Diverticulosis and Diverticulitis

What Is It?

Diverticulosis develops in weak spots along the walls of the colon, typically in the part of the colon called the sigmoid colon on the left side of the abdomen. In response to abnormal pressure in the colon, small, balloonlike pouches called diverticula may poke outward through the weak spots. Most people have no symptoms, but if a diverticulum bleeds or becomes infected, hospital care generally is required. Surgery may be recommended in specific circumstances.

The condition is more prevalent as people age. For example, it is estimated that half of people in the United States aged 60 to 80 have diverticulosis, but only one person in 10 develops it by age 40. It is equally common in women and men.

About 10 percent to 25 percent of people with this condition develop diverticulitis. This occurs when the diverticula become inflamed or infected. It is characterized by constant pain, usually in the lower abdomen, and often fever and other symptoms.

Diverticulitis can lead to serious complications such as abscess, perforation, intestinal blockage from internal scarring, or fistula, which is an abnormal connection between two organs. A rare but life-threatening complication called peritonitis can occur when diverticula rupture, leaking infection into the abdominal cavity.

Symptoms

Most people who have diverticulosis have no symptoms, but some have mild cramps, constipation or bloating. Diverticulitis has much more severe symptoms, including any of the following, but particularly the first two:

• Steady abdominal pain
• Tenderness to pressure in the lower abdomen
• Fever
• Nausea
• Vomiting
• Chills
• Cramping
• Change in bowel habits (constipation or diarrhea)
• Rectal bleeding
• Sharper pain with breathing or jarring movements such as walking.

Diagnosis

The symptoms of diverticular disease can mimic other diseases, including irritable bowel syndrome, stomach ulcers, acute appendicitis, Crohn's disease, bladder infection, kidney stones, colitis, or tumors of the ovary or colon.

Your doctor will ask about your medical history, bowel habits and diet and will conduct a physical examination, including a rectal examination with a gloved finger to detect tenderness, blockage or blood. Your doctor may press on your abdomen to check for tenderness. If inflammation is spreading, discomfort will remain even after the doctor removes the pressure. Sharper pain on movement, such as walking, suggests that an abscess may have ruptured.