Diverticular disease consists of three conditions that involve the development of small sacs or pockets in the wall of the colon, including diverticulosis, diverticular bleeding, and diverticulitis.
Diverticulosis is the formation of numerous tiny pockets, or diverticula, in the lining of the bowel. Diverticula, which can range from pea-size to much larger, are formed by increased pressure on weakened spots of the intestinal walls by gas, waste, or liquid. Diverticula can form while straining during a bowel movement, such as with constipation. They are most common in the lower portion of the large intestine (called the sigmoid colon).
Diverticulosis is very common and occurs in 10% of people over age 40 and in 50% of people over age 60. Most people will have no or few symptoms from diverticula.
Complications can occur in about 20% of people with diverticulosis. One of these complications is rectal bleeding, called diverticular bleeding, and another is diverticular infection, called diverticulitis.
Diverticular bleeding occurs with chronic injury to the small blood vessels that are next to the diverticula.
Diverticulitis occurs when there is inflammation and infection in one or more diverticula. This usually happens when outpouchings become blocked with waste, allowing bacteria to build up, causing infection.
What Are the Symptoms of Diverticulosis?
Diverticulosis does not cause any troublesome symptoms.
What Are the Symptoms of Diverticulitis?
Diverticulitis, infection and inflammation of diverticula, can occur suddenly and without warning.
Symptoms of diverticulitis may include:
- Alternating diarrhea and constipation.
- Painful cramps or tenderness in the lower abdomen.
- Chills or fever.
How Is Diverticulosis Diagnosed?
Because people with diverticulosis do not have any symptoms, it is usually found through tests ordered for an unrelated reason.
How Is Diverticulitis Diagnosed?
If you are experiencing the symptoms of diverticulitis, it is important to see your doctor.
Your doctor will ask questions about your medical history (such as bowel habits, symptoms, diet, and current medications) and perform a physical exam, possibly including a digital rectal exam.
One or more diagnostic tests may be ordered. Tests may include X-rays, CT scanning, ultrasound testing, a sigmoidoscopy, colonoscopy, and blood tests to look for signs of infection or the extent of bleeding.
In people with rapid, heavy rectal bleeding, the doctor may perform a procedure called angiography to locate the source of the bleeding.
How Is Diverticulosis Treated?
People who have diverticulosis without symptoms or complications do not need specific treatment, yet it is important to adopt a high-fiber diet to prevent the further formation of diverticula.
Laxatives should not be used to treat diverticulosis and enemas should also be avoided or used infrequently.
What Are the Complications of Diverticulitis?
Serious complications can occur as a result of diverticulitis. Most of them are the result of the development of a tear or perforation of the intestinal wall. If this occurs, intestinal waste material can leak out of the intestines and into the surrounding abdominal cavity causing the following problems:
- Peritonitis (a painful infection of the abdominal cavity)
- Abscesses ("walled off" infections in the abdomen)
- Obstruction (blockages of the intestine)