Learn About Diverticulosis

What is the definition of Diverticulosis?

Diverticulosis occurs when small, bulging sacs or pouches form on the inner wall of the intestine. These sacs are called diverticula. Most often, these pouches form in the large intestine (colon). They may also occur in the jejunum in the small intestine, although this is less common.

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What are the alternative names for Diverticulosis?

Diverticula - diverticulosis; Diverticular disease - diverticulosis; G.I. bleed - diverticulosis; Gastrointestinal hemorrhage - diverticulosis; Gastrointestinal bleed - diverticulosis; Jejunal diverticulosis

What are the causes of Diverticulosis?

Diverticulosis is less common in people age 40 and younger. It's more common in older adults. About half of Americans over age 60 have this condition. Most people will have it by age 80.

No one knows exactly what causes these pouches to form.

For many years, it was thought that eating a low-fiber diet may play a role. Not eating enough fiber can cause constipation (hard stools). Straining to pass stools (feces) increases the pressure in the colon or intestines. This may cause the pouches to form at weak spots in the colon wall. However, whether a low-fiber diet leads to this problem is not well proven.

Other possible risk factors that are also not well proven are lack of exercise and obesity.

Eating nuts, popcorn, or corn does not appear to lead to inflammation of these pouches (diverticulitis).

What are the symptoms of Diverticulosis?

Most people with diverticulosis have no symptoms.

When symptoms occur, they may include:

  • Pain and cramps in your stomach especially in the left lower abdomen
  • Constipation (sometimes diarrhea)
  • Bloating or gas
  • Not feeling hungry and not eating

You may notice small amounts of blood in your stools or on toilet paper. Rarely, more severe bleeding may occur.

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What are the current treatments for Diverticulosis?

Because most people have no symptoms, most of the time, no treatment is needed.

Your health care provider may recommend getting more fiber in your diet. A high-fiber diet has many health benefits. Most people don't get enough fiber. To help prevent constipation, you should:

  • Eat plenty of whole grains, beans, fruits, and vegetables. Limit processed foods.
  • Drink plenty of fluids.
  • Get regular exercise.
  • Talk with your provider about taking a fiber supplement.

You should avoid NSAIDs such as aspirin, ibuprofen (Motrin), and naproxen (Aleve). These medicines can make bleeding more likely.

For bleeding that does not stop or recurs:

  • Colonoscopy may be used to inject medicines or burn a certain area in the intestine to stop the bleeding.
  • Angiography may be used to infuse medicines or block off a blood vessel.

If bleeding does not stop or recurs many times, removal of a section of the colon may be needed.

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What is the outlook (prognosis) for Diverticulosis?

Most people who have diverticulosis have no symptoms. Once these pouches have formed, you will have them for life.

Up to 25% of people with the condition will develop diverticulitis. This occurs when small pieces of stool become trapped in the pouches, causing infection or swelling.

What are the possible complications of Diverticulosis?

More serious problems that may develop include:

  • Abnormal connections that form between parts of the colon or between the colon and another part of the body (fistula)
  • Hole or tear in the colon (perforation)
  • Narrowed area in the colon (stricture)
  • Pockets filled with pus or infection (abscess)
When should I contact a medical professional for Diverticulosis?

Call your provider if symptoms of diverticulitis occur.

Barium enema
Colon diverticula - series
What are the latest Diverticulosis Clinical Trials?
A Prospective Randomised Placebo Controlled Trial on Prophylactic Endoscopic Clipping of Colonic Diverticula (PECoD)
Summary: This study will evaluate the effect of endoscopic clipping of colonic diverticula in treatment of symptoms related to diverticular disease. Half of the participants will undergo colonoscopy without the clipping procedure and half will have colonoscopy with clipping of all visible diverticula.
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Minimally Invasive Endoscopic Treatment of Zenker's Diverticulum Comparing LigaSureTM vs SB-Knife.
Summary: The main purpose of this trial is to evaluate two devices used in the treatment of Zenker Diverticulum using flexible endoscopy (LigaSure and SB-knife). Analyze the technical success, clinical success, relapses, complications, and the mean procedure time with each device prospectively in order to transfer objective and uniform results to routine clinical practice.
What are the Latest Advances for Diverticulosis?
Treatment of Giant Esophageal Epiphrenic Diverticulum Using Robotic-Assisted Surgery.
Summary: Treatment of Giant Esophageal Epiphrenic Diverticulum Using Robotic-Assisted Surgery.
The Clinical Efficacy of Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy in the Treatment of Calyceal Diverticulum Stones: A Meta-Analysis.
Summary: The Clinical Efficacy of Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy in the Treatment of Calyceal Diverticulum Stones: A Meta-Analysis.
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Laparoszkópos appendectomia gyermekkorban.
Summary: Laparoszkópos appendectomia gyermekkorban.
Who are the sources who wrote this article ?

Published Date: October 27, 2021
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Goldblum JR. Large bowel. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 17.

Fransman RB, Harmon JW. The management of diverticulosis of the small bowel. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:143-145.

Winter D, Ryan E. Diverticular disease. In: Clark S, ed. Colorectal Surgery: A Companion to Specialist Surgical Practice. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 10.