From the Guidelines
Diverticula formation is primarily caused by a combination of genetic factors, low-fiber diet, and lifestyle factors, including physical inactivity, obesity, and smoking, which increase the pressure within the colon and weaken the intestinal wall. The most recent and highest quality study, 1, suggests that approximately 50% of the risk for diverticulitis is attributable to genetic factors, and a prudent dietary pattern high in fiber from fruits, vegetables, whole grains, and legumes can decrease the risk of incident diverticulitis.
Risk Factors
- Genetic factors: Twin and sibling studies indicate that 40–50% of the risk for diverticulitis is attributed to genetic effects 1
- Low-fiber diet: A low-fiber diet leads to smaller, harder stools that require more pressure to move through the digestive tract, increasing the strain on the colon wall 1
- Lifestyle factors: Physical inactivity, obesity, smoking, and certain medications like non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of diverticula formation 1
- Aging: The colon wall naturally weakens with age, making it more susceptible to diverticula formation
Prevention
- Maintaining a high-fiber diet (25-30 grams daily) is recommended to prevent diverticula formation 1
- Staying well-hydrated, exercising regularly, and maintaining a healthy weight can also help prevent diverticula formation
- A prudent dietary pattern high in fiber from fruits, vegetables, whole grains, and legumes can decrease the risk of incident diverticulitis 1
From the Research
Causes of Diverticula Formation
The formation of diverticula, also known as diverticulosis, is a complex process that involves multiple factors. Some of the key factors that contribute to the development of diverticula include:
- Low-fiber diet: A diet that is low in fiber can lead to constipation, which can increase the pressure on the colon and cause diverticula to form 2, 3, 4, 5
- Physical inactivity: A sedentary lifestyle can contribute to the development of diverticula, possibly due to decreased bowel motility and increased pressure on the colon 4, 5
- Obesity: Being overweight or obese can increase the pressure on the colon and contribute to the development of diverticula 2, 5
- Smoking: Smoking can weaken the muscles in the colon and increase the risk of diverticula formation 5
- Age: Diverticula are more common in older adults, possibly due to age-related changes in the colon 2, 3, 4, 5
- Involutional changes: Changes in the gastrointestinal tract that occur with aging can also contribute to the development of diverticula 2
Pathogenesis of Diverticula
The pathogenesis of diverticula is multifactorial and involves changes in the colon, including:
- Increased intraluminal pressure: Increased pressure on the colon can cause diverticula to form 6
- Dysmotility: Abnormal movement of the colon can contribute to the development of diverticula 6
- Morphological changes: Changes in the structure of the colon can also contribute to the development of diverticula 6
- Low-fiber diet: A diet that is low in fiber can lead to constipation and increased pressure on the colon, which can cause diverticula to form 2, 3, 4, 5
Prevention of Diverticula
Preventing diverticula involves making lifestyle changes, such as:
- Eating a high-fiber diet: A diet that is high in fiber can help to prevent constipation and reduce the pressure on the colon 2, 3, 4, 5
- Staying physically active: Regular exercise can help to improve bowel motility and reduce the risk of diverticula formation 4, 5
- Maintaining a healthy weight: Being overweight or obese can increase the pressure on the colon and contribute to the development of diverticula, so maintaining a healthy weight can help to prevent diverticula 2, 5
- Avoiding smoking: Smoking can weaken the muscles in the colon and increase the risk of diverticula formation, so avoiding smoking can help to prevent diverticula 5