Diverticular Disease
The colon is about 5 feet long and its function is to reabsorb water into our bodies. As we digest food, the nutrients are broken down by the stomach and small intestines and absorbed mostly in the small intestine. During this process, our gastrointestinal system secretes 5 to 6 liters of fluid daily to help absorb these nutrients. The leftovers, mixed with the liters of fluid, enter the colon (i.e., large intestine) where, over the course of a few days, the fluid is reabsorbed back into the body. What remains then become more solid, forming stool. One can live without a colon, but is more prone to dehydration. In addition, most patients can live a completely normal life after segmental resection (i.e., removal of a small piece of the colon). Such surgery is commonly performed for colorectal cancer or diverticular disease.
Diverticular disease of the colon is defined as the formation of protrusions, or pockets, in the wall of the colon. These pockets are acquired over time, and their presence is called diverticulosis. Diverticulosis is incredibly common, especially in westernized nations. The incidence of diverticulosis increases with age. Early studies have demonstrated an incidence of 1-2% in patients under the age of 30. However, as we age we acquire more of these diverticuli (pockets), and the incidence is greater than 50% in octogenarians. Once diverticulosis is present, 10-25% of patients will develop acute diverticulitis.
Diverticular disease medical expert witness specialties include gastroenterology, general surgery, pathology, colon-rectal surgery, immunology, internal medicine, family medicine, and hospitalist medicine.