Diverticulosis and Diverticulitis

What is diverticulosis?

From: MedlinePlus, National Library of Medicine

Diverticula are small pouches, or sacs, that bulge outward through weak spots in your colon. They mostly form in the lower part of the colon. Diverticulosis is a condition in which you have these pouches. Most people who have diverticulosis do not have symptoms or problems. But sometimes the pouches can cause symptoms or become inflamed.

What is diverticulitis?

From: MedlinePlus, National Library of Medicine

Diverticulitis is the name for the condition you have when one or more of the pouches get inflamed. Diverticulitis may come on suddenly. It can sometimes cause serious health problems.

What is diverticular disease?

From: MedlinePlus, National Library of Medicine

Diverticular disease is a condition that happens when the pouches cause:

• Chronic (long-term) symptoms
• Diverticular bleeding
• Diverticulitis or diverticulitis complications

What causes diverticulosis and diverticulitis?

From: MedlinePlus, National Library of Medicine

Researchers aren't sure what causes diverticulosis and diverticulitis. They think certain factors may play a role in causing or increasing the risk for these conditions, including:

• Your genetics. Certain genes may make some people more likely to develop the conditions.
• Lifestyle factors such as: Diets low in fiber and high in red meat Lack of physical activity Taking certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids Having obesity Smoking

Researchers are also looking at other possible factors that may play a role in these conditions. Those factors include bacteria or stool (poop) getting caught in a pouch in your colon and changes in the microbiome in the intestines. Your microbiome is made up of the bacteria and other organisms in your intestines.

Who is more likely to develop diverticulosis and diverticulitis?

From: MedlinePlus, National Library of Medicine

Diverticulosis is common, especially as people age. More than one-third of U.S. adults between the ages of 50 and 59 have diverticulosis. More than two-thirds who are over age 80 have it. Most of those people will not have symptoms or problems. But some of them will develop diverticulitis.

What are the symptoms of diverticulosis and diverticulitis?

From: MedlinePlus, National Library of Medicine

Diverticulosis usually doesn't cause symptoms. But some people can have chronic symptoms such as:

Diverticulitis may cause acute symptoms such as:

The pain caused by diverticulitis is usually severe and comes on suddenly. Less often, the pain may be mild and worsen over several days.

• Bloating
• Constipation or diarrhea
• Cramping or pain in the lower abdomen (belly)
• Abdominal pain, most often in the lower left side of your abdomen
• Constipation or diarrhea
• Fevers and chills
• Nausea or vomiting

What other problems can diverticulosis and diverticulitis cause?

From: MedlinePlus, National Library of Medicine

Some people with diverticulosis and diverticulitis may develop serious health problems (complications). Diverticular bleeding happens when a small blood vessel within the wall of a pouch bursts. The bleeding may be severe and sometimes even life-threatening.

People with diverticulitis can also develop serious problems such as:

• Abscess, a painful, swollen, pus-filled area caused by infection
• Fistula, an abnormal opening or passage between the colon and another part of the body, such as the bladder or vagina
• Intestinal obstruction, a partial or total blockage that keeps food, fluids, air, or stool from moving through your intestines
• Perforation, or a hole, in your colon
• Peritonitis, an infection of the lining of the abdominal cavity

How are diverticulosis and diverticulitis diagnosed?

From: MedlinePlus, National Library of Medicine

Diverticulosis may be found when your health care provider is doing tests for another reason. Diverticulitis is usually found when you are having an acute attack.

To make a diagnosis, your provider will review your medical history, do a physical exam, and order tests. The tests may include:

• Blood tests
• Stool tests
• Imaging tests such as CT scan, ultrasound, or MRI
• Colonoscopy

What are the treatments for diverticulosis and diverticulitis?

From: MedlinePlus, National Library of Medicine

If your diverticulosis is causing chronic symptoms, your provider may recommend:

If you have diverticulitis without complications, your provider may recommend treatment at home. However, you probably need treatment in the hospital if you have severe diverticulitis, diverticulitis with complications, or a high risk for complications.

Treatments for diverticulitis may include:

If your diverticulitis doesn't improve with treatment or if it causes complications, you may need surgery to remove part of your colon.

• High-fiber foods or fiber supplements
• Antibiotics
• Medicines to reduce inflammation
• Probiotics
• Antibiotics, except for very mild cases.
• A clear liquid diet for a short time to rest the colon. Your provider may suggest slowly adding solid foods to your diet as your symptoms improve.
• Medicines for pain. This is usually acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may increase the chance of diverticulitis complications.
• Antispasmodic medicines to relieve spasms.

Can diverticulitis be prevented?

From: MedlinePlus, National Library of Medicine

Your provider may recommend lifestyle changes to prevent diverticulitis:

• Eating a diet high in fiber and low in red meat
• Being physically active on a regular basis
• Not smoking (and quitting smoking if you are a smoker)
• Reaching and maintaining a healthy weight

Which doctor should you see?

The suggested department for discussing Diverticulosis and Diverticulitis is Gastroenterology, with a gastroenterologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which digestive symptoms or nutritional changes matter most?
• What question would an endoscopy, scan or laboratory test answer if one is proposed?
• How should persistent pain, bleeding or difficulty eating be followed up?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.