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Diverticulosis

German: Divertikulose

1 Definition

Diverticulosis is a condition where the colon develops multiple diverticula (pouches). Those pouches however, are false diverticula (also called pseudiverticula), meaning that not all layers of the intestinal wall are affected.

2 Epidemiology

Diverticulosis is an example of diseases of affluence in developed countries, promoted by a diet lacking fiber. The condition is most common in people >70 years.

3 Pathogenesis

Pathogenesis of diverticulosis is not yet fully understood. Epidemiological data and clinical observation point to certain predisposing factors:

4 Localization

Diverticula generally can appear in all sections of the colon. Most often, the sigmoid colon is affected.

5 Clinical significance

Diverticulosis is frequently discovered as an additional finding in the course of a colonoscopy because most patients (80%) with the condition remain asymptomatic. Diverticulosis only becomes a primary symptom when it progresses to diverticulitis (inflammation of the diverticula).

5.1 Complications

Besides acute diverticulitis, additional complications can occur because of diverticulosis. Those include:

6 Therapy

The usual course of action is to wait and observe the development of the disease. Emergency surgery is indicated when complications or chronically recurring diverticulitis occur.

When asymptomatic diverticulosis has been diagnosed, the patients should switch to a diet high in fiber. Furthermore, irregularities in the frequency of defecation should be regulated.

In case of acute diverticulitis, depending on severity, conservative treatment in consultation with a surgeon is the preferred method. The general principles are:

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