What is Sigmoid Diverticulosis?

Sigmoid diverticulosis is a condition in which small pouches called diverticula form on the wall of the sigmoid colon, which is the part of the large intestine that connects to the rectum. It's typically associated with certain risk factors, including age and a poor diet. Though many people with this disorder have few symptoms, it can cause pain and digestive dysfunction. It is often treatable with medication and lifestyle changes, though severe cases may require surgery.

It's not entirely clear why people develop sigmoid diverticulosis, but diet, position while defecating, and age likely play a role. People who eat a diet that is low in fiber may need the sigmoid colon to make strong contractions before they can pass stools, which may stress the intestinal tissue and contribute to the formation of diverticula. Those that sit as in a chair while defecating instead of squatting tend to strain more, which is thought to be harder on the colon as well. Additionally, as people age, the connective fibers in the intestines tend to deteriorate and lose their strength, which could contribute to the formation of pouches.

Since there are several possible causes that likely work together with each other, there are a variety of risk factors for this condition. One major one is a low-fiber diet. Fiber aids in the passageway of stool through the colon by adding bulk and moisture, which decreases the strength of the contraction necessary to propel it through the system. Eating lots of red meat can also contribute to the development of this condition, since it is hard to digest, as can chronic constipation, smoking, and obesity. Aging is particularly associated with sigmoid diverticulosis because of the weakening of the colon wall as well as the increased likelihood of having other digestive conditions that irritate the intestines.

This condition develops over time, and it can take years for symptoms to appear. When people do start experiencing symptoms, they usually have nausea, vomiting, bloating, constipation or diarrhea, and a fever. Some people also pass blood in their stool, or have abdominal pain, especially on the left side of the body, since that's where the sigmoid colon is located. Anyone who experiences sudden rectal bleeding or intense abdominal pain should seek medical care, since this could be a sign of life-threatening complications.

In the early stages, sigmoid diverticulosis can be treated at home with dietary and lifestyle modifications, including eating more fiber and exercising regularly. People with a history of diverticula may want to avoid food with small seeds in it, since these can get stuck in the pouches and irritate them. Any pain or intestinal cramps can often be relieved with a heating pad and over-the-counter (OTC) pain medication to relieve pain or gas. Elderly people should speak with a healthcare professional before taking painkillers though, since using Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) is associated with an increased risk of complications in older people.

More severe cases of sigmoid diverticulosis may require prescription medications including pain management and antispasmodics to decrease the contracts of the colon. People who have severe or frequent attacks of diverticulosis may need surgery to repair or remove abscesses and lesions, repair tears in the colon wall, removing bowel obstructions, or removing entire sections of intestine.

The most common complication of sigmoid diverticulosis is diverticulitis, which occurs when the diverticula become infected and inflamed. This causes a fever, intense pain in the lower left abdomen, a fever, nausea, and increased urination if the infection is near the bladder. If diverticulitis is left untreated, it can cause peritonitis, a condition in which waste from the intestines enters the abdominal cavity, causing severe inflammation and infection. Once this happens, infection can spread to other parts of the body through the blood, a life-threatening condition known as sepsis.