Diverticular diseases

Diverticulosis is a condition where a pouch protrudes out from a weak spot in your gastrointestinal tract (digestive tract). It happens most often in the lower colon, which is found on the lower left side of your abdomen (belly). However, these pouches can occur at any point in the digestive tract, which includes the pharynx (throat), esophagus, stomach, small intestine, large intestine (colon), rectum and anus.

One pouch is called a diverticulum. The word for more than one pouch is diverticula.

Most people who have colon diverticulosis have no symptoms or problems and only find out about it after they have a colonoscopy or other colon screening. It’s uncommon in people younger than 30 and most common among people older than 60. Once these pouches have formed, they don’t go away unless they need to be removed surgically.

What is diverticulitis & diverticular disease?

Diverticular disease happens when one or more of the colonic diverticula (pouches) causes:

• Diverticulitis (inflammation or infection of diverticula) or diverticulitis complications
• Chronic symptoms like bloating, constipation, diarrhea, or cramping or pain in the lower abdomen
• Bleeding (can be severe and life-threatening)

Common colon diverticulitis symptoms

• Abdominal pain
• Constipation or diarrhea
• Fevers and chills
• Nausea or vomiting

Pain from colonic diverticulitis may come on suddenly and be severe. Or it may start out mild and get worse gradually over several days. The amount of pain from colonic diverticulitis can change over time.

Complications of colon diverticulitis & diverticular disease

• Abscess: A painful, swollen, pus-filled area caused by infection
• Fistula: An abnormal opening between the colon and an adjacent organ such as the bladder
• Intestinal obstruction: A blockage of the movement of contents through your intestines
• Perforation of the colon: A hole in the wall of the colon
• Peritonitis: An infection of the lining of the abdominal cavity

What causes diverticula & diverticulitis?

Recent research suggests colonic diverticula have multiple causes, including genetic or environmental factors. It’s believed that increased pressure in the colon contributes to diverticula of the colon. Some lifestyle factors that contribute to developing colonic diverticula are:

• Diets low in fiber and high in red meat
• Lack of physical activity
• Use of medicines such as nonsteroidal anti-inflammatory drugs and steroids
• Obesity
• Smoking

Esophageal diverticula

Like having a diverticulum in other parts of your digestive tract, having an esophageal diverticulum can often produce no diverticulitis symptoms and need no diverticulitis treatment. It may only be discovered if you have a diagnostic test for some reason. It’s fairly rare and usually only affects people in their 70s or 80s.

Diverticulosis of the throat can form anywhere in the esophagus. A diverticulum in the top part of the esophagus is called a Zenker’s diverticulum.

Symptoms of esophageal diverticula:

• Difficulty swallowing
• Feeling that food is caught in the throat
• Regurgitating food
• Pain when swallowing
• Chronic cough
• Bad breath
• Chest or neck pain

One symptom unique to diverticulitis of the throat is Boyce’s sign – a gurgling sound caused by air passing through the diverticulum.

Having throat diverticulitis can increase the risk of developing complications such as:

• An obstruction that makes it hard to swallow
• Pneumonia after aspirating food into the lungs
• Squamous cell carcinoma

Having any of these complications may mean you need diverticulitis medicines and diverticulitis treatment.

Treatments for diverticular disease & diverticulitis

For diverticulitis treatment, many doctors recommend changing gradually to a diverticulitis diet that includes drinking more water or juice and eating foods high in fiber such as whole grains, fruits and vegetables. Your doctor may also recommend avoiding smoking, limiting red meat, and getting enough sleep and exercise.

You probably won’t need to avoid any foods. Standard advice for people with diverticula of the colon used to be that they should avoid foods like popcorn, nuts and seeds. Recent research suggests none of these foods affects whether a person will develop colonic diverticulitis symptoms, so this advice is no longer given.

Your doctor may suggest you take over-the-counter stool softeners. They may prescribe pain medications or other diverticulitis medicines to help keep your stools soft and moving smoothly through your system.

Other nonsurgical treatments for diverticulitis

If these measures don’t help enough, you may be put on a liquid diet and be given antibiotics or other diverticulitis medicines. If those things help, you’ll be ready to gradually start a high-fiber diverticulitis diet again.

If your symptoms are severe or frequent, you may need to be treated in a hospital where you can receive diverticulitis IV fluids and antibiotics. At the same time, you’ll be fed a low-fiber or liquid diet.

Treatment for esophageal diverticula

Nonsurgical treatments for diverticulitis in the throat include lifestyle changes such as taking small bites of food, chewing food thoroughly, eating a bland diet, and drinking plenty of water during and after meals to help with digestion.

Surgical treatments

If severe symptoms don’t get better or if you have complications, you may need surgery to:

• Make the top of the esophagus wider so food can pass more easily
• Remove a small part of the digestive tract that includes the diverticula
• Widen the openings to the diverticula so they drain more easily