No matter how hard we try, we cannot escape some of the natural side effects of aging. One of these is years of wear and tear on our intestines from eating, absorbing, and processing food. To push along digested food, muscles along the colon wall contract, applying pressure in a wavelike motion along the full length of the colon. This helps move waste to the rectum—our signal that we need to find a bathroom.
Over time, repeated and sometimes uneven pressure—due to constipation, for instance—weakens the lining of the colon. Without its strong elasticity, the lining can bulge through the colon wall, forming a sac or pouch, a condition called diverticulosis. (The technical term for these small pouches is diverticula.) Most adults over age 60 have these pouches, which usually cause no problems. However, if a problem develops in one of these sacs, the result can be a painful and dangerous condition called diverticulitis.
Diverticulitis can bring abdominal pain, fevers, and nausea, among other symptoms. Usually, diverticulitis can be resolved with mild treatments, including temporary diet changes and sometimes antibiotics. Most people with diverticulitis recover completely. But, at its most severe, a pouch can burst open, spilling fecal matter directly into a person’s bloodstream. This results in an immediate risk of developing a blood infection called sepsis, which can be life-threatening. Occasionally surgery is necessary to repair a section of the colon with a burst pouch or to correct a fistula—an abnormal connection—that a pouch may have formed with a nearby organ.
Yale Medicine’s expert team of digestive disease physicians and surgeons can help determine the best course of treatment for patients with diverticulitis. Our gastroenterologists rely on the latest evidence when deciding the best course of treatment for each patient. “We now understand that antibiotics may not be necessary to treat mild episodes of diverticulitis and surgery may only be required for a minority of patients with complicated diverticulitis,” says Yale Medicine gastroenterologist Anil Nagar, MD.