What Is Diverticulitis?

What Is Diverticulitis?

Diverticulitis is a disease that occurs in the colon. Diverticula are small pockets that form in the wall of the colon. The small pockets, or diverticula, in the colon can become inflamed and infected. This is called diverticulitis.

Diverticulitis becomes more common as a person ages. Having a diet low in fiber and not getting enough physical activity increase your risk of developing this disease. 

Signs and Symptoms

Pain in the lower left or occasionally the right portion of the abdomen is the most common symptom of diverticulitis. This pain may get worse over several days and may vary in severity. In addition, nausea, vomiting, diarrhea and constipation may occur. In moderate to severe symptoms a person has more severe pain, cannot keep any liquids down and may have a fever.

The arteries supplying blood to the damaged part of the colon may weaken and rupture. This is diverticular bleeding.

Diverticular bleeding may not cause pain or other symptoms. Blood may be present in the bowel movement. The bowel movement may be maroon or dark red or contain bright red blood, or there may be passage of blood without a bowel movement.

Diagnosis

Diverticulitis is often diagnosed when acute symptoms are present. The first step in determining the diagnosis and the best treatment involves a detailed history and physical exam. Based on this information, your doctor may order a number of tests. These may include the following. 

Imaging Tests

CT scan: During a CT scan, pictures are taken of cross sections or slices of the abdominal structures in your body. This includes the colon or large intestine.

Barium enema: The barium used in a barium enema will help show the large intestine on the X-ray.

Colonoscopy: You may be referred by your PCP to a gastroenterologist who may do a colonoscopy to visualize the inside of your entire colon, not just the lower portion.

Sigmoidoscopy: You may be referred by your PCP to a gastroenterologist who may do a sigmoidoscopy to visualize the inside of your colon. A small flexible tube is used to see inside the rectum and lower portion of the colon. If the test is positive, your doctor may recommend a colonoscopy.

Monitoring Diverticulitis

Once a person is diagnosed with diverticulitis, an evaluation of the entire colon with a colonoscopy is often recommended. This can identify the extent of disease and identify other issues such as colon polyps. Further follow-up with a gastroenterologist also is recommended.

Treatment

The treatment of diverticulitis depends on the severity of the symptoms.

Treatment of mild symptoms often occurs at home. Treatment includes drinking clear liquids and using oral antibiotics. Symptoms should improve in 2-3 days, and the diet can be slowly advanced. Communication with your health care provider is important if symptoms worsen or do not improve.

Treatment of moderate to severe symptoms of diverticulitis occurs in the hospital. Moderate to severe symptoms may include fever, worsening abdominal pain and vomiting. This treatment includes IV (intravenous) fluids, IV antibiotics and clear liquids or nothing consumed by mouth to rest the GI tract.

If a perforation, obstruction, abscess or fistula (abnormal opening in the intestine) is present, further treatment is often needed. Recurrent episodes or a severe episode of diverticulitis also may require surgery to remove the diseased portion of the colon. If the surgery is done on an emergency basis, two surgeries may be required.

Treatment for diverticular bleeding will include urgent hospitalization and resuscitation, which will include IV placement, IV fluids and possible blood transfusion. If bleeding persists, identification and treatment of the bleeding site will be needed. The patient will likely need emergency evaluation with a possible colonoscopy and endoscopic treatment. It is also possible that angiography with angiographic therapy or surgical intervention may be needed. 

Diverticulitis Clinical Trials

Clinical trials help determine new treatment options for diseases and conditions. Patients with diverticulitis have access to clinical trials and should speak with their physician to determine what trials might work best for them.

See a Specialist

It’s important to be evaluated by a gastroenterologist if you, your child or a loved one:

• Has symptoms of diverticulitis
• Has had a history of diverticulosis
• Would like strategies to help improve your current treatment of diverticulitis

At National Jewish Health in Denver, Colorado, our gastroenterologists treat hundreds of patients with a variety digestive disorders each year. Learn more about our gastroenterology program or use the button below to make an appointment.