Diverticular Disease
is when small pockets/pouches (diverticula) form in the wall of the gastrointestinal track.
Diverticulosis
The etiology of diverticulosis (i.e. the presence of pouch-like protrusions in the intestinal wall) is not well understood, although it seems to be correlated with genetics and age-related changes to the wall of the gastrointestinal tract. Diverticula may be caused by increased luminal pressure leading to the protrusion of the mucosal layer of the gastrointestinal tract through weak points in the muscular layer of the gastrointestinal tract.
Diverticulitis
Evidence suggests the possibility of both an inflammatory and an infectious cause, which may vary between individuals. Infection may be bacterial, where a diverticulum is perforated and releases intestinal bacteria (resulting in inflammation), or it may be viral, as active replication of the cytomegalovirus has been found in colonic tissue of over two thirds of individuals with diverticulitis. The role of an individual’s immune response and gut microbiome in the development of diverticulitis is currently being investigated.
Diverticular Disease Pathophysiology
Diagnosis of Diverticular Disease
Unless diverticula are acutely inflamed (i.e. diverticulitis), diverticula are usually found incidentally during colonoscopy, barium enema, MRI or abdominal CT. Diverticulitis is suspected in people with abdominal pain and a known history of diverticulosis.
Dietary Management of Diverticular Disease
Diet plays a key role in the prevention and management of diverticular disease and acute diverticulitis. Some interventions that may be considered in the management can include:
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Change in dietary and lifestyle habits
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Modified fibre diet
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Prebiotics
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Probiotics
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Limiting gut irritants
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Ensuring adequate vitamin D levels
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Gastrointestinal System - Diverticular Disease Background. 2018. PEN
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Baum JA, Ching Companioni RA. Colonic diverticulosis. Merck Manual Professional Version. 2019 Mar. Available from: https://www.merckmanuals.com/professional/gastrointestinal-disorders/diverticular-disease/colonic-diverticulosis
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Ghoulam EM, Clarrett DM, Marsicano EV. Diverticulitis: practice essentials, background, pathophysiology. Medscape. 2019 Oct 18. Available from: https://emedicine.medscape.com/article/173388-overview
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