What is diverticulosis?

Diverticulosis is a condition that occurs when the innermost layer of the digestive tract pushes through weak spots in the outermost layer of the digestive tract – resulting in small “pouches” or “pockets.” Diverticula generally form in the lower part of the large intestine (i.e., colon). Some people who have diverticulosis only have several pouches on the left side of their colon, while others may have multiple pouches throughout their colon.

Who gets diverticulosis?

While it is uncommon for people who are under 40 years of age, diverticulosis does affect about half of all Americans who are over 60 years old and nearly every American who is 80 years of age or older.

What causes diverticulosis?

Because it is uncommon in areas where the inhabitants’ diets are high in fiber and rich in grains, fruits and vegetables, gastroenterologists believe that diverticulosis is more prevalent in the U.S. because of a low fiber diet. Low fiber diets lead to constipation, which increases pressure in the digestive tract and forces people to strain when they have bowel movements. The combination of this pressure and straining over many years may lead to diverticulosis.

What are the symptoms of diverticulosis?

Some people will experience bloating, abdominal cramps or constipation — as it can be difficult to pass stool through the affected part of the colon. However, most of the people who have diverticulosis don’t know it because it doesn’t generally exhibit obvious symptoms.

How do gastroenterologists diagnose diverticulosis?

Because most people don’t exhibit obvious symptoms, diverticulosis is often diagnosed when a patient is being evaluated for another condition or during a screening exam for colon cancer. Gastroenterologists discover the pouches in the patient’s colon using a small camera that is attached to a flexible tube that is inserted through the rectum. They use a sigmoidoscopy to examine the rectum and lower part of the colon, while they use a colonoscopy — which is equipped with a longer tube — to examine the entire colon. Diverticulosis can also be diagnosed using other imaging tests, including a computed tomography (CT) scan or barium x-ray.

How do gastroenterologists treat diverticulosis?

Medications: Certain medications can help soften yet bulk up one’s stool, which makes bowel movements easier. Available in pill, powder and wafer form, examples of these medications include:

  • Psyllium
  • Methylcellulose
  • Polycarbophil

Dietary Changes: Keeping in mind that the diverticulum or pouches will not disappear on their own, most patients who have diverticulosis do not need treatment. But when they do experience abdominal pain, bloating or constipation, a high fiber diet can help make their stools softer and easier to pass. Gastroenterologists recommended that people consume 20 to 35 grams of fiber per day, yet the average American only gets about half that amount. Patients are encouraged to consume more fiber by eating more fruits, vegetables and grains, including:

  • Peas
  • Berries
  • Beans
  • Oats
  • Broccoli

Can diverticulosis lead to complications?

Diverticulosis may lead to several complications, including infection, bleeding or colonic blockage. This includes:

  • Diverticulitis, which occurs when a pouch becomes filled with stool – causing inflammation. This can result in localized abdominal pain, fever, nausea and vomiting. Your gastroenterologist may order a CT scan to determine or confirm whether you have diverticulitis. Minor cases of diverticulitis do not require hospitalization, and infections are often treated with oral antibiotics. It is also worth noting that diverticulitis is not related to seed or nut consumption.
  • Abscess/Peritonitis. Gone untreated, diverticulitis can result in an abscess (i.e., collection of pus) on the outside of the colon or peritonitis, which is a generalized infection in the lining of the abdominal cavity. Gastroenterologists use CT scans to diagnose these conditions, which generally require hospitalization, and are treated with intravenous antibiotics and by draining the abscess.
  • Diverticular hemorrhage, which is the most common cause of major colonic (i.e., rectal) bleeding in patients who are over 40 years old. This condition is painless, and the bleeding normally stops on its own. But if the bleeding persists, the patient may be hospitalized to receive a blood transfusion — and the gastroenterologist may conduct a colonoscopy to determine if there are any other causes of the bleeding. Radiological procedures or surgery may also be used to stop bleeding that cannot be controlled by other means.
  • Colonic obstruction, which may afflict patients who have had multiple bouts of diverticulitis as this thickens the walls of the colon. Surgery is sometimes needed to remove the obstruction.

Important Reminder: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.