$Unique_ID{BRK03668} $Pretitle{} $Title{Diverticulosis} $Subject{Diverticulosis Diverticulosis of the Colon Colon, Diverticulosis Diverticulitis Familial Polyposis Carcinoma of the Colon} $Volume{} $Log{} Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc. 464: Diverticulosis ** IMPORTANT ** It is possible the main title of the article (Diverticulosis) is not the name you expected. Please check the SYNONYMS listing on the next page to find alternate names, disorder subdivisions, and related disorders covered by this article. Synonyms Diverticulosis of the Colon Colon, Diverticulosis Information on the following disorders can be found in the Related Disorders section of this report: Carcinoma of the Colon Diverticulitis Familial Polyposis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Diverticulosis is characterized by small sac-like hernias of inner intestinal tissue protruding through the muscular wall of the large intestine (colon). These so-called diverticula may occur in any part of the colon, but most frequently in the lowest part (sigmoid). Symptoms Diverticulosis is characterized by small sac-like bodies (diverticula) which protrude through the wall of the colon. The diverticular wall consists of a thin layer of mucous membrane tissue. Diverticula can vary in size from 0.1 inch to larger than 1 inch in diameter, and are frequently responsible for bleeding from the rectum. Diverticulitis occurs when diverticula become infected. However, until this occurs most persons with diverticula show no symptoms. Causes Diverticulosis may be caused by a highly refined diet lacking sufficient fiber and bulk. The lack of bulk may cause muscle spasms of the colon, especially in the lower section called the sigmoid. Pressure inside the colon builds up and the mucous tissue eventually pushes through the muscular coat of the colon, usually where the blood vessels pierce the muscle. Ulceration of the diverticulum may occur causing rectal bleeding. Chronic constipation may also cause Diverticulosis. If the sacs become infected Diverticulosis becomes Diverticulitis. (For more information, see the Related Disorders section of this report.) Affected Population Diverticulosis is a common disorder affecting 30 to 40% of persons over age 50. The incidence increases with each subsequent decade of life. It affects males and females in equal numbers. Diverticulitis is less common than Diverticulosis. Related Disorders Diverticulitis is characterized by inflammation of one or more diverticula. Perforation of a diverticulum may lead to inflammation or contamination of the surrounding tissues in the abdominal cavity. The inflamed bowel segment often adheres to other parts of the bowel or the vagina. An abnormal connection to those organs (fistula) may develop. With repeated inflammation, the colon wall thickens, its cavity narrows, and acute obstruction or perforation may occur. Carcinoma (Adenocarcinoma) of the Colon is characterized by pain in the lower abdomen, constipation or diarrhea, excessive gas (flatulence), liquid narrow feces streaked with blood, and nausea. Patients with this disorder lose weight. The cause of this type of cancer is unknown. It may be associated with polyps or ulcerative colitis. This cancer tends to run in families and has a peak incidence between the ages of 50 and 60. Familial Polyposis of the Colon is a genetic digestive disorder that is usually without noticeable symptoms for years. A polyp is a mass of tissue that arises from the mucous membrane of the intestine and protrudes into its cavity. Familial Polyposis is characterized by rectal bleeding, possibly diarrhea or constipation, intermittent abdominal pain and weight loss. The polyps usually develop during puberty or early adulthood. Untreated patients with Familial Polyposis have a very high risk of developing colonic cancer. (For more information, choose "Polyposis" as your search term in the Rare Disease Database.) Therapies: Standard Diverticulosis may be treated by a diet high in fiber; e.g. whole wheat bread, bran cereal, etc. Application of heat, adequate rest, a diet with substantial bulk and medication usually relieve symptoms. Small doses of the barbiturate drug phenobarbital, and the anticholinergic muscle relaxant belladonna, may also relieve abdominal distress. If severe bleeding occurs, immediate hospitalization, blood transfusions, and close observation are necessary. Surgery may occasionally be required to treat severe bleeding. If the source of the bleeding can be identified, that segment of the colon may be removed. In very severe cases, removal of the whole colon may be recommended. This surgical procedure can be performed in steps to reduce the risk in elderly patients. Therapies: Investigational This disease entry is based upon medical information available through December 1988. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Diverticulosis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 National Digestive Diseases Information Clearinghouse Box NDIC Bethesda, MD 20892 (301) 468-2168 References Internal Medicine, 2nd ed.: Jay H. Stein, et al., eds. Little, Brown, 1987. Pp. 168-179. FINDINGS IN PATIENTS WITH DIVERTICULOSIS AND DIVERTICULITIS OF THE COLON: E.J. Lubbers, et al.; Arch Chir Neerl (1976: issue 28(3)). Pp. 179- 186. COLONIC BLEEDING IN THE ELDERLY: K.V. Avots-Avotkin, et al.; Clin Geriatr Med (May 1985: issue 1(2)). Pp. 433-443.