Benjamin J. Marano Jr, MD
Hartsdale, NY
Hal J. Freiman, MD
New York

Extensive diverticulosis was found throughout the length of the colon of an 84-year-old woman, who depended on a weekly dose of magnesium citrate to have a bowel movement. Typical lesions are shown here (A and B). Diverticula may occur singly or clustered in small groups, with narrow or broad openings into the colonic lumen.

Diverticulosis rarely affects persons under age 40; however, its incidence increases dramatically with each succeeding decade. Although patients with this disorder are frequently asymptomatic, abdominal cramps, constipation, and flatulence may mark the presence of the disease.

Diverticulosis is a major cause of painless rectal bleeding in the elderly, and it may be a presenting complaint in some. Acute diverticulitis develops in a small percentage of those who have this condition.

For patients with uncomplicated diverticulosis, an increase in dietary fiber or fiber supplements can reduce symptoms. For those unwilling or unable to change their eating habits, fiber-bulking laxatives are helpful.