Diverticulitis (Diverticulosis) - Causes

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What causes diverticula, and how do diverticula form?

The muscular wall of the colon grows thicker with age, although the cause of this thickening is unclear. It may reflect the increasing pressures required by the colon to eliminate feces. For example, a diet low in fiber can lead to small, hard stools which are difficult to pass and which require increased pressure to pass. The lack of fiber and small stools also may allow segments of the colon to close off from the rest of the colon when the colonic muscle in the segment contracts. The pressure in these closed-off segments may become high since the increased pressure cannot dissipate to the rest of the colon. Over time, high pressures in the colon push the inner intestinal lining outward (herniation) through weak areas in the muscular walls. These pouches or sacs that develop are called diverticula.

Lack of fiber in the diet is considered the most likely cause of diverticula, and there is a good correlation among societies around the world between the amount of fiber in the diet and the prevalence of diverticula. Many patients with diverticular disease have excessive thickening of the muscular wall of the colon where the diverticula form. The muscle also contracts more strongly. These abnormalities of the muscle may be contributing factors in the formation of diverticula. Microscopic examination of the edges of the diverticula show signs of inflammation, and it has been suggested that there may be an inflammatory component to the formation of the diverticula.

Return to Diverticulitis (Diverticulosis, Diverticular Disease)

See what others are saying

Comment from: miggins, 55-64 Female (Patient) Published: July 14

I'm experiencing a second diverticulitis attack; first due to reaction to naproxen prescribed after hip surgery 3 years ago, now same problem with Ibuprofen, taken daily post-surgery for broken wrist. Last time I ended up hospitalized five days, no food or water for four, on IV antibiotics, morphine, etc. It was horrible, but I didn't need surgery. This time, I'm trying clear liquids, first three days, then low fiber, but it came back, so now on second day clear liquids. How long!

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Comment from: Miami Sue, 55-64 Female (Patient) Published: April 28

In 2008 I had a colonoscopy and was congratulated because no polyps were found. I did have diverticulosis and had no understanding of what that meant. I was active with a healthy diet and when I got increasing abdominal pain in 2011 I called my doctor. He asked if my appendix had been removed. I said no and he sent me to the hospital. There I was diagnosed with diverticulitis, given antibiotics and sent home with prescriptions for Cipro and Flagyl (10 days). After taking same I felt much better. My attack occurred after eating a box of crackers with poppy seeds. Now there is a debate, some doctors say it doesn't matter what you eat, others say avoid nuts and seeds but eat high fiber. The catch is that high fiber foods are difficult to digest, so if you are having a flare up you should not eat high fiber foods and fruit. Allow your bowels to rest and heal first. Probiotics are not a cure but they support colon/abdominal health, especially if you take antibiotics. I had additional flare ups in 2013, 2014 and 2015. I decided to have the surgery as I had lost a lot of weight (I was small to begin with) and was in a lot of pain and did not want to perforate. It is just 3 weeks since my surgery and I am feeling so much better. Eating fish and poultry, I can now tolerate salad and green vegetables. My advice is, each person is different, so if you aren't having flare ups maintain a healthy (high fiber, low grease) diet with exercise but if you are having repeated infections contact an experienced highly skilled surgeon and schedule your operation.

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