diverticulosis

Diverticula are small pouches, or sacs, that bulge outward through weak spots in your colon. They mostly form in the lower part of the colon. Diverticulosis is a condition in which you have these pouches. Most people who have diverticulosis do not have symptoms or problems. But sometimes the pouches can cause symptoms or become inflamed.

Diverticulitis is the name for the condition you have when one or more of the pouches get inflamed. Diverticulitis may come on suddenly. It can sometimes cause serious health problems.

Diverticular disease is a condition that happens when the pouches cause:

• Chronic (long-term) symptoms
• Diverticular bleeding
• Diverticulitis or diverticulitis complications

Researchers aren't sure what causes diverticulosis and diverticulitis. They think certain factors may play a role in causing or increasing the risk for these conditions, including:

• Your genetics. Certain genes may make some people more likely to develop the conditions.
• Lifestyle factors such as:
  • Diets low in fiber and high in red meat
  • Lack of physical activity
  • Taking certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
  • Having obesity
  • Smoking

Researchers are also looking at other possible factors that may play a role in these conditions. Those factors include bacteria or stool (poop) getting caught in a pouch in your colon and changes in the microbiome in the intestines. Your microbiome is made up of the bacteria and other organisms in your intestines.

Diverticulosis is common, especially as people age. More than one-third of U.S. adults between the ages of 50 and 59 have diverticulosis. More than two-thirds who are over age 80 have it. Most of those people will not have symptoms or problems. But some of them will develop diverticulitis.

Diverticulosis usually doesn't cause symptoms. But some people can have chronic symptoms such as:

• Bloating
• Constipation or diarrhea
• Cramping or painin the lower abdomen (belly)

Diverticulitis may cause acute symptoms such as:

• Abdominal pain, most often in the lower left side of your abdomen
• Constipation or diarrhea
• Fevers and chills
• Nausea or vomiting

The pain caused by diverticulitis is usually severe and comes on suddenly. Less often, the pain may be mild and worsen over several days.

Some people with diverticulosis and diverticulitis may develop serious health problems (complications). Diverticular bleeding happens when a small blood vessel within the wall of a pouch bursts. The bleeding may be severe and sometimes even life-threatening.

People with diverticulitis can also develop serious problems such as:

• Abscess, a painful, swollen, pus-filled area caused by infection
• Fistula, an abnormal opening or passage between the colon and another part of the body, such as the bladder or vagina
• Intestinal obstruction, a partial or total blockage that keeps food, fluids, air, or stool from moving through your intestines
• Perforation, or a hole, in your colon
• Peritonitis, an infection of the lining of the abdominal cavity

Diverticulosis may be found when your health care provider is doing tests for another reason. Diverticulitis is usually found when you are having an acute attack.

To make a diagnosis, your provider will review your medical history, do a physical exam, and order tests. The tests may include:

• Blood tests
• Stool tests
• Imaging tests such as CT scan, ultrasound, or MRI
• Colonoscopy

f your diverticulosis is causing chronic symptoms, your provider may recommend:

• High-fiber foods or fiber supplements
• Antibiotics
• Medicines to reduce inflammation
• Probiotics

If you have diverticulitis without complications, your provider may recommend treatment at home. However, you probably need treatment in the hospital if you have severe diverticulitis, diverticulitis with complications, or a high risk for complications.

Treatments for diverticulitis may include:

• Antibiotics, except for very mild cases.
• A clear liquid diet for a short time to rest the colon. Your provider may suggest slowly adding solid foods to your diet as your symptoms improve.
• Medicines for pain. This is usually acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may increase the chance of diverticulitis complications.
• Antispasmodic medicines to relieve spasms.

If your diverticulitis doesn't improve with treatment or if it causes complications, you may need surgery to remove part of your colon.

Your provider may recommend lifestyle changes to prevent diverticulitis:

• Eating a diet high in fiber and low in red meat
• Being physically active on a regular basis
• Not smoking (and quitting smoking if you are a smoker)
• Reaching and maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Your small intestine is the longest part of your digestive system - about twenty feet long! It connects your stomach to your large intestine (or colon) and folds many times to fit inside your abdomen. Your small intestine does most of the digesting of the foods you eat. It has three areas called the duodenum, the ileum, and the jejunum.

Problems with the small intestine can include:

• Bleeding
• Celiac disease
• Crohn's disease
• Infections
• Intestinal cancer
• Intestinal obstruction
• Irritable bowel syndrome
• Ulcers, such as peptic ulcer

Treatment of disorders of the small intestine depends on the cause.

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

A birth defect may affect how the body looks, works, or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. Others, like heart disease, are found using special tests. Birth defects can range from mild to severe. How a birth defect affects a child's life depends mostly on which organ or body part is involved and how severe the defect is.

