II. Definitions
- Diverticulum (Diverticula, Diverticuli)
- Small pouch or sac that bulges from the wall of a hollow organ (e.g. Colonic Diverticuli)
- Diverticulosis
- Colonic Diverticula present on Colonoscopy or imaging
- Acute Diverticulitis
- Inflammation of a Diverticulum
III. Epidemiology
- Attributed to the low fiber diets in developed countries
- Rare in non-developed countries, where fiber intake is higher
- Diverticulosis Prevalence
- Age over 40 years: 10%
- Age over 60 years: 50%
- Age over 80 years: 50 to 70%
IV. Pathophysiology
- Low fiber diet predisposes to small stools, straining and increased bowel luminal pressures
- Characteristics
- Colonic Muscle wall is weak where vessels penetrate
- Large Bowel submucosa Herniates through the bowel's muscular layer
- Diverticuli develop with patient's age
- Usually multiple Diverticuli present
- Size: Usually <10 mm
- Colonic Muscle wall is weak where vessels penetrate
- Distribution
- Sigmoid colon
- Most common site for Diverticuli in western societies (accounts for 85% of Diverticuli)
- Ascending colon (right Diverticuli)
- Age <60 years
- Asian patients
- Sigmoid colon
- Protective factors
- Vegetarian Diet
- High fiber diet
V. Symptoms
- Asymptomatic in 85% of patients
-
Colicky Abdominal Pain without inflammation in 15%
- Relieved with Bowel Movement or Flatus
- Worse with eating
- Associated with bloating and Constipation
- Left lower abdominal tenderness to palpation
- Diverticulitis develops in 5% of patients
VI. Differential Diagnosis
VII. Diagnosis: Symptomatic Diverticular Disease
-
Colonoscopy is test of choice
- Rules out Colon Cancer
- Contraindicated in active Diverticulitis
VIII. Management
- High fiber diet
- Avoid high residue foods (seeds, nuts, corn)
- Recommended theoretically to prevent lodging in tics, but has been dispelled as a risk factor
- No evidence to support this
- Antispasmodic agents have no evidence to support use
IX. Complications
-
Diverticulitis
- Incidence 1.5 to 6 per 1000 person years for those with Diverticula
- Affects 1 to 4% (up to >10% in some studies) of patients with Diverticular Disease (lifetime risk)
-
Diverticular Hemorrhage
- Incidence 0.46 per 1000 person years for those with Diverticula
- Most common cause of Lower Gastrointestinal Bleeding
X. References
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | A pouch or sac opening from the COLON. |
| Concepts | Anatomical Abnormality (T190) |
| MSH | D004241 |
| ICD9 | 562.1 |
| English | Diverticula of colon, Colonic diverticula, Diverticulum, Colon [Disease/Finding], diverticula colon, diverticula of colon, colon diverticulum, colonic diverticula, diverticulum colon, colon diverticula, Colonic Diverticulum, Diverticulum, Colon, Diverticulum, Colonic, Colon Diverticula, Diverticula, Colon, Colonic Diverticula, Diverticula, Colonic, Colon diverticulum anatomic structure, colon; diverticulum, Colon Diverticulum |
| Dutch | colondivertikels, colon; divertikel, Colondiverticulosis, Colondivertikel, Divertikel, colon- |
| German | Divertikel des Kolons, Divertikel, Kolon-, Kolondivertikel |
| Portuguese | Divertículos do cólon, Divertículo Colônico, Divertículo Cólico, Divertículo do Colo |
| Spanish | Divertículos de colon, Divertículo Colónico, Divertículo Cólico, Divertículo del Colon |
| Swedish | Kolondivertikel |
| Japanese | ｹｯﾁｮｳｹｲｼﾂ, 大腸憩室, 結腸憩室, 憩室-結腸 |
| Czech | kolon - divertikl, Divertikly tračníku |
| Finnish | Koolonin divertikkeli |
| Russian | TOLSTOGO KISHECHNIKA DIVERTIKULEZ, TOLSTOI KISHKI DIVERTIKULEZ, DIVERTIKUL TOLSTOI KISHKI, TOLSTOI KISHKI DIVERTIKUL, DIVERTIKULEZ TOLSTOGO KISHECHNIKA, ДИВЕРТИКУЛЕЗ ТОЛСТОГО КИШЕЧНИКА, ДИВЕРТИКУЛ ТОЛСТОЙ КИШКИ, ТОЛСТОГО КИШЕЧНИКА ДИВЕРТИКУЛЕЗ, ТОЛСТОЙ КИШКИ ДИВЕРТИКУЛ, ТОЛСТОЙ КИШКИ ДИВЕРТИКУЛЕЗ |
| Italian | Diverticoli del colon, Diverticolo del colon |
| Croatian | DIVERTIKULUM KOLONA |
| Polish | Uchyłkowatość jelita grubego, Uchyłek okrężnicy, Uchyłki jelita grubego |
| Hungarian | Vastagbél diverticulumai |
| Norwegian | Tykktarmsdivertikkel, Divertikkel, tykktarm, Colondivertikkel, Divertikkel, kolon, Kolondivertikkel, Divertikkel, colon |
| French | Diverticules intestinaux, Diverticule colique, Diverticule du côlon, Diverticules du côlon |
Ontology: Diverticulum (C0012817)
| Definition (MSH) | A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT. |
| Definition (CHV) | a pouch in a hollow organ such as intestine |
| Definition (CHV) | a pouch in a hollow organ such as intestine |
| Definition (CHV) | a pouch in a hollow organ such as intestine |
| Definition (NCI_NCI-GLOSS) | A small pouch or sac that bulges out from the wall of a hollow organ, such as the colon. |
