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Diverticulosis & Diverticulitis

Diverticulosis means small pouches have formed in the colon wall; when a pouch becomes inflamed or infected, the condition is called diverticulitis, causing abdominal pain and fever.

Gastrointestinal
Diverticulosis is a condition in which small pouches, called diverticula, form at weak spots in the wall of the colon. The pouches themselves are usually harmless, but when one becomes inflamed or infected the condition is called diverticulitis, which can cause significant abdominal pain and occasionally serious complications. Diverticulosis becomes much more common with age — roughly half of Americans over 60 have it — so it is a condition internists see and manage regularly. 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.
When to Seek Immediate Care: Go to the emergency department for severe or rapidly worsening abdominal pain, a high fever, persistent vomiting, or significant rectal bleeding. These can signal a complication that needs urgent treatment. Diverticula can also bleed painlessly on their own; sudden passage of a large amount of red or maroon blood from the rectum should always be treated as an emergency, even without pain. Most people with diverticulosis never develop diverticulitis, and flares that do occur are very manageable with prompt attention. The internal-medicine team at Zimmer Medical Group can help you treat an episode and build a prevention plan.

Related Medications

Commonly prescribed medications for this condition

Amoxicillin-ClavulanateCiprofloxacinMetronidazole

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