For some birth defects, researchers know the cause. But for many birth defects, the exact cause is unknown. Researchers think that most birth defects are caused by a complex mix of factors, which can include:

• Genetics. One or more genes might have a change or mutation that prevents them from working properly. For example, this happens in Fragile X syndrome. With some defects, a gene or part of the gene might be missing.
• Chromosomal problems. In some cases, a chromosome or part of a chromosome might be missing. This is what happens in Turner syndrome. In other cases, such as with Down syndrome, the child has an extra chromosome.
• Exposures to medicines, chemicals, or other toxic substances. For example, alcohol misuse can cause fetal alcohol spectrum disorders.
• Infections during pregnancy. For example, infection with Zika virus during pregnancy can cause a serious defect in the brain.
• Lack of certain nutrients. Not getting enough folic acid before and during pregnancy is a key factor in causing neural tube defects.

Certain factors may increase the chances of having a baby with a birth defect, such as:

• Smoking, drinking alcohol, or taking certain "street" drugs during pregnancy
• Having certain medical conditions, such as obesity or uncontrolled diabetes, before and during pregnancy
• Taking certain medicines
• Having someone in your family with a birth defect. To learn more about your risk of having a baby with a birth defect, you can talk with a genetic counselor,
• Being an older mother, typically over the age of 34 years

Health care providers can diagnose some birth defects during pregnancy, using prenatal testing. That's why it important to get regular prenatal care.

Other birth defects may not be found until after the baby is born. Providers may find them through newborn screening. Some defects, such as club foot, are obvious right away. Other times, the health care provider may not discover a defect until later in life, when the child has symptoms.

Children with birth defects often need special care and treatments. Because the symptoms and problems caused by birth defects vary, the treatments also vary. Possible treatments may include surgery, medicines, assistive devices, physical therapy, and speech therapy.

Often, children with birth defects need a variety of services and may need to see several specialists. The primary health care provider can coordinate the special care that the child needs.

Not all birth defects can be prevented. But there are things you can do before and during pregnancy to increase your chance of having a healthy baby:

• Start prenatal care as soon as you think you might be pregnant, and see your health care provider regularly during pregnancy
• Get 400 micrograms (mcg) of folic acid every day. If possible, you should start taking it at least one month before you get pregnant.
• Don't drink alcohol, smoke, or use "street" drugs
• Talk to your health care provider about any medicines you are taking or thinking about taking. This includes prescription and over-the-counter medicines, as well as dietary or herbal supplements.
• Learn how to prevent infections during pregnancy
• If you have any medical conditions, try to get them under control before you get pregnant

Centers for Disease Control and Prevention

Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from any of these areas. The amount of bleeding can be so small that only a lab test can find it.

Signs of bleeding in the digestive tract depend where it is and how much bleeding there is.

Signs of bleeding in the upper digestive tract include:

• Bright red blood in vomit
• Vomit that looks like coffee grounds
• Black or tarry stool
• Dark blood mixed with stool

Signs of bleeding in the lower digestive tract include:

• Black or tarry stool
• Dark blood mixed with stool
• Stool mixed or coated with bright red blood

GI bleeding is not a disease, but a symptom of a disease. There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus.

The test used most often to look for the cause of GI bleeding is called endoscopy. It uses a flexible instrument inserted through the mouth or rectum to view the inside of the GI tract. A type of endoscopy called colonoscopy looks at the large intestine.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool. Many disorders affect the colon's ability to work properly. Some of these include:

• Colorectal cancer
• Colonic polyps - extra tissue growing in the colon that can become cancerous
• Ulcerative colitis - ulcers of the colon and rectum
• Diverticulitis - inflammation or infection of pouches in the colon
• Irritable bowel syndrome - an uncomfortable condition causing abdominal cramping and other symptoms

Treatment for colonic diseases varies greatly depending on the disease and its severity. Treatment may involve diet, medicines and in some cases, surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

When you eat, your body breaks food down to a form it can use to build and nourish cells and provide energy. This process is called digestion.

Your digestive system is a series of hollow organs joined in a long, twisting tube. It runs from your mouth to your anus and includes your esophagus, stomach, and small and large intestines. Your liver, gallbladder and pancreas are also involved. They produce juices to help digestion.

There are many types of digestive disorders. The symptoms vary widely depending on the problem. In general, you should see your doctor if you have:

• Blood in your stool
• Changes in bowel habits
• Severe abdominal pain
• Unintentional weight loss
• Heartburn not relieved by antacids

NIH: National Institute of Diabetes and Digestive and Kidney Diseases