Conditions

Diverticulosis and Diverticulitis

What is diverticulosis and diverticulitis?

Diverticulosis is the presence of pouches or sacs (diverticula) in the gastrointestinal tract, though commonly this term refers to these pouches in the colon (large intestine). These diverticula occur due to an underlying weakness of the muscle layer of the colon, mostly commonly found in the sigmoid colon (the last section of the colon). It is thought that half) of U.S. adults will develop colonic diverticulosis.

Diverticulitis is when one of these pouches (diverticula) becomes infected or inflamed. Fifteen to 25 percent of people with diverticulosis will develop diverticulitis.

What are the symptoms of diverticulosis and diverticulitis?

Diverticulosis often does not have symptoms.

Diverticulitis symptoms include pain — typically in the left lower abdomen — and fever. Other less common symptoms include diarrhea, nausea and blood in the stool.

How is diverticulosis and diverticulitis diagnosed?

Diverticulosis is often found during routine colonoscopy or flexible sigmoidoscopy. It is also often noted during a CT scan of the abdomen.

Diverticulitis is diagnosed by CT scan after onset of abdominal pain. Colonoscopy and flexible sigmoidoscopy should be avoided in patients if an acute diverticulitis is suspected, or there has been a recent diverticulitis episode.

How is diverticulosis and diverticulitis treated?

Diverticulosis does not require treatment. It is recommended that patients eat a high fiber diet, which is currently thought to help prevent the development of additional diverticula or pouches. For diverticulosis patients, we recommend 20 grams per day of dietary fiber intake. Most American get about 10-15 grams in a typical diet, so the addition of a fiber supplement (psyllium powder or tablets, methylcellulose gummi bears or powder) can help get one to the recommended daily intake amount. Contrary to widely discussed advice (both from friends, family, or the internet), there is no need to avoid seeds, nuts, or popcorn; there has never been a medical study documenting these foods contribute to diverticulitis episodes.

Diverticulitis treatment depends on the severity of the infection. Routinely, the majority of infections are mild and only require rest and oral antibiotics at home. In more severe cases, hospitalization and the use of IV antibiotics is required. In rare cases, emergency drainage of an abscess or surgical therapy is warranted. For recurrent episodes, elective surgical resection of the affected part of the colon is considered.