Rectal Bleeding (cont.)
Diverticulosis
Diverticulosis is a condition in which the colon contains
outpouchings (little sacks). Diverticula develop in most people by the age of
50-60. The cause of colonic diverticula is not entirely known, but may be due to
years of high pressure within the colon or a weakness in the wall of the colon.
Diverticula are permanent, and no diet will cause them to disappear. The only
way to rid a person of diverticula is to surgically remove the part of the colon
that contains the diverticula. A person with diverticulosis typically has many
diverticula scattered throughout the colon, but diverticula are most common in
the sigmoid colon.
Most people with diverticulosis have few or no symptoms.
Diverticulosis is not a problem unless a diverticulum ruptures and an infection
(abscess) results, a condition called diverticulitis. Diverticulitis causes
abdominal pain, fever and tenderness usually in the left lower abdomen. Rarely,
bleeding can occur from a diverticulum during diverticulitis when a blood vessel
inside the diverticulum is weakened by the infection and ruptures.
Bleeding from
diverticulosis (diverticular bleeding) without the presence of diverticulitis is
painless. Bleeding from diverticulosis is generally more severe and brisker than
bleeding from anal fissures, hemorrhoids, and colon tumors. Diverticular
bleeding is the most common cause of moderate to severe rectal bleeding that
requires hospitalization and blood transfusions among the elderly population in
the Western world.
When bleeding occurs in a diverticulum located in the sigmoid
colon, the bleeding tends to be bright red. When bleeding occurs in a
diverticulum located in the right colon, the bleeding may also be bright red if
the bleeding is brisk; However, the color is more likely to be dark red, maroon,
or, sometimes, even black (melena).
Bleeding from diverticulosis is usually
brief (it stops on its own). However, diverticular bleeding tends to recur. For
example, a patient may experience several episodes of rectal bleeding from
diverticula during the same hospitalization. Even after discharge from the
hospital, approximately 25% of the patients who do not have the
diverticula-containing part of their colon surgically removed will experience
another episode of diverticular bleeding within 4-5 years. For more, please see
the Diverticulosis article.
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