ABSTRACT
This chapter discusses that concepts of the pathogenesis and treatment of diverticular disease are supported chiefly by epidemiological and physiological observations which suggest that a deficiency of dietary fiber is a major and remediable factor in the disease process. As striking as the increase in incidence is the occurrence of diverticular disease almost exclusively in industrialized Western-type cultures. Autopsy series and other epidemiologic studies suggest that approximately 50% of the population in the 7th through 9th decades will be affected by diverticular disease. A clinical presentation of abdominal pain and tenderness will prompt most physicians to proceed with a barium enema roentgenogram. The inflammation in symptomatic diverticulitis then extends widely within or through the serosa, and usually remains confined by the adjacent organs or mesentery. The advocates of the fiber hypothesis predict that one result of such dietary changes, if started early in life, would be the primary prevention of colonic diverticula.
