What is diverticulosis?
Diverticulosis is a condition that develops when pouches (diverticula ) form in the wall of the colon (large intestine). These pouches are usually very small (5 to 10 millimeters) in diameter but can be larger.
In diverticulosis, the pouches in the colon wall do not cause symptoms. Diverticulosis may not be discovered unless symptoms occur, such as in painful diverticular disease or in diverticulitis. As many as 80 out of 100 people who have diverticulosis never get diverticulitis.1 In many cases, diverticulosis is discovered only when tests are done to find the cause of a different medical problem or during a screening exam.
What causes diverticulosis?
The reason pouches (diverticula) form in the colon wall is not completely understood. Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall.
Normally, a diet with adequate fiber (also called roughage) produces stool that is bulky and can move easily through the colon. If a diet is low in fiber, the colon must exert more pressure than usual to move small, hard stool. A low-fiber diet also can increase the time stool remains in the bowel, adding to the high pressure.
Pouches may form when the high pressure pushes against weak spots in the colon where blood vessels pass through the muscle layer of the bowel wall to supply blood to the inner wall.
What are the symptoms?
Most people don’t have symptoms. You may have had diverticulosis for years by the time symptoms occur (if they do). Over time, some people get an infection in the pouches (diverticulitis). For more information, see the topic Diverticulitis.
Your doctor may use the term painful diverticular disease. It’s likely that painful diverticular disease is caused by irritable bowel syndrome (IBS). Symptoms include diarrhea and cramping abdominal (belly) pain, with no fever or other sign of an infection. For information on the symptoms of IBS, see the topic Irritable Bowel Syndrome (IBS).
How is diverticulosis diagnosed?
In many cases, diverticulosis is discovered only when tests, such as a barium enema X-ray or a colonoscopy, are done to find the cause of a different medical problem or during a screening exam.
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)
If an abscess is present, the doctor will need to drain the fluid by inserting a needle into the infected area. Sometimes surgery is needed to clean the abscess and remove part of the colon. If the infection spreads into the abdominal cavity (peritonitis), surgery is needed to clean the cavity and remove the damaged part of the colon. Without proper treatment, peritonitis can be fatal.
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