What is Colonic Diverticulosis?

A diverticulum is an outpouching of the large bowel wall.

Colonic diverticulosis causes no symptoms. Diverticulitis (inflammation of a diverticulum) may cause fever, tummy pain, diarrhea, nausea and vomiting.

Colonic diverticulosis is common. In contrast to Westerners, diverticular disease among Asians demonstrates right-sided predominance. It is more common in older people, increasing from less than 5% at age 40, to 30% by age 60, to 65% by age 85.

Among all patients with diverticulosis:

  • 80-85% remain asymptomatic
  • 15-20% develop diverticulitis

Diverticulosis

Diverticulosis is usually found incidentally when doing tests for other reasons.

Diverticulosis may be diagnosed with the following:

  • Barium enema is an x-ray study that uses contrast, barium to view the outline of the large bowel.
  • Colonoscopy is a video examination of the entire large bowel with a long flexible tube which is inserted through the anus.

No specific treatment is needed if there are no symptoms.

Increasing fiber in the diet may help to bulk the stools and may prevent the formation of new diverticuli, diverticulitis, or diverticular bleeding.

Fiber is not proven to prevent these conditions.

Diverticulitis

Diverticulitis refers to the inflammation of a diverticulum.

The presentation depends on the severity of the inflammation.

The most common symptom is:

  • pain in the abdomen

Less common symptoms include:

  • fever
  • nausea and vomiting
  • constipation
  • diarrhea
  • urinary symptoms

Treatment of diverticulitis depends on the severity of symptoms and clinical findings.

Those with mild symptoms may be treated at home with clear liquid diet and oral antibiotics.

People with moderate to severe symptoms usually need hospitalization, when the patient is not allowed to eat or drink, and fluids and antibiotics may be given via a vein.

Colonoscopy may be performed after an episode of diverticulitis resolves to examine the whole colon to determine the extent of disease and to rule out the presence of abnormal lesions such as polyps or cancer.

Surgery may be needed in those who develop serious complications. Surgery to remove diseased area of the large bowel may not be needed for patients who improve with medical therapy.

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