Diverticula – What are Diverticula?

A diverticulum (plural: diverticula’s) is medical term for an out pouching of a hollow (or a fluid filled) structure in the body. It usually implies that the structure is not normally present, i.e. pathological. However, embryologically, some normal structures begin development as a diverticulum arising from another structure.

Diverticular disease is common in the Western world but is extremely rare in areas such as Asia and Africa. Diverticular disease increases with age. It is uncommon before the age of forty, and is seen in more than fifty percent of people over the age of sixty in the United States. Whereas most patients with diverticular disease have no or few symptoms, some patients will develop bleeding, infection (diverticulitis), constipation, abdominal cramps, and even colon obstruction.

Diverticula are thought to be caused by increased pressure within the lumen of the colon. Increased intra-colonic pressure secondary to constipation may lead to weaknesses in the colon walls giving way to diverticula. Other causes may include a colonic spasm which increases pressure, which may be due to dehydration or low-fiber diets; although this may also be due to constipation. Fiber causes stools to retain more water and become easier to pass (either soluble or insoluble fiber will do this).

The large intestine is a long tube-like structure that stores and eliminates waste material. During normal lower intestinal function, the waste material (stool or feces) is slowly pushed along the large intestine to the rectum by the muscular bands in the colon. As a person ages, this continuous pressure can cause a bulging pocket of tissue or sac (called a diverticulum) that pushes out from the colon wall. More than one sac is called diverticula’s.

Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age.

Diverticulitis occurs when there is inflammation and infection in one or more diverticula. This usually happens when outpouchings become blocked with waste, allowing bacteria to build up, causing infection.

No one knows for certain why diverticulosis develops; however, a few theories have been suggested. Some experts believe that abnormal contraction and spasm (resulting in intermittent high pressure in the colon) may cause diverticula to form in a weak spot of the intestinal wall. Low fiber diets may play a role in the development of diverticulosis. In rural Africa where the diet is high in roughage, diverticulosis is rare.

Female urethral diverticulum is a localized outpouching of the urethra into the anterior vaginal wall. Most often present in the mid or distal urethra, it results from enlargement of obstructed periurethral glands.

Although urethral diverticulum is often difficult to diagnose, it has been identified with increasing frequency over the past several decades because of increased physician awareness of the condition. The most common associated symptoms are urinary frequency, urgency, and dysuria. Occasionally, urethral carcinoma and calculi may be present.

Symptoms are due to the muscle abnormality and consist of pain, usually in the left lower part of the abdomen, often abdominal distension, an irregular bowel habit with pellet-like stools, and sometimes small quantities of blood passed with bowel actions. These symptoms are similar to those of the irritable bowel syndrome which is not surprising because both disorders, at least in part, are due to abnormal muscle function.