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Colonic Diverticular Disease

Colonic Polyps

What are the symptoms of Colonic Diverticular Disease?

The symptoms of Colonic Diverticular Disease can vary depending on whether a person has diverticulosis or diverticulitis.

  • Diverticulosis
    • Often asymptomatic: most people with diverticulosis do not experience any symptoms.
    • Mild symptoms (if present): some individuals may experience mild cramps, bloating, or irregular bowel habits, such as constipation or diarrhoea.
  • Diverticulitis
    • Abdominal pain: usually presents as severe and sudden pain, commonly in the lower left side of the abdomen.
    • Fever: a high temperature often accompanies the inflammation.
    • Nausea and vomiting: these symptoms can occur due to the body’s response to the infection and inflammation.
    • Changes in bowel habits: this can include constipation or diarrhoea, which may accompany the abdominal pain.
    • Tenderness in the abdomen: the area over the affected diverticula may become tender to touch.
    • Rectal bleeding: in some cases, there might be rectal bleeding due to inflammation or infection.
severe abdominal pain diverticulitis singapore
Abdominal pain, particularly in the lower left side, is a common symptom of diverticulitis.

Is Colonic Diverticular Disease painful?

Colonic Diverticular Disease can be painful, particularly when diverticulitis develops. While diverticulosis, the presence of diverticula, is often asymptomatic and not typically associated with pain, diverticulitis involves the inflammation or infection of these diverticula and can cause significant discomfort. Individuals with diverticulitis often experience severe and sudden pain, usually in the lower left side of the abdomen. This pain is typically accompanied by other symptoms such as fever, nausea, vomiting, and changes in bowel habits like constipation or diarrhoea. The affected area of the abdomen may also become tender to the touch.

Who is at risk of Colonic Diverticular Disease in Singapore?

In Singapore, the following factors exacerbate the risk for developing Colonic Diverticular Disease:
  • Age: the risk increases significantly with age, particularly after the age of 40. As people get older, the walls of the colon can weaken, which makes it more susceptible to diverticula formation.
  • Diet: a diet low in fibre and high in refined foods is a significant risk factor. Fiber helps maintain regular bowel movements and reduces pressure within the colon. A low-fiber diet can lead to constipation and increased pressure, which may contribute to the formation of diverticula.
  • Genetics: a family history of colonic diverticular disease can increase an individual’s risk, as research suggests a genetic predisposition to the condition.
  • Physical Activity: lack of regular exercise is associated with a higher risk of developing diverticular disease. Physical activity helps maintain healthy bowel function and reduce pressure in the colon.
  • Obesity: being overweight or obese can increase the likelihood of developing diverticular disease due to increased pressure on the colon walls.
  • Smoking: smoking has been linked to an increased risk of diverticulitis, the inflammatory form of the disease.
  • Certain medications: use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and opioids, can increase the risk of developing diverticulitis.

However, while these factors contribute to the likelihood of developing colonic diverticular disease, lifestyle choices can play a significant role in its prevention and management.

What are the available treatment options for Colonic Diverticular Disease in Singapore?

Treatment options for Colonic Diverticular Disease vary based on whether the patient has uncomplicated diverticulosis or complicated diverticulitis. Here's a detailed look at the treatments:

Diverticulosis

  • Dietary changes:
      • High-fibre diet: increasing dietary fibre intake is crucial. Foods rich in fibre, such as fruits, vegetables, whole grains, and legumes, help soften stool and reduce pressure in the colon.
      • Hydration: drinking plenty of water aids in maintaining soft stool consistency and regular bowel movements.
  • Lifestyle modifications:
      • Regular exercise: engaging in regular physical activity can help improve bowel function and reduce pressure in the colon.
      • Avoiding straining: avoiding straining during bowel movements can help reduce the risk of developing diverticula.

Diverticulitis

  • Mild Cases:
      • Antibiotics: oral antibiotics are often prescribed to treat the infection and inflammation.
      • Dietary adjustments: a temporary liquid or low-fiber diet may be recommended until symptoms improve, followed by a gradual reintroduction of fiber.
  • Severe Cases:
      • Hospitalisation: severe cases may require hospitalization for intravenous antibiotics and fluids.
      • Bowel rest: patients may be put on a clear liquid diet or given nothing by mouth (NPO) to allow the colon to rest and heal.
      • Surgical intervention:
      • Abscess drainage: if an abscess has formed, it may need to be drained, usually via a needle guided by ultrasound or CT scan.
      • Surgery: surgery may be necessary in cases of recurrent diverticulitis, complications like perforation, peritonitis, fistula, or significant bleeding. Surgical options include:
        • Primary bowel resection: the affected portion of the colon is removed, and the healthy ends are reconnected (anastomosis).
        • Bowel resection with colostomy: in some cases, especially when inflammation is severe, a temporary colostomy may be created. This involves diverting the colon's end to an opening in the abdominal wall (stoma), where waste is collected in a bag. The colostomy can be reversed once the colon heals.
  • Long-term management:
      • Ongoing high-fibre diet: continuing a high-fibre diet helps prevent future episodes.
      • Regular follow-ups: regular medical check-ups to monitor the condition and prevent complications.

Treatment plans are tailored to the individual based on the severity of the disease, overall health, and response to initial treatments. 

If you are experiencing the symptoms of Colonic Diverticular Disease, please schedule an appointment with CRCS Clinic to learn more about this condition and a thorough diagnosis. 

Frequently Asked Questions

Yes, maintaining a high-fibre diet, staying hydrated, and engaging in regular physical activity can help prevent complications and manage the disease effectively.

Contrary to past beliefs, recent research suggests that nuts and seeds do not increase the risk of diverticulitis and can be safely consumed as part of a balanced diet.

Surgery is usually only necessary for severe or recurrent cases of diverticulitis, especially if complications arise. Most cases can be managed with antibiotics and dietary changes.

While stress does not directly cause diverticular disease, it can impact your overall digestive health. Managing stress through relaxation techniques may help improve symptoms.

Yes, regular exercise is beneficial and can help manage symptoms. However, it's important to listen to your body and avoid activities that cause discomfort.

Screening recommendations can vary, but typically, a colonoscopy every 5-10 years is advised, especially after the age of 50 or earlier if you have a strong family history or symptoms.

Many people with diverticular disease live healthy lives with proper management. Complications can occur but are often preventable with lifestyle adjustments and medical care.

Generally, it's recommended to avoid foods that may irritate the colon, such as processed foods and those low in fibre. Focus on a balanced diet rich in fruits, vegetables, and whole grains.

For mild flare-ups, rest, a liquid or low-fibre diet, and over-the-counter pain relief can help. If symptoms are severe or persistent, seek medical attention.

Location

Colorectal Care Specialists (CRCS)

3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

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