of the most common causes of abdominal pain, especially in older adults.

Bloating, constipation or diarrhea, cramping and pain… While most of us have experienced these symptoms at one time or another in our lives for a variety of reasons, they can also be key indicators for one of the most commonly diagnosed gastrointestinal diseases: diverticulitis.

Diverticulitis begins with diverticulosis – a common and harmless condition. Research suggests that about 35 percent of U.S. adults age 50 years or younger have diverticulosis, while about 58 percent of those older than age 60 have diverticulosis. Less than five percent of people with diverticulosis will eventually develop the symptoms associated with diverticulitis.

“Diverticulosis is the presence of a sac-like protrusion of the colon [large intestine] wall,” explains Andrew Chang, MD, gastroenterologist with Sierra Nevada Gastroenterology Medical Associates. “When that protrusion becomes infected or inflamed, then it is called diverticulitis.”



Diverticulitis accounts for close to two million outpatient doctor visits in the U.S. every year and leads to more than 200,000 hospitalizations. The economic impact of the disease is estimated to be more than $5.5 billion annually.

The risk of developing diverticulosis goes up as we age. In fact, Dr. Chang says that by the age of 80, nearly everyone will have diverticulosis. Very few will actually experience symptoms or problems, though.



Other factors that can increase your risk for diverticulosis are obesity, smoking tobacco, lack of exercise, and a diet high in animal fat and low in fiber.

Interestingly, genetics is believed to play a role as well.

“It is now thought that 40 to 50 percent of diverticulitis has a genetic component,” says Dr. Chang. “Siblings of someone with diverticulitis have a three times higher risk for developing it.”

The initial symptom of diverticulitis is pain in the abdomen, which can be confusing given the many different potential reasons behind it.

“With diverticulitis , the abdominal pain is usually located in the left lower quadrant of the abdomen, although it may present in other areas as well,” Dr. Chang says. “Other symptoms may include nausea, vomiting, low grade fevers, or change in bowels with either diarrhea or constipation.”

If the diverticulitis is very advanced or severe, Dr. Chang says patients may experience hypotension (dangerously low blood pressure), shock, or signs of bowel obstruction.

If you believe you may be experiencing diverticulitis, Dr. Chang recommends contacting your primary care physician.

“We do not recommend patients try to treat their symptoms at home,” he says. “If it is acute diverticulitis, it is typically treated with a course of antibiotics that can be prescribed by a physician.”

Left untreated, a case of diverticulitis can cause serious complications. According to Dr. Chang, approximately 15 percent of patients with acute diverticulitis can develop complications that may include abscess formation, bowel obstruction, or perforation or fistula formation between the colon and other surrounding organs, such as the bladder. If left untreated, these complications can be serious and even life-threatening.

Once you have one bout with diverticulitis, you are increasingly likely to have another.

Dr. Andrew Chang

“If a person has had an episode of diverticulitis, the recurrence rate is eight percent in the first year and 20 percent within ten years,” Dr. Chang says. “About 20 to 50 percent of people who have had diverticulitis will experience a recurrence at some point.”

For patients who have had one or more bouts, prevention becomes key – and examining your diet is usually the first step.

“A Mediterranean or anti-inflammatory diet has been shown to reduce the incidence of diverticulitis,” Dr. Chang explains. “One myth I would like to bust is the misconception that seeds, nuts and popcorn consumption can increase the risk of diverticulitis. Large, well-performed studies have clearly shown that these foods do not cause diverticulitis, therefore these foods do not have to be avoided.”

Other proven prevention tactics include more vigorous exercise, not smoking, weight reduction, and avoiding regular use of nonsteroidal anti-inflammatory drugs (with the exception of aspirin) and opiates.

Colon Cancer Awareness

March is Colon Cancer Awareness Month and Dr. Chang reminds us that colon cancer is the third most common cancer in both men and women in the U.S. Approximately 150,000 people will be diagnosed with colon or rectal cancer annually.

The American Cancer Society and American College of Gastroenterology recently updated the recommended age for initial colonoscopy to 45 for routine screening. This is earlier than the previous recommended age of 50. This change is based on the rising number of colon cancers occurring before the age of 50.

Colonoscopy is still the preferred tool to not only screen for but also prevent colon cancer. It can be safely performed, and should not be delayed, even in a pandemic. Please contact your physician to discuss your best options.


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