Patients generally have increased muscular contractions in the sigmoid colon that produce muscular thickness and increased intraluminal pressure. This increased pressure, accompanied by a weakness in the colon wall, causes diverticular formations. In addition, diet may be a contributing factor. A diet with insufficient fiber reduces fecal residue, narrows the bowel lumen, and leads to higher intra-abdominal pressure during defecation. Diverticulitis is caused when stool and bacteria are retained in the diverticular outpouches, leading to the formation of a hardened mass called a fecalith. The fecalith obstructs blood supply to the diverticular area, leading to inflammation, edema of tissues, and possible bowel perforation and peritonitis.

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