Treatment of colonic diverticulosis

Sometimes abdominal discomfort, unstable bowel movements, or periodic pain on the lower left side of the abdomen seem insignificant. Many people do not see a doctor for years, attributing this to dietary habits or stress. However, in some cases, the cause of such symptoms is diverticulosis of the large intestine — a condition that requires attention and medical supervision.

If explained simply, what is diverticulosis? It is the formation of small protrusions in the intestinal wall that occur in areas of its weakening. Most often, the changes are localized in the left sections of the large intestine. By themselves, such formations may not bother a person for a long time, but under certain conditions they can become inflamed and cause serious complications.

Timely diagnosis makes it possible to identify the problem at an early stage, and properly selected treatment tactics help control the course of the disease and reduce the risk of exacerbations. That is why it is important not to ignore recurring symptoms and to consult a specialist for examination.

The formation of diverticula is associated with increased pressure inside the intestine and gradual weakening of its wall. With age, tissues lose elasticity, and sac-like protrusions may form in areas of natural weakness.

In most cases, the changes are localized in the left sections of the large intestine. The sigmoid colon is its lower section in front of the rectum, where intraluminal pressure is usually higher. That is why diverticulosis of the sigmoid colon is the most common form of diverticulosis of the large intestine.

Most often, diverticulosis of the intestine develops under the influence of the following factors:

• chronic constipation, leading to regular straining during defecation;
• a diet low in fiber;
• insufficient physical activity;
• excess body weight;
• age-related changes in connective tissue;
• concomitant metabolic disorders, in particular diabetes mellitus.

The combination of these factors contributes to an increase in intraluminal pressure and gradual weakening of the intestinal wall. As a result, diverticula are formed, which may not cause symptoms for a long time. However, when intestinal contents stagnate in their lumen, the risk of inflammation and the development of complications increases, so even in the absence of pronounced complaints, it is important to monitor the condition of the intestine.

The pain usually has an aching character, may intensify after eating or before defecation, and decrease after the passage of gas or bowel emptying. This is exactly how diverticulosis of the intestine often manifests itself in the initial stages.

If inflammation develops in the diverticulum, diverticulitis occurs. In such a case, the symptoms become more pronounced: the temperature rises, sharp abdominal pain appears, nausea and general weakness are possible. This is a condition that requires immediate medical attention.

The examination begins with a detailed conversation and clinical examination. The doctor clarifies the nature of the pain, the frequency of bowel movements, the presence of bloating, and increased temperature. Already at this stage, diverticulosis of the large intestine can be suspected, however, instrumental methods are necessary to confirm the diagnosis.

Main diagnostic methods:

• Colonoscopy — allows direct examination of the mucous membrane of the large intestine and detection of diverticula, as well as exclusion of other causes of pain or bowel movement disturbances;
• CT of the intestine — is used when inflammation or complications are suspected, helps assess the condition of the intestinal wall and surrounding tissues, detect abscesses or perforation;
• MRI of the intestine — is used when additional visualization is needed and allows a more detailed assessment of the extent of the pathological process;
• laboratory blood tests — help detect signs of inflammation and assess the general condition of the body.

A comprehensive examination makes it possible to determine the exact diagnosis and choose the optimal treatment tactics.

In most cases, in diverticulosis of the intestine, treatment is conservative in nature and is aimed at normalizing bowel function and preventing inflammation.

Usually, the doctor recommends:

• gradually adding vegetables, fruits, greens, whole-grain porridges (buckwheat, oatmeal), and bran to the diet;
• drinking a sufficient amount of water during the day;
• establishing a regular eating schedule without long breaks;
• if necessary, using mild laxatives or medications to regulate intestinal motility.

It is important to understand: diverticula do not disappear, however, properly selected tactics make it possible to control the course of the disease and significantly reduce the risk of complications.

In most people, diverticulosis of the large intestine may not cause pronounced symptoms for a long time. However, under certain conditions (stagnation of intestinal contents, microtraumatization of the wall), complications may develop that require urgent medical care.

The most common complications include:

• diverticulitis — an inflammatory process in the intestinal wall in the area of the diverticulum, which manifests itself by local pain (more often on the lower left side of the abdomen), increased temperature, and general weakness;
• intestinal bleeding — may be accompanied by the appearance of blood in the stool or a sudden decrease in blood pressure and weakness;
• abscess — the formation of a limited purulent focus in the tissues around the intestine;
• perforation — a violation of the integrity of the intestinal wall with the development of inflammation of the peritoneum;
• intestinal obstruction — narrowing of the intestinal lumen as a result of inflammation or cicatricial changes.

Alarm symptoms are increased pain, elevated temperature, nausea, vomiting, severe weakness, or blood in the stool. In such cases, it is necessary to consult a doctor urgently. To clarify the nature of the complication and assess the condition of the tissues, CT of the intestine may be performed, which allows detection of an abscess, perforation, or other dangerous changes.

Prevention of diverticulosis is aimed at maintaining regular bowel function and reducing intraluminal pressure. Dietary habits, sufficient fluid intake, and physical activity are of primary importance.

It is important that the diet for diverticulosis includes daily consumption of products that promote soft and regular bowel emptying. It is advisable to include vegetables (zucchini, carrots, pumpkin, broccoli), fruits (apples, pears, plums), berries, greens, whole-grain porridges (buckwheat, oatmeal), and bread made from coarse flour in the diet. New products should be added gradually in order to avoid bloating and discomfort.

It is also recommended:

• to drink at least 1.5–2 liters of water per day (in the absence of contraindications);
• to maintain daily physical activity — even ordinary walking improves peristalsis;
• not to suppress the urge to defecate and to avoid excessive straining;
• to limit refined products, excess white flour, and sweets;
• to control body weight and concomitant metabolic disorders.

Following these recommendations helps reduce the risk of exacerbations, the development of diverticulitis, and other complications.

The cost of treatment is determined individually and depends on the clinical situation. The form of the disease, the presence of complications, the need for additional examinations, and the scope of the necessary therapy are important.

In cases when diverticulosis of the large intestine is diagnosed, the scope of care may include a consultation with a gastroenterologist or surgeon, laboratory tests, instrumental diagnostic methods, drug treatment, and in the event of complications — inpatient observation or surgical intervention.

You can preliminarily familiarize yourself with the current prices for doctors’ consultations here. In more detail regarding the next steps and the cost of procedures, the doctor can guide you during the appointment after the initial assessment of the condition. To book a consultation, contact the contact center or use the online booking form on the website.