Many adults experience occasional abdominal discomfort, bloating (link to bloating & excessive gas) or changes in bowel habits at some point in life. While these symptoms are often attributed to diet, stress or ageing, they may sometimes be related to diverticular disease, a condition involving small pouches that develop within the wall of the large intestine.
Although diverticular disease was historically considered less common in Asian populations, studies have reported increasing prevalence across many newly industrialised countries in Asia over recent decades. As dietary habits, urbanisation and life expectancy continue to change, the condition is being recognised more frequently throughout the region, including the Philippines.
Many individuals remain unaware that they have diverticula until the condition is discovered during a colonoscopy or imaging study performed for unrelated reasons. While most people never develop symptoms, some experience recurrent abdominal discomfort, bowel habit changes or episodes of inflammation that may benefit from specialist assessment and treatment.
Diverticular disease is an umbrella term that includes both diverticulosis and diverticulitis (link to diverticulitis).
Unlike functional digestive disorders, diverticular disease involves structural changes in the colon wall and may sometimes require medical or surgical treatment.
Diverticular disease and irritable bowel syndrome (IBS) can both cause abdominal discomfort and bowel habit changes, but they are fundamentally different conditions.
FEATURE | DIVERTICULAR DISEASE | IBS |
Underlying problem | Structural changes in the colon with diverticula formation | Functional bowel disorder |
Inflammation | May occur, particularly with diverticulitis | Typically absent |
Visible abnormalities | Diverticula may be seen on colonoscopy or imaging | Usually no structural abnormalities |
Complications | May lead to infection, abscess, bleeding or perforation | Does not cause bowel damage |
Treatment focus | Preventing complications and treating inflammation | Managing bowel sensitivity and symptoms |
This distinction is important because diverticular disease, particularly when inflamed, may require antibiotics, procedures or surgery, whereas IBS is usually managed with lifestyle and symptom-based treatments.
The condition develops through a combination of structural changes in the colon wall and chronic pressure within the bowel. These mechanisms contribute to the formation of diverticula and may influence whether symptoms or complications develop.
Possible contributing factors include:
As dietary patterns in many Asian countries become increasingly westernised, lower fibre intake and more sedentary lifestyles may contribute to the growing recognition of diverticular disease across the region.
Many people with diverticular disease have no symptoms. When symptoms do occur, they may vary depending on whether inflammation is present.
Common symptoms may include:
When diverticulitis develops, symptoms may become more pronounced and include:
Although diverticular disease can affect adults of different ages, certain factors may increase the likelihood of developing diverticula or experiencing complications. As life expectancy increases and lifestyle patterns evolve across the Philippines, these risk factors are becoming increasingly relevant.
These include:
If diverticular disease progresses or becomes inflamed, complications may develop involving the colon and surrounding tissues. Potential complications include:
Many patients confuse diverticulosis and diverticulitis because both involve diverticula within the colon. However, they represent different stages of the condition.
FEATURE | DIVERTICULOSIS | DIVERTICULITIS |
Diverticula present | Yes | Yes |
Inflammation | No | Yes |
Symptoms | Often none | Abdominal pain, fever, bowel changes |
Infection | No | May occur |
Antibiotics required | Usually not | Sometimes required |
Surgery required | Rarely | Occasionally, in severe or recurrent cases |
Because symptoms may resemble food poisoning, irritable bowel syndrome, gastritis or other digestive disorders, some patients experience delayed diagnosis before diverticular disease is eventually identified.
Assessment typically begins with a detailed review of symptoms, medical history and risk factors.
Dr Aaron Poh typically performs:
Treatment is tailored according to whether the patient has uncomplicated diverticulosis, active diverticulitis or complications requiring procedural intervention.
For some patients from the Philippines, the challenge is not only the symptoms themselves but the uncertainty surrounding recurring abdominal discomfort, repeated episodes of suspected diverticulitis or unexplained bowel habit changes.
Many individuals receive treatment during acute flare-ups but may not undergo a comprehensive assessment to determine the extent of diverticular disease, whether complications are developing or whether another digestive condition could be contributing to their symptoms.
In Singapore, patients often seek a more coordinated evaluation where consultation, imaging studies, colonoscopy and treatment planning can be organised within a structured timeframe.
Patients travelling from the Philippines are encouraged to bring previous colonoscopy reports, CT scans, laboratory results and medication records, as these may help streamline assessment and avoid unnecessary duplication of investigations.
For patients travelling from the Philippines, care at Alpine Surgical Practice can be arranged before you leave home.
An initial teleconsultation with Dr Aaron Poh can be scheduled prior to your trip. This allows your symptoms, medical history and any existing investigation results — such as previous CT scans, colonoscopy reports or blood tests — to be reviewed in advance, so that the most appropriate assessments can be planned ahead of your arrival. This helps make your time in Singapore more focused and efficient.
The team at Alpine Surgical Practice is available to assist with the practical aspects of your visit, including scheduling investigations and follow-up appointments within your intended stay. Patients are encouraged to contact the clinic in advance so that arrangements can be made around your travel dates as smoothly as possible.
Recurring abdominal pain, bloating or changes in bowel habits can become frustrating, particularly when symptoms repeatedly return despite medication or dietary adjustments.
At Alpine Surgical, assessment begins with understanding your symptoms, previous episodes of diverticulitis, bowel habits and any investigations that may already have been performed.
Dr Aaron Poh carefully evaluates whether symptoms are related to uncomplicated diverticular disease, active diverticulitis or another digestive condition that may require further investigation. Where appropriate, imaging studies, colonoscopy and additional testing can be arranged to clarify the diagnosis and guide treatment decisions.
If you have been experiencing recurring abdominal pain, repeated diverticulitis attacks or persistent bowel symptoms, arranging an appointment may help provide greater diagnostic clarity and a structured long-term management plan.
Dr Aaron Poh is a fully accredited General Surgeon with dual subspecialties in Colorectal Surgery and Trauma Surgery, recognised by Singapore’s Specialist Accreditation Board and Ministry of Health. He is the Medical Director of Alpine Surgical Practice, with clinics located at Mount Elizabeth Hospital, Parkway East Hospital, and Farrer Park Hospitals.
Dr Aaron Poh has extensive experience, having performed over 5,000 endoscopic procedures. He is a strong advocate for early detection through colonoscopy, particularly for individuals at risk of colorectal cancer. His expertise includes advanced endoscopic techniques such as Endoscopic Mucosal Resection (EMR) for complex polyps and colonic stenting for obstructed cancers, which help patients avoid major emergency surgery.
When surgery is required, he specialises in minimally invasive laparoscopic colorectal cancer surgery, offering patients faster recovery with less pain and scarring. In addition to cancer care, he manages a wide range of anal conditions including haemorrhoids, fistulas, fissures, and abscesses, providing comprehensive colorectal treatment.
Copyright © Alpine Surgical Practice | Terms & Conditions
