How the Colon Works
Colon is the organ responsible for the final step in digesting food. It receives partly digested
liquid stool from the small bowel, dehydrates it and delivers it to the rectum for evacuation. Colon
is a hollow tube that begins at the appendix, located next to the right hip bone, and ends at the
rectum. This hollow tube is composed of two layers. The inner layer has cells that are specialized for
absorbing fluid and dehydrating stool. When these cells malfunction diarrhea is the end result. When
one is dehydrated these cells work overtime to return fluids to the body and constipation ensues.
The outer layer of the colon (tube) is muscle. This muscle contracts and relaxes periodically and acts
to push the stool along in the colon. Malfunction of this muscle group can also lead to diarrhea and
constipation. Under normal circumstances the inner layer of the tube is completely contained inside
the outer layer of the tube. Under certain conditions the outer muscle layer weakens and can no longer
contain the inner portion of the tube. These areas of weakness allow portions of the inner tube to
push through and form “outpouchings” in the colon. The medical terminology for these outpouchings is
“diverticulosis”.
Diverticulosis vs. Diverticulitis
A large proportion of individuals in the United States who are otherwise healthy and without any
symptoms will have these outpouchings called “diverticulosis” on examination. A majority of people
with diverticulosis will never have any associated problems. Symptoms arise when stool is impacted in
these outpouchings causing perforations in the wall of the inner tube leading to minor or major
infections, a condition referred to as “diverticluitis”. Alternatively, due to individual
characteristics these outpouchings may cause bleeding in susceptible individuals.
What Causes Diverticulosis
In general any condition that causes long standing constipation, increased pressure inside the abdomen
or muscular de-conditioning leads to diverticulosis
• Straining to have a bowel movement
• Chronic cough
• Dehydration
• Chronic gas
• Diets with low transit time in the bowel. Typically these are low fiber diets with high
meat/fat content.
How to avoid Diverticulosis and Its Complications
• Avoid dehydration
• Avoid constipation
• Quit smoking or seek treatment for chronic cough
• Dietary modification
• Eat at regular times.
• Try to have a bowel movement at the same time each day.
• Don't strain.
• Don't put off having a bowel movement when you have the urge. Doing so may make
the stools drier and harder, which may make you strain
more.
• Eat a high-fiber diet.
• Get regular exercise.
Avoid taking medications that slow the activity of the intestines. These include:
• painkillers containing narcotics
• antidepressants
• Some blood pressure (calcium channel blockers).
• Calcium supplements
• Blood thinners, aspirin and anti-inflammatory medication increase the risk of bleeding from
diverticuli.