Diverticulosis is the presence of diverticula (dy-ver-TIK-yoo-la) in the colon and large intestine. Diverticula are small sacs or pouches that bulge outward from the inside surface of the intestinal wall. If diverticula become inflamed or infected, the resulting disease is called diverticulitis.
Diverticula are small sacs or pouches that bulge outward from the inside surface of the intestinal wall. Diverticula occur most commonly in the sigmoid colon, which is the S-shaped part of the large intestine closest to the rectum. Many diverticula are usually present, and they may range from pea size or smaller to about one inch in diameter. The pouches form as a result of transmural (across-the-wall) pressure in the lower intestine that often occurs during constipation. A high-fiber diet that keeps wastes moving smoothly through the bowel and distributes pressure more evenly is thought to reduce the likelihood of developing diverticulosis or the related condition called diverticulitis.
Diverticulosis is caused by not enough roughage (fiber) in the diet. Roughage is coarse, bulky food rich in plant fiber. Observations show that people in developing countries whose diets include large amounts of plant materials (fruits and vegetables) almost never have diverticulosis. Diverticulosis is common in the United States and other developed countries where refined foods often lack significant amounts of fiber.
Young people rarely have diverticulosis, but it becomes more common as people age. By the time individuals in the United States reach 60 years of age, they have about a 50 percent chance of having diverticulosis.
Diverticulitis is not contagious.
People with diverticulosis may not know they have diverticulitis/diverticulosis because it does not always cause symptoms. Sometimes, however, the diverticula may become plugged with waste and infected, causing diverticulitis. The symptoms of diverticulitis may include abdominal * pain, fever, and tenderness when external pressure is applied over the abdomen. At other times, the small artery feeding the diverticulum may rupture and cause severe bleeding from the rectum. Both these conditions require immediate attention.
A doctor may discover that a person has diverticula by x-ray examination or by looking inside the colon through a viewing instrument such as a sigmoidoscope (sig-MOI-duh-skope) or a colonoscope (koLON-o-skope). Doctors often discover diverticula that have not caused symptoms during routine medical procedures.
Diverticulosis usually requires no special treatment, although doctors may recommend increased roughage in the diet. In mild cases of diverticulitis, treatment may include drinking more fluids, staying in bed, and taking antibiotics to control infection. Sometimes doctors recommend intravenous fluids * containing antibiotics.
Occasionally diverticulitis may be accompanied by serious complications. If diverticula rupture (RUP-chur, break open), intestinal contents may leak or spill out and cause an infection in the surrounding abdomen. Sometimes the intestine may become blocked or narrowed, in which case a patient may need surgery. Another situation that may call for surgery is a bleeding diverticulum. Often, bleeding diverticula can be corrected with medical treatment, but when that fails and a diverticulum continues to bleed, it may require surgical removal.
Medical professionals typically recommend adequate amounts of vegetable fiber in the diet as a way to avoid diverticulosis and diverticulitis. Bran, cabbage, beans, and whole-grain breads are examples of foods high in dietary fiber. Physicians may also suggest fiber supplements, especially for older adults, to maintain regular bowel habits and to reduce the risk of diverticulitis. Drinking plenty of water can help prevent diverticulitis and diverticulosis.
See also Constipation • Diarrhea • Irritable Bowel Syndrome
Mariani, Russell. Healing Digestive Illness: Root Causes and Solutions. 2nd ed. South Hadley, MA: Maramor Press, 2014.
American College of Gastroenterology. “Diverticulosis and Diverticulitis.” http://patients.gi.org/topics/diverticulosis-and-diverticulitis/ (accessed December 4, 2015).
American College of Gastroenterology. 6400 Goldsboro Rd., Suite 200, Bethesda, MD 20817. Telephone: 301-263-9000. Website: http://www.gi.org (accessed December 4, 2015).
* abdominal (ab-DAH-mih-nul) refers to the area of the body below the ribs and above the hips that contains the stomach, intestines, and other organs.
* intravenous (in-tra-VEE-nus) fluids are fluids injected directly into a vein.