My father had diverticulitis and ended up needing surgery. Later, my brother had a milder case and he too had surgery. I am wondering if this condition is hereditary or if it has more to do with lifestyle? My father and brother are the two members of the family that are heavy beer drinkers and have poor eating habits.

C.

Diverticulitis is an inflammatory condition in which small pockets, called diverticula, develop in the wall of the colon. These pockets, which usually occur after the age of 40, have been linked to several possible lifestyle factors including diet and constipation. Although diverticula themselves are not harmful, they can pose a health hazard if they bleed or become infected.

Diverticulitis is a complication resulting from a tiny perforation in a pocket, which in turn causes an inflammatory reaction in that segment of colon. In most cases, the infection and inflammatory reaction remain localized and no further damage occurs. However, in a small percentage of cases the infection may spread, resulting in an abdominal abscess which may require drainage. Surgical therapy is often needed in these cases to remove the affected segment of colon. Even in mild cases of diverticulitis, doctors often recommend elective surgical removal of that segment of colon to prevent further attacks.

To address your concerns, diverticula are acquired, not hereditary. They are very common among people who eat a diet high in fat and low in fiber. In fact, some studies estimate that more than half of Americans over age 60 have diverticula. Patients usually discover that they have diverticula while they are undergoing a colonoscopy done for other reasons, or when they experience a complication such as bleeding or diverticulitis. Although no studies have been done looking into how to prevent diverticula formation, it is known that they are much less common in certain populations (such as Chinese or African) that consume large amounts of dietary fiber. Thus, eating more high-fiber foods - and less fatty foods -- would be a prudent move for someone hoping to reduce the chances of diverticulitis.