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What is diverticular disease?

Diverticular disease is an infection in the tiny pouches that some people get in their colon; the pouches are called diverticula. The pouches bulge out through weak spots in your colon and can become inflamed or infected.

Diverticular disease includes the following health problems:

  • Diverticulosis; when you have tiny pouches or diverticular in your colon.
  • Diverticulitis; when the pouches in your colon get infected.

About half of all Americans over the age of 60 will have diverticulosis; some people with diverticulosis can also get diverticulitis. 

Diverticular disease is often seen in developed countries and is very common in the U.S., England, and Australia; people in these countries eat less fiber. Diverticular disease is rare in countries such as Asia and Africa because people in these countries eat more fiber and vegetables.


What causes diverticular disease?

The cause of diverticular disease is unknown, but physicians think it might happen when not enough fiber is eaten. Fiber is the part of fruits, vegetables and grains that the body cannot digest and helps make your stools soft and easy to pass. Eating more fiber helps stop constipation which is the main cause of greater pressure in your colon. When you are constipated, your muscles strain to move stool that’s too hard. The extra pressure from this straining makes the weak spots in your colon bulge out; these pouches that bulge out are the diverticula. 

It is unknown what causes the infection that leads to diverticulitis, but it’s thought that it may start when stool or bacteria are caught in the diverticula.


Who is at risk for diverticular disease?

It’s unclear if diet affects your risk of getting the diverticular disease, but you are more at risk for the disease if you:

  • Are over 50 years old
  • Are male
  • Have diverticulosis
  • Are obese
  • Do not get enough exercise
  • Use nonsteroidal anti-inflammatory drugs
  • Smoke


What are the symptoms of diverticular disease?

Each person’s symptoms may vary and may include:

  • Diverticulosis – You can have diverticulosis and not have any pain or symptoms, however, symptoms may include mild cramps, swelling or bloating and constipation. These symptoms can also be caused by irritable bowel syndrome, stomach ulcers or other health problems and do not always mean that you have diverticulosis.
  • Diverticulitis – The most common symptom of diverticulitis is abdominal pain. The most common sign that you have it is feeling sore or sensitive on the left side of your lower belly. If an infection is the cause, then you may have fever, nausea, vomiting, chills, cramping, and constipation. 
  • Diverticular colitis – This is when the colon gets inflamed as a result of the diverticular disease; this is less common than diverticulitis.

The symptoms of diverticular disease may look like other health problems; always see your physician to be sure.


How is diverticular disease diagnosed?

Your physician will look at your past health and do a physical exam; he or she may also use some of the following tests:

  • X-rays
  • Digital rectal exam checks if you have problems in the anus or rectal area. Your physician will gently put a gloved, lubricated finger into your rectum to check the muscle that closes off the anus.
  • A stool sample checks for any abnormal bacteria or parasites in your digestive tract. A small stool sample is taken and sent to a lab.
  • CT scan shows detailed images of any part of the body, such as the bones, muscles, fat and organs and is used to check for complications of diverticular disease like diverticulitis.
  • Barium enema or lower GI (gastrointestinal) series is an X-ray exam of your rectum, the large intestine and the lower part of your small intestine. You will be given a metallic fluid called barium that coats the organs so that they can be seen on an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An X-ray of your belly will show if you have any narrowed areas, blockages or other problems.
  • Virtual colonoscopy is a CT scan that checks your colon using air and contrast.
  • Flexible sigmoidoscopy is a test that checks the inside of part of your large intestine and helps to tell what is causing constipation. A short, flexible, lighted tube is put into your intestine through the rectum blowing air into your intestine to make it swell, making it easier to see the inside. A tissue sample can be taken if needed
  • Colonoscopy looks at the full-length of your large intestine and can help check for any abnormal growths, tissue that is red or swollen, ulcers or bleeding. A long, flexible, lighted tube is put into your rectum up into the colon allowing your physician to see the lining of your colon and take out a tissue sample to test it. He or she can also treat some problems that may be found.


How is diverticular disease treated?

Your physician will make a care plan for you based on:

  • Your age, overall health and medical history
  • How serious your case is
  • How well you handle certain medicines, treatments or therapies
  • If your condition is expected to get worse
  • Your opinion and what you would like to do

Your physician may tell you to eat more foods that have fiber such as:

  • Whole grain breads and cereals
  • Fruit such as berries, apples and peaches
  • Vegetables like broccoli, cabbage, spinach, carrots, asparagus and squash
  • Beans

Treatment for diverticulitis may also include:

  • Pain medicines
  • Antibiotics to fight infections
  • Medicines to control muscle spasms
  • Letting your colon rest by have a liquid diet and staying in bed
  • Bowel rest or eating only clear liquids for some time

You may need to stay in the hospital if you have a bad attack with severe pain or infection; in some cases surgery may be needed.


What are the complications of diverticular disease?

Diverticular disease can cause other health problems such as:

  • Infection
  • Holes or tears
  • Blockages
  • Bleeding
  • Colitis