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| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = {{PAGENAME}} | | | Name = {{PAGENAME}} | |
| ICD10 = {{ICD10|K|57||k|55}} |
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| ICD9 = {{ICD9|562.01}} |
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| ICDO = |
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| Image = Diverticulosis_2.jpg | | | Image = Diverticulosis_2.jpg | |
| Caption = Diverticulosis as seen [[colonoscopy|endoscopically]] | | | Caption = Diverticulosis as seen [[colonoscopy|endoscopically]] | |
| OMIM = 223320 |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| DiseasesDB = 3871 |
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| }} | | }} |
| {{Diverticulosis}} | | {{Diverticulosis}} |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}}{{AE}} {{MehdiP}} |
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| {{SK}} Diverticular disease; diverticulosis of colon; diverticulosis of large intestine | | {{SK}} Diverticular disease; diverticulosis of colon; diverticulosis of large intestine |
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| ==Overview== | | ==[[Diverticulosis overview|Overview]]== |
| '''Diverticulosis''' is the condition of having [[diverticulum|diverticula]] in the [[colon (anatomy)|colon]] which are outpocketings of the colonic [[mucosa]] and submucosa through weaknesses of [[muscle]] layers in the colon wall. These are more common in the [[sigmoid colon]], which is a common place for increased pressure. This is uncommon before the age of 40 and increases in incidence after that age.<ref name="pmid17468551">{{cite journal |author=Comparato G, Pilotto A, Franzè A, Franceschi M, Di Mario F |title=Diverticular disease in the elderly |journal=Digestive diseases (Basel, Switzerland) |volume=25 |issue=2 |pages=151–9 |year=2007 |pmid=17468551 |doi=10.1159/000099480}}</ref>
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| ==Causes==
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| Diverticula are thought to be caused by increased pressure within the [[lumen]] of the colon. Increased intra-colonic pressure secondary to constipation may lead to weaknesses in the colon walls giving way to diverticula. Other causes ''may'' include a colonic spasm which increases pressure, which may be due to [[dehydration]] or low-fiber [[Diet (nutrition)|diet]]s;<ref>[http://www.merck.com/mrkshared/CVMHighLight?file=/mrkshared/mmanual/section3/chapter33/33b.jsp%3Fregion%3Dmerckcom&word=diverticulosis&domain=www.merck.com#hl_anchor Merck Manual online]</ref> although this may also be due to constipation. [[dietary fiber|Fiber]] causes stools to retain more water and become easier to pass (either soluble or insoluble fiber will do this). A diet without sufficient fiber makes the [[feces|stool]]s small, requiring the bowel to squeeze harder to remove the smaller stool.
| | ==[[Diverticulosis historical perspective|Historical Perspective]]== |
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| Risk factors:
| | ==[[Diverticulosis classification|Classification]]== |
| * a diet which is low in fiber content or high in fat
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| * increasing age,
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| * constipating conditions, and
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| * [[connective tissue]] disorders which may cause weakness in the colon wall (such as [[Marfan syndrome]]).
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| ==Epidemiology== | | ==[[Diverticulosis pathophysiology|Pathophysiology]]== |
| About 10% of the US population over the age of 40 and half over the age of 60 has diverticulosis. This disease is common in the US, Britain, Australia, Canada, and is uncommon in Asia and Africa. It is the most common cause for rectal bleeding in US adults over the age of 40 years.
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| Large mouth diverticula are associated with [[scleroderma]].
| | ==[[Diverticulosis causes|Causes]]== |
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| ==Symptoms== | | ==[[Diverticulosis differential diagnosis|Differentiating Diverticulosis from other Diseases]]== |
| Often this disorder has no symptoms. The most common is [[bleeding]] (variable amounts), [[bloating]], [[abdominal pain]]/[[cramp]]ing after meals or otherwise often in the left lower [[abdomen]], and changes in bowel movements ([[diarrhea]] or [[constipation]]). Sometimes, symptoms include nonspecific chronic discomfort in the lower left abdomen, with occasional acute episodes of sharper pain. The discomfort is sometimes described as a general feeling of pressure in the region, or pulling sensation. A tickling sensation may be felt as the small pockets fill and unfill; a feeling like gas may be moving in areas outside the colon. First-time bleeding from the [[rectum]] should be followed up with a physician, especially if over age 40 because of the possibility of [[colon cancer]]. Symptoms of [[anemia]] may present: [[fatigue (physical)|fatigue]], [[light-headedness]], or [[dyspnea|shortness of breath]].
