DIVERTICULAR DISEASE
Posted by admin on May 12th, 2010DIVERTICULAR DISEASE
Colonic diverticula are herniations of colonic miico.su through the smooth muscle layers. Diverticulosis is the presence of diverticula without infiamimition. Painful diverticular disease is diverticulosis accompanied by painful spasm or other symptoms. Diverticulitis is an infection arising from colonic diverticula.
Diverticula develop in areas where circular smooth muscle has been weakened by the penetration of blood vessels to the submucosa. Usually, diverticula are found in the sigmoid and descending colons and rarely in the rectum.
Diverticula are associated with aging, which may lead to structural weakening of colonic muscle. Diverticular disease occurs in abou! 40% of those > 65 yr and about 50% of those > 80 yr in Western countries. Diverticula have been found with increasing frequency in Western populations, probably because of increased longevity and insufficient dielary fiber. Low fiber diets may increase colonic motor activity and intraluminal pressures; therefore, fiber supplements are recommended for diverticulosis and painful diverticular disease.
The incidence of diverticulitis increases with the duration of diverticulosis. Diverticulitis develops in 15% [o 25% of persons wilh diverticulosis who are followed up s~ 10 yr. The organisms that cause diverticulitis include usual colonic flora (eg, aerobic and anaerobic gram-negative bacilli); the role of entcrococci is unknown.
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