Causes and Risk Factors
Diverticula form when pressure inside the colon pushes the inner lining outward through weak points in the muscle wall. Several factors make diverticulosis, and flares of diverticulitis, more likely:- Age: The colon wall naturally weakens over time, so pouches become more common in later decades of life.
- Low-fiber diet: A diet low in fiber produces harder stool and higher pressure inside the colon.
- Excess weight and inactivity: Both are associated with a higher risk of diverticulitis episodes.
- Smoking: Tobacco use increases the risk of complicated diverticulitis.
- Certain medications: Regular use of NSAIDs such as ibuprofen has been linked to a higher risk of diverticular complications.
- Family history: Genetics play a meaningful role in who develops diverticular disease.
Symptoms
Diverticulosis alone usually causes no symptoms at all, and many people learn they have it only after a colonoscopy or CT scan done for another reason. Occasional cramping, bloating, or changes in bowel habits can occur and may overlap with symptoms of irritable bowel syndrome. Diverticulitis is different and typically causes:- Abdominal pain: Usually steady pain in the lower left side of the abdomen that may build over a day or two.
- Fever and chills: Signs that inflammation or infection is present.
- Nausea and loss of appetite: Sometimes with vomiting.
- A change in bowel habits: Constipation is common; some people have diarrhea.
Diagnosis
When diverticulitis is suspected, a CT scan of the abdomen is the most reliable way to confirm the diagnosis and check for complications such as an abscess or perforation. Blood tests can show signs of infection. After an episode fully resolves, a colonoscopy is often recommended — if one has not been done recently — to examine the colon and rule out other conditions, including colon polyps and inflammatory bowel disease such as Crohn's disease.Treatment
Treatment depends on how severe the episode is.- Mild, uncomplicated diverticulitis: Many episodes can be managed at home with rest, a temporary liquid or low-residue diet, and close follow-up. Antibiotics such as amoxicillin-clavulanate, or ciprofloxacin combined with metronidazole, are prescribed when needed.
- Complicated diverticulitis: High fever, an abscess, or perforation requires hospital care with intravenous antibiotics and sometimes drainage or surgery.
- Prevention between episodes: A high-fiber diet, plenty of fluids, regular exercise, and maintaining a healthy weight all lower the risk of recurrence. Contrary to older advice, nuts, seeds, and popcorn do not need to be avoided.
- Recurrent disease: After multiple significant episodes, elective surgery to remove the affected segment of colon may be discussed.