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Diverticula are small sacs or herniations of the intestinal wall, generally small, ranging from a few millimeters to a centimeter or two.

Although there are congenital diverticula in the large bowel, the disease actually refers basically to the foreground or also called pseudo or false diverticula, because it only involves two layers of the intestine (mucosa and serosa) as opposed to containing the congenital 3 (mucosa, muscle and serosa), which are the so-called real pathology that deals with diverticula that are most commonly acquired in the distal colon or large intestine, also called the sigmoid colon, and are generally due to a Western type diet low in fiber, usually combined with the presence of irritants, which results in areas of high pressure within the intestine precisely where the stool is solid and the walls of the intestine must work harder in order to move it out from these areas, pushing outward from the inner layer, or mucosa, through weakened sites of the intestinal wall, i.e. at the site where blood vessels penetrate from outside to provide oxygen and nutrition to the colon.

The large spectrum of presentations of this disease is known by colonic diverticular disease and its manifestations can be acute diverticulitis, or infection of a diverticulum, due to accumulation of fecal matter in it, and this is reflected by intense abdominal pain, abdominal distension or swelling, difficulty in expelling gas or feces per rectum, fever and signs of severe general distress. Another common manifestation is of peritonitis with intestinal perforation. In addition to the above symptoms, this illness presents with intense abdominal pain and stiffness and can result in a state of shock. Other clinical signs may include rectal bleeding, sometimes alarming in the amount. There are other complications such as fistulization (opening of the bowel to another organ) to the bladder or other organ, which are less common. The resolution of these complications can range from diet and management with powerful antibiotics, hospitalization, and even emergency surgery, having to remove the affected portion of intestine and intestinal reconnection can be delayed. These cases are commonly seen in patients with a pouch that collects the fecal material in the abdomen.

It is important to note that approximately 75% of patients presenting with complications never knew they were carriers of colonic diverticular disease. In other cases the symptoms are attributed to mundane situations such as on a food-intake, consumption of irritating food, or an exacerbation of a chronic colitis and is known by the patient. Of this 75%, 10 to 20% of patients may have a serious and potentially fatal complication.

The most important aspect is based on health education, in which by knowing the nature of the disease, the patient carries out appropriate measures to avoid or lessen the chances of introducing disease and possibly prevent the dreaded complications of infection and perforation. So, if you have risk factors, for example, over the age of 40, low-fiber diet, frequently consume gastric irritants, have a history of colonic dysfunction, colitis, or have left lower abdominal pain, you should seek the advice of a medical specialist to perform relevant tests to make an appropriate diagnosis and treatment plan. Such diagnostic include, a barium enema, which is an x-ray study utilizing the administration of a contrast agent via rectal enema. A colonoscopy, which has the advantage of establishing a more precise differential diagnosis with malignant entities or premalignant lesions. During a colonoscopy it is also possible to take biopsies of and remove precancerous lesions such as polyps. Once diagnosed, it is important to increase the consumption of vegetable fiber, possibly using supplements such as psyllium, and avoiding irritating foods from the diet, junk or fast foods, drink at least 2 liters of water daily, exercise regularly 3-5 times per week for an hour, and follow up regularly with your medical specialist.

The most frequent causes of rectorrhagia are hemorrhoids, anal fissure, chronic intestinal inflammatory illness, polyps, diverticulosis, and colorectal cancer. Given the diversity of causes and symptoms, it is important to consider the age at presentation as well as the accompanying clinical symptoms. For example, in a young patient with bright red blood, generally in a small amount that is accompanied by intense pain with defecation, the cause is probably an anal fissure. However, if the bleeding occurs in an adult over 40 years of age and is accompanied by changes in bowel habits (e.g. the bowel movements begin to be fragmented, markedly thin, or they begin to change in consistency, or if there is a sensation of incomplete emptying), other pathologies should be ruled out, including colonic diverticulum, polyps, internal hemorrhoids, and colorectal cancer.

Apart from the emphasis on the age of the patients, is important to consider family history of varicose or hemorrhoids, family history of cancer of the digestive system or colon, the presence of associated illness like liver cirrhosis, and the chronic use of medications or chronic laxative use.

Likewise, if we have a patient with an abundant rectal hemorrhage, is greater 45 years of age, and additionally complains of abdominal inconveniences, inflammation, changes in bowel habits (generally with constipation and to the sensation incomplete defecation), who also complains of exhaustion, weight loss, and loss of appetite, is imperative to rule out colorectal cancer. Keep in mind that these symptoms represent advanced stages of this disease. It should also be taken into account that in the early stages of this disease there are generally no symptoms that present for many years, which is why detection by endoscopy and ablation of adenomatous polyps is important.

In this manner, the doctor will plan diagnostic studies with emphasis on those patients with the greater risk factors for pathologies.

Once in the medical doctor's office, a complete medical history will be performed, as well as a careful physical examination of the abdomen as well as the anal region by a manual rectal exam and anoscopy. The doctor may request, for further diagnostic study, a Video-Endoscopic study of the colon, which is a very modern study that is performed by introducing a scope into the anus, and he colon is completely inspected, possibly taking biopsies, eradicate polyps, as was as recording images to a DVD for future comparison. This is all performed while the patient is under sedation.

In colon center our fundamental objective is preventative medicine and early diagnosis to improve the quality of life for our patients.