Diverticula

Overview

Diverticula are small, bulging and often asymptomatic pouches that form along the walls of hollow organs when naturally weak places in the tissue give way under pressure. They occur in the intestine, the oesophagus and the bladder. Diverticula can form in the cardiac wall after a heart attack. Pouches in the walls of blood vessels are called "aneurysms". More detailed information can be found in the individual chapters.

Symptoms

• Often asymptomatic
• Large intestine, i.e. bowel or colon (most often affected)
  • Sometimes constipation
  • Symptoms when inflamed: see “diverticulitis"
• Small intestine
  • Flatulence
  • Belching
  • Feeling of fullness
  • When inflamed: abdominal pain, fever
• Oesophagus
  • See “oesophageal diverticula”
• Bladder
  • Tendency to develop infections
  • Feels as if bladder doesn’t empty completely
  • Sometimes wetting
• Generally bleeding diverticula
  • Blood in stools, urine, genital tract, etc.
  • Chronic bleeding: fatigue, anaemia

Complications

• Diverticulitis
• Formation of abscesses (collection of pus)
• Formation of fistula (formation of passages)
• Scars (surrounding tissue, muscles)
• Peritonitis
• Intestinal ruptures (perforation)
• Intestinal obstruction

Causes and treatment

Causes

• General classification
  • True diverticula: pouches containing all layers of the hollow organ
  • False diverticula: pouches only involving the muscular mucosa of the hollow organ
• Tissue or muscle weakness
• Develop on organ wall under outside pressure
• Increased inner pressure on organ (e.g. with constipation)

Risk factors

• Age > 60 years
• Medication (steroids, opiates)
• Consumption of tobacco and alcohol
• Lack of exercise
• Obesity
• Insufficient fluid intake
• One-sided diet low in fibre

Further treatment by your doctor / in hospital

Possible tests

• Physical examination
• Blood test
• Imaging (selection)
  • Ultrasound (sonography)
  • Colonoscopy/oesophagoscopy
  • Cytoscopy
  • CT scan (computed tomography)

Possible therapies

• Nutritional counselling
• Antibiotics, if necessary
• Surgery, if necessary

What can I do myself?

• Sufficient exercise
• Adjust diet
  • Fibre-rich and low-fat food: vegetables, salad, fruit, whole grain products
  • Avoid constipating foods, if necessary
• Drink enough, approx. 1.5 litres per day (more for fever and sweating)
• Don't suppress the urge to defecate
• Household remedies to take internally:
  • Prunes
  • Figs, apple sauce
  • Sauerkraut juice

When to see a doctor?

• Blood in stools or urine
• Blood in the genital area (between periods)
• Purulent yellow secretion in stools, urine, genital area
• Severe abdominal pain
• Accompanied by fever
• Wetting
• Constipation or diarrhoea over a longer period
• Vomiting, regurgitation of food residues

Synonyms

diverticula, diverticulum, diverticuli