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Colon diverticula
Last reviewed: 04.07.2025
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A diverticulum is a hernia-like formation in the wall of a hollow organ. Ruysch first used this term in 1698 to describe a sac-like protrusion in the wall of the ileum. The first work on diverticula of the colon in humans was published by Morgagni in 1769, and the clinical picture of diverticulitis was described by Virchow in 1853.
Diverticular disease of the colon is a collective term that includes both uncomplicated and complicated diverticula (according to some authors, diverticula with symptoms). Diverticulosis of the colon is the presence of multiple diverticula (a number of researchers understand this term only to mean uncomplicated diverticula).
Frequency and epidemiology. Diverticula of the colon are a common pathology. Their frequency increases with age. They occur in the general population in 3-5% of cases, in people over 40 - in 10%, over 60 - in 30%, over 70 - in 40%, in people 85 and older - in 60-66% of cases. In industrially developed countries, diverticulosis is detected much more often than in developing countries, in rural areas less often than in cities, which is associated with nutritional characteristics. Racial characteristics are not decisive, since the native inhabitants of Asia and Africa, when moving to the West and changing their traditional diet to low-slag food, suffer from this pathology as often as Westerners.
Most authors believe that diverticular disease of the colon is equally common in men and women. However, there is evidence of a slight predominance of men and a higher incidence of the disease in women.
Currently, there is no consensus on the existence of a relationship between the incidence of diverticular disease of the colon and the degree of nutritional status and the nature of work activity.
Classification of diverticula. There are true and false diverticula. True diverticula are a protrusion of the entire intestinal wall, which contains the mucous membrane, muscular layer and serosa. They have a wide connection with the intestine and are easily emptied. Usually these are single diverticula, less often multiple. Inflammation in them develops relatively rarely, just as not all people develop appendicitis.
Classification of colon diverticula
Causes of development and pathogenesis of diverticular disease of the colon. Intestinal diverticula can be congenital and acquired. Congenital ones occur due to a local developmental defect. The causes and mechanism of development of acquired diverticula remain unclear. It is believed that 2 groups of factors are responsible for their occurrence: factors that increase intraintestinal pressure (constipation, flatulence, systematic use of laxatives, intestinal stenosis, etc.) and those that cause weakening of the intestinal wall (avitaminosis, dystrophy, inflammation, ischemia, congestion in the portal vein system, abdominal trauma, fatty degeneration of the intestinal muscle, congenital insufficiency of the intestinal wall).
Causes of colon diverticula development
Based on clinical features, asymptomatic diverticula, uncomplicated diverticular disease, and diverticular disease with complications are distinguished.
For a long time, there was a perception that uncomplicated diverticular disease of the colon was asymptomatic. Studies in recent decades indicate that most patients with uncomplicated diverticula have clinical manifestations. Diverticula were asymptomatic in only 14% of cases of uncomplicated diverticulosis and in 5% of all cases of their detection.
Diagnosis of diverticular disease of the colon. Recognizing diverticular disease is not an easy task. This is explained by the absence of pathognomonic symptoms, the possibility of different localization of diverticula, and therefore pain, the main clinical sign of this disease, the presence, as a rule, in elderly people of concomitant diseases, the symptoms of which can mask the manifestations of diverticular disease.
Diagnosis of colon diverticula
Treatment of diverticular disease of the colon is conservative and surgical. Indications for surgical treatment are severe complications of the disease - massive, life-threatening bleeding, perforation of the diverticulum, peritonitis, abscess, fistulas, increasing intestinal obstruction and suspicion of cancer.
Treatment of colon diverticula
To prevent and treat diverticulitis, it is necessary to normalize the intestinal microflora. For this purpose, it is necessary not only to act on certain opportunistic microorganisms, but also to increase the reactivity of the macroorganism. Patients are prescribed vitamins, desensitizing agents, eubiotics, biological preparations (bifidumbacterin, lactobacterin, bificol for 1.5-2 months).
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