Diverticulosis and Diverticulitis Treatment

Diverticular disease is a condition that occurs when a person has problems from small pouches, or sacs, that have formed and pushed outward through weak spots in the colon wall. Each pouch is called a diverticulum. Multiple pouches are called diverticula. Diverticula are most common in the lower part of the colon, called the sigmoid colon.

Diverticulitis occurs when the diverticula become inflamed, or irritated and swollen, and infected.

When a person has diverticula that do not cause diverticulitis, the condition is called diverticulosis. Most people with diverticulosis do not have symptoms, but some people with diverticulosis have constipation or diarrhea. People may also have chronic cramping or pain in the lower abdomen or bloating.

Other conditions, such as irritable bowel syndrome and stomach ulcers, cause similar problems, so these symptoms do not always mean a person has diverticulosis. People with these symptoms should see their health care provider.

What causes diverticulosis?
Scientists are not certain what causes diverticulosis. For more than 50 years, the most widely accepted theory was that a low-fiber diet led to diverticulosis. Diverticulosis was first noticed in the United States in the early 1900s, around the time processed foods were introduced into the American diet. Consumption of processed foods greatly reduced Americans’ fiber intake. Diverticulosis is common in Western and industrialized countries where low-fiber diets are common. The condition is rare in Asia and Africa, where most people eat high-fiber diets.

Studies have also found links between diverticular disease and obesity, lack of exercise, smoking, and certain medications including nonsteroidal anti-inflammatory drugs, such as aspirin, and steroids.

Scientists agree that with diverticulitis, inflammation may begin when bacteria or stool get caught in a diverticulum. In the colon, inflammation also may be caused by a decrease in healthy bacteria and an increase in disease-causing bacteria. This change in the bacteria may permit chronic inflammation to develop in the colon.

Who gets diverticulosis?
Diverticulosis becomes more common as people age, particularly in people older than age 50. Some people with diverticulosis develop diverticulitis, and the number of cases is increasing. Although diverticular disease is generally thought to be a condition found in older adults, it is becoming more common in people younger than age 50, most of whom are male.

What are the symptoms of diverticular disease?
People with diverticulitis may have many symptoms, the most common of which is pain in the lower left side of the abdomen. The pain is usually severe and comes on suddenly, though it can also be mild and then worsen over several days. The intensity of the pain can fluctuate. Diverticulitis may also cause

  • Fevers and chills
  • Nausea or vomiting
  • A change in bowel habits—constipation or diarrhea
  • Diverticular bleeding

In most cases, people with diverticular bleeding suddenly have a large amount of red or maroon-colored blood in their stool. Diverticular bleeding may also cause

  • Weakness
  • Dizziness or light-headedness
  • Abdominal cramping

How are diverticulosis and diverticular disease diagnosed?
Diverticulosis is often found during a routine x-ray or a colonoscopy.

Diverticular Disease: Dr. Jones will ask about the person’s health, symptoms, bowel habits, diet, and medications, and will perform a physical exam, which may include a rectal exam. A rectal exam is performed in the office. To perform the exam, Dr. Jones asks the patient to bend over a table or lie on one side while holding the knees close to the chest. Dr. Jones slides a gloved, lubricated finger into the rectum. The exam is used to check for pain, bleeding, or a blockage in the intestine. Dr. Jones may also schedule a blood test, CT scan, lower G.I. series or colonoscopy.