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| ==Testing== | | ==[[Diverticulosis epidemiology and demographics|Epidemiology and Demographics]]== |
| [[Colonoscopy]] is the most used test for diagnosis. This is important for treatment and investigation of other diseases. Other tests include abdominal [[X-ray]], [[barium enema]], [[computed tomography|CT]], or [[MRI]]. | |
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| ==Complications== | | ==[[Diverticulosis risk factors|Risk Factors]]== |
| Infection of a diverticulum can result in [[diverticulitis]]. This occurs in 10-25% of persons with diverticulosis (NIDDK website). Tears in the colon leading to bleeding or perforations may occur, intestinal obstruction may occur (constipation or diarrhea does not rule this possibility out), [[peritonitis]], [[abscess]] formation, [[Retroperitoneum|retroperitoneal]] [[fibrosis]], [[sepsis]], and [[fistula]] formation.
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| Infection of a diverticulum often occurs as a result of stool collecting in a diverticulum.
| | ==[[Diverticulosis screening|Screening]]== |
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| | ==[[Diverticulosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| | ==Diagnosis== |
| | [[Diverticulosis history and symptoms|History and Symptoms]] | [[Diverticulosis physical examination|Physical Examination]] | [[Diverticulosis laboratory findings|Laboratory Findings]] | [[Diverticulosis CT|CT]] | [[Diverticulosis endoscopy|Endoscopy]] | [[Diverticulosis other imaging findings|Other Imaging Findings]] | [[Diverticulosis other diagnostic studies|Other diagnostic studies]] |
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| ==Treatment== | | ==Treatment== |
| | [[Diverticulosis medical therapy|Medical Therapy]] | [[Diverticulosis surgery|Surgery]] | [[Diverticulosis primary prevention|Primary Prevention]] | [[Diverticulosis secondary prevention|Secondary Prevention]] | [[Diverticulosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Diverticulosis future or investigational therapies|Future or Investigational Therapies]] |
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| Often no treatment is needed. Increases in hydration, increasing fiber content in the diet<ref name="pmid16948968">{{cite journal |author=Eglash A, Lane CH, Schneider DM |title=Clinical inquiries. What is the most beneficial diet for patients with diverticulosis? |journal=The Journal of family practice |volume=55 |issue=9 |pages=813–5 |year=2006 |pmid=16948968 |doi=}}</ref> (the [[American Dietetic Association]] recommends 20-35 grams each day), or removing factors resulting in constipation help decrease the incidence of new diverticula or possibly keep them from bursting or becoming inflamed (ADA website). [[dietary fiber|Fiber supplements]] may aid if diet is inadequate. If the diverticula are unusually large (greater than 1 inch), often infected (see [[diverticulitis]]), or exhibit uncontrollable bleeding, surgery can be performed to decrease relapse or other complications. The [[National Institute of Diabetes and Digestive and Kidney Diseases
| | ==Case Studies== |
| |NIDDK]] says foods such as [[nut (fruit)|nut]]s, [[popcorn]] hulls, [[sunflower seed]]s, [[Pumpkin|pumpkin seed]]s, [[caraway]] [[seed]]s, and [[Sesame|sesame seed]]s have traditionally been labeled as problem foods for people with this condition;<ref name="titleDiverticulosis and Diverticulitis">{{cite web |url=http://www.digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/ |title=Diverticulosis and Diverticulitis |accessdate=2007-11-19 |format= |work=}}</ref> however, no scientific data exists to prove this hypothesis. The seeds in [[tomato]]es, [[zucchini]], [[cucumber]]s, [[strawberry|strawberries]], [[raspberry|raspberries]], and [[Poppy|poppy seed]]s, are not considered harmful by the NIDDK. Treatments, like some colon cleansers, that cause hard stools, constipation, and straining, are not recommended.
| | [[Diverticulosis case study one|Case #1]] |
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| == Histopathology of Diverticulosis==
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| <youtube v=FXmcSbftZtQ/>
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| ==References==
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| {{reflist|2}} | | {{reflist|2}} |
| | {{WH}} |
| | {{WS}} |
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| ==External links==
| | [[Category:Gastroenterology]] |
| * [http://www.eatright.org J. American Diet Assoc. 2002;102:993-1000]
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| {{Gastroenterology}}
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| [[Category:Surgery]] | | [[Category:Surgery]] |
| [[Category:Gastroenterology]]
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| [[Category:Inflammations]]
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| [[Category:Conditions diagnosed by stool test]]
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| [[bg:Дивертикулоза]]
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| [[de:Divertikulose]]
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| [[fr:Diverticulose]]
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| [[lt:Storosios žarnos divertikuliozė]]
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| [[nl:Diverticulose]]
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| [[pl:Choroba uchyłkowa jelit]]
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| [[fi:Divertikuloosi]]
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| [[sv:Divertikulos]]
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| [[te:డైవర్టిక్యులైటిస్]]
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