Well, not ticks, but ‘tics’ – or diverticuli. What are tics, anyway? This is a question that I am often asked following a colonoscopy when they are commonly found. Diverticuli are basically a pouch or sac off the colon wall created by herniation of the inner lining of the colon. They pop out through a muscular defect created by a blood vessel that goes through the wall. Basically, they look like a small cave that stuff can get stuck in. There may be an associated thickening of the muscular folds of the colon, causing narrowing of the passageway.
Diverticuli are very common as people age. In Western society, thirty to sixty percent of 60 year olds may have them, typically in the lower left colon (sigmoid) whereas in Asian societies the incidence is much much lower and they are more common in the right colon (ascending). The incidence progressively rises as we age.
Usually diverticuli are asymptomatic but about 20% of people may have a complication. This is called diverticulitis. (Any medical word with itis at the end of it means inflammation.). Diverticulitis occurs when the diverticulum becomes ulcerated or inflamed and there is leakage of colonic contents either on a small or large scale. As well, diverticulosis may be associated with increased risk of bleeding from blood vessels associated with them or from colitis (note from previous lesson – inflammation of the colon).
Other than age, risk factors for diverticulosis include obesity, steroids and anti-inflammatory drugs, smoking, sedentary lifestyle, low vitamin D levels and a diet high in meat and low in fiber. It used to be felt that foods like seeds, nuts or popcorn could increase your risk of suffering a complication, however this has been disproven by more recent studies.
Once you know that you have this condition, there is a tendency to want to treat the onset of abdominal pain with antibiotics. However, this may be unnecessary and warrants further discussion, examination and possibly blood work or a CT scan to be ordered by your doctor. Pain may originate due to abnormal colonic movement in the area of diverticuli, constipation or increased sensitivities in the area.
So, if you have this condition, increase your dietary fiber, ideally to 25 grams daily, stop smoking, avoid red meat and exercise! Our trainer Troy is fond of saying “slouch on the couch and you will get a pouch.” This pouch may just be a diverticulum! If, despite these efforts, you experience pain in the lower left abdomen that persists with or without a fever or bleeding (less common complication), contact your gastroenterologist .
Diverticulosis- the condition of having multiple diverticuli
Diverticuli- more than one diverticulum (singular)
Diverticulitis-inflammation associated with diverticuli