Diverticulitis, Diverticulosis and Diverticular Bleeding--Managing these Afflictions of the Colon

Nariman Malik, BSc

Diverticular disease of the colon had been a rare clinical entity before the twentieth century. Currently, diverticulosis is the most common condition affecting the intestine.1 The incidence of diverticular disease increases with age from approximately 9% in those younger than 50 to 50% in those over the age of 70.2 Diverticular disease is almost exclusively seen in populations that consume low fibre diets such as those common in Western society. Interestingly, these conditions are less common in vegetarians than in non-vegetarians. There is no associated risk with smoking, caffeine, or alcohol use.3

A diverticulum is defined as a sac-like protrusion of the colonic wall. Colonic diverticuli are formed by the herniation of the mucosa and submucosa through the muscularis mucosa. They tend to develop at points where the vasa recta penetrates the circular muscle layer.

Diverticular disease is a spectrum of diseases that encompass three clinical multi-faceted conditions: diverticulosis, diverticulitis, and diverticular bleeding. Each condition has a unique set of presenting symptoms and an individualized course of management (see Table 1).