| Concepts | Pathologic Function (T046) |
| MSH | D004240 |
| SnomedCT | 31113003 |
| English | Diverticula, Diverticulum NOS, Diverticulum [Disease/Finding], Diverticulum, diverticulum, diverticulums, diverticula, Diverticulum (morphologic abnormality), Diverticulum, NOS |
| Italian | Diverticoli, Diverticolo NAS, Diverticolo |
| Dutch | divertikel NAO, divertikels, divertikel, Divertikel |
| French | Diverticule SAI, Diverticule, Diverticules |
| German | Divertikel NNB, Divertikelbildung, Divertikel |
| Portuguese | Divertículo NE, Divertículos, Divertículo |
| Spanish | Divertículo NEOM, divertículo (anomalía morfológica), divertículos, divertículo, Divertículos, Divertículo |
| Japanese | 憩室ＮＯＳ, ｹｲｼﾂ, ｹｲｼﾂNOS, ｹｲｼﾂｼｮｳ, 憩室症, 憩室 |
| Swedish | Divertikel |
| Czech | divertikl, Divertikl NOS, Divertikly, Divertikl |
| Finnish | Divertikkeli |
| Russian | DIVERTIKULEZ, DIVERTIKUL, ДИВЕРТИКУЛ, ДИВЕРТИКУЛЕЗ |
| Croatian | Not Translated[Diverticulum] |
| Latvian | Not Translated[Diverticulum] |
| Polish | Uchyłkowatość, Uchyłek |
| Hungarian | Diverticulum k.m.n., Diverticulum, Diverticulumok |
| Norwegian | Divertikkel |
Ontology: Diverticulosis (C1510475)
| Definition (MSH) | A condition characterized by the presence of multiple diverticuli in the walls of an organ. |
| Definition (NCI_NCI-GLOSS) | A condition marked by small sacs or pouches in the walls of a hollow organ, such as the colon. These sacs can become inflamed and cause a condition called diverticulitis. |
| Definition (NCI) | A finding indicating the presence of multiple pouches, usually in the colonic or gastric wall. |
| Concepts | Anatomical Abnormality (T190) , Disease or Syndrome (T047) |
| MSH | D004240 |
| ICD9 | 562 |
| ICD10 | K57 , K57.90 |
| SnomedCT | 68047000, 155778008, 197094004, 235772003, 197081001, 197093005, 197116004, 155781003, 197082008, 155780002, 271365001, 31113003, 397881000, 63532004 |
| English | Diverticula of intestine NOS, Diverticula of the intestine NOS, Diverticular disease intestine, Diverticular disorder of intestine, Diverticulosis NOS, Diverticulosis unspecified, diverticula of intestine (diagnosis), diverticulosis (diagnosis), diverticulosis, diverticula of intestine, Diverticular disorders, Diverticulum intestinal, Diverticular disease of intestine, Diverticular disease of intestine NOS, intestinal diverticulum, Disease;diverticular;intestine, diverticulum intestinal, Diverticulosis NOS (disorder), Diverticular disease(& [of intestine]), Diverticulosis unspecified (disorder), Diverticular disorder of intestine (disorder), Diverticular disease(& [of intestine]) (disorder), Diverticula of the intestine NOS (disorder), Diverticula of intestine, Diverticular disease, DD - Diverticular disease, Diverticula of intestine (disorder), Diverticular disease (disorder), Diverticulum of intestine, Diverticula of intestine, NOS, Diverticular Disorder, Diverticulosis, diverticular disease |
| Italian | Disturbi diverticolari, Diverticolo dell'intestino, Malattia diverticolare, Diverticoli dell'intestino, Diverticolosi |
| Dutch | diverticulose, divertikelziekte, darmdivertikels, Diverticulose/diverticulitis, darmdivertikel, divertikelaandoeningen, Divertikelziekte, Diverticulosis |
| French | Diverticulite de l'intestin, Maladie diverticulaire, Diverticulose, Affections diverticulaires, Diverticule intestinal |
| German | Divertikelerkrankung, Divertikel des Darms, Divertikulose, Divertikulose des Darmes, Darmdivertikel, Divertikelerkrankungen |
| Portuguese | Divertículos do intestino, Doença diverticular, Diverticulose, Afecções diverticulares, Divertículo intestinal |
| Spanish | Enfermedad diverticular, Divertículos de intestino, Diverticulosis, trastorno diverticular de intestino (trastorno), Diverticulosis NOS, trastorno diverticular de intestino, diverticulosis no especificada, diverticulosis, SAI (trastorno), divertículos intestinales, SAI (trastorno), diverticulosis, SAI, divertículos intestinales, SAI, diverticulosis no especificada (trastorno), diverticulosis, divertículo del intestino (trastorno), divertículo del intestino, divertículo intestinal, enfermedad diverticular (trastorno), enfermedad diverticular, Trastornos diverticulares, Divertículo intestinal |
| Japanese | 憩室疾患, 腸憩室, 憩室症, 憩室性疾患, ﾁｮｳｹｲｼﾂ, ｹｲｼﾂｾｲｼｯｶﾝ, ｹｲｼﾂｼｮｳ, ｹｲｼﾂｼｯｶﾝ |
| Czech | Divertikulóza, Divertikl střeva, Divertikly střeva, Divertikulární poruchy, Divertikulární nemoc, divertikulóza |
| Korean | 창자의 곁주머니(게실)병 |
| Hungarian | Diverticulosis, Intestinalis diverticulum, Bél diverticulumai, Diverticulum betegségek, Diverticulosisos betegség |
| Norwegian | Divertikulose |
