Diverticula are saclike pouches that protrude from the smooth muscular layer of the colon. They tend to develop where the muscles are weakest, at the places where blood vessels cross through the muscles. The appearance of these pouches is called diverticulosis. The condition usually develops after age 40; about one-third of Americans develop diverticulosis by age 60, and two-thirds have it by age 85. In 15% to 20% of people with diverticulosis, the pouches become inflamed (diverticulitis), causing symptoms.
Diverticulosis was uncommon in the United States 100 years ago. The principal factor driving its increase is diet, especially the consumption of refined carbohydrates. Refined carbohydrates deprive you of fiber, which is needed to speed and ease the process of elimination. Without enough fiber, the colon must contract with extra force to expel stool. That puts more pressure on the colon wall, which increases the risk for diverticulosis and its complications. Other possible risk factors include high consumption of fat and red meat, obesity, cigarette smoking, and the use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen. Regular physical activity appears to reduce risk.
Harvard Men’s Health Watch notes that diverticular disease is largely preventable. A high-fiber diet sharply reduces the risk of developing diverticula. Even after the pouches form, dietary fiber reduces the likelihood they will become inflamed and cause pain or bleeding. The Institute of Medicine recommends 30 to 38 grams of fiber a day for men and 21 to 30 grams for women, depending on age.
Although prevention is always best, Harvard Men’s Health Watch also reviews new ways to diagnose and treat diverticular disease and its complications.
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