What is Diverticulosis?

Diverticula are sac-like pouches that bulge outward through weak areas in your colon, typically where blood vessels enter the colon muscles. In most people, diverticuli develop in the sigmoid colon, where the colon is narrowest.

Diverticulosis is a condition in which these pouches form. Most people with diverticulosis do not experience symptoms, but sometimes the pouches can become inflamed or cause other issues, leading to a condition called diverticulitis.

What is Diverticulitis?

Diverticulitis occurs when one or more of the diverticula become inflamed. This condition can develop suddenly and, in some cases, lead to serious complications, such as sepsis (a blood infection).

What Causes Diverticulosis and Diverticulitis?

Risk factors for developing diverticulitis include:

• Age: Diverticulosis is rare before age 40, but about one-third of people will develop the condition by age 60, and two-thirds by age 85.

• Genetics: Certain genes may make some individuals more prone to developing diverticulosis and diverticulitis.

• Lifestyle factors:

  • Diets low in fiber

  • Diets high in red meat and fat

  • Lack of physical activity

  • Obesity

  • Smoking

• Certain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids can increase the risk.

• Constipation: This increases the risk of stool bacteria becoming trapped in the colon pouches and disrupting the intestinal microbiome. Small, hard stools require excessive colon contractions, raising pressure on the colon wall and increasing the risk of diverticulosis.

What Are the Symptoms of Diverticulosis and Diverticulitis?

• Diverticulosis: Most people with diverticulosis do not have symptoms. Some may experience chronic symptoms, including:

  • Bloating

  • Alternating constipation and diarrhea

  • Abdominal cramping

• Diverticulitis: This condition can cause acute symptoms, including:

  • Severe abdominal pain (often sudden)

  • Constipation or diarrhea

  • Fevers and chills

  • Nausea or vomiting

The pain caused by diverticulitis is typically severe and sudden, but in some cases, it may start mildly and worsen over a few days.

Other complications of diverticulitis include:

• Abscess: A painful, swollen, pus-filled area caused by infection

• Fistula: An abnormal passage between the colon and another part of the body, such as the bladder or vagina

• Intestinal narrowing (stricture): A blockage preventing food, fluids, air, or stool from moving through the intestines

• Perforation: A hole in the colon that can lead to sepsis or life-threatening infection

What Other Problems Can Diverticulosis Cause?

• Diverticular bleeding: This occurs when a small blood vessel within a diverticulum ruptures, potentially causing severe and life-threatening bleeding.

How Are Diverticulosis and Diverticulitis Diagnosed?

To diagnose diverticulosis or diverticulitis, we will review your medical history, perform a physical exam, and order tests, which may include:

• Blood tests

• Stool tests

• Imaging tests, such as a CT scan

• Colonoscopy

What Are the Treatments for Diverticulitis?

• Antibiotics: Intravenous antibiotics are typically administered for acute or early attacks, followed by oral antibiotics.

• Clear liquid diet: A short-term liquid diet may help rest the colon.

• Anti-inflammatory medications: To reduce inflammation

• Probiotics: To support gut health

• Antispasmodic medicines: To relieve spasms

If diverticulitis does not improve with treatment or causes complications, surgery may be necessary to remove the diseased portion of the colon.

Can Diverticulitis Be Prevented?

Lifestyle changes can help minimize the risk of developing diverticulitis:

• Eating a diet high in fiber and low in red meat

• Engaging in regular physical activity

• Not smoking

• Maintaining a healthy weight