Diverticular Disease: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Raosaheb Rathod , Gastroenterologists Medical

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Diverticular Disease is a common digestive condition in which small bulging pouches, called diverticula, develop in the wall of the colon. While many people experience no symptoms, some may develop abdominal pain, bloating, constipation, or inflammation known as diverticulitis. The risk of diverticular disease increases with age and certain lifestyle factors. Early diagnosis and appropriate treatment can help relieve symptoms, prevent complications, and support digestive health.

What are the Types of Diverticular Disease?

There are several types of diverticular disease, each with its own characteristics and implications:

Diverticulosis: This is the presence of diverticula in the colon. It is typically asymptomatic and often found incidentally during routine examinations such as colonoscopies.
Diverticulitis: This occurs when the diverticula become inflamed or infected, leading to symptoms such as abdominal pain, fever, and changes in bowel habits.
Diverticular Bleeding: This is less common but can occur when a blood vessel in a diverticulum bursts, leading to rectal bleeding.

What are the Symptoms and Warning Signs of Diverticular Disease?

Symptoms vary depending on the stage and severity of the condition. Mild disease may cause intermittent digestive discomfort, while diverticulitis can produce more severe symptoms.

Prompt medical evaluation helps prevent complications such as abscesses or bowel perforation.

Common Symptoms

Lower abdominal pain, especially on the left side
Bloating
Constipation or diarrhea
Abdominal tenderness
Excessive gas
Changes in bowel habits

Severe Symptoms

High fever and chills
Severe abdominal pain
Nausea and vomiting
Rectal bleeding
Abscess formation
Bowel perforation or peritonitis

What are the Causes of Diverticular Disease?

The exact cause of diverticular disease is not entirely understood, but several factors are known to contribute to its development:

Low Fiber Diet

A diet low in fibre is widely recognized as a significant risk factor for diverticular disease. Fiber helps maintain regular bowel movements and reduces pressure in the colon. Without enough fibre, stools can become hard and difficult to pass, increasing the pressure and leading to the formation of diverticula.

Aging

As individuals age, the walls of the colon naturally weaken, making the formation of diverticula more likely. This explains the higher prevalence of the disease in older populations.

Genetic Factors

There is evidence to suggest that genetics play a role in the development of diverticular disease, with some people being more predisposed to the condition than others.

Other Risk Factors

Other potential risk factors include obesity, smoking, lack of exercise, and the use of certain medications such as steroids and nonsteroidal anti-inflammatory drugs (NSAIDs).

When to See a Doctor for Diverticular Disease?

Individuals with persistent abdominal pain, changes in bowel habits, rectal bleeding, or symptoms suggestive of diverticulitis should consult a Medical Gastroenterologist or General Surgeon for evaluation.

You should see a doctor if you experience:

Persistent lower abdominal pain
Changes in bowel habits lasting several weeks
Blood in the stool or rectal bleeding

Seek immediate medical attention if you:

Develop severe abdominal pain with fever
Experience persistent vomiting or inability to pass stool or gas
Notice signs of severe bleeding, dizziness, or symptoms of peritonitis

These symptoms may indicate complicated diverticulitis requiring urgent medical or surgical treatment.

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How is Diverticular Disease Diagnosed?

Diagnosis is based on the medical history, physical examination, laboratory tests, and imaging studies. During an acute attack of diverticulitis, imaging helps confirm the diagnosis and detect complications.

Early diagnosis allows timely treatment and reduces the risk of serious complications.

Diagnostic Methods

Medical history and physical examination
Blood tests including complete blood count (CBC) and inflammatory markers
Computed tomography (CT) scan of the abdomen and pelvis
Colonoscopy after recovery from acute diverticulitis to evaluate the colon
Ultrasound or Magnetic Resonance Imaging (MRI) in selected cases
Stool tests when indicated to exclude other gastrointestinal disorders

What are the Treatment Options of Diverticular Disease?

Treatment for diverticular disease depends on the severity of symptoms and the presence of complications.

Diverticulosis

For asymptomatic diverticulosis, lifestyle changes are often recommended to prevent progression, including:

High-Fiber Diet: Incorporating more fruits, vegetables, and whole grains into the diet to promote regular bowel movements.
Hydration: Drinking plenty of fluids to help soften stools.
Regular Exercise: To maintain healthy bowel function.

Diverticulitis

For mild cases of diverticulitis, treatment typically involves:

Antibiotics: To treat or prevent infection.
Dietary Modifications: Initially, a clear liquid diet may be recommended, gradually progressing to a low-fiber diet as symptoms improve.

In severe cases, hospitalization and surgical intervention may be necessary, especially if complications such as abscesses or perforations occur.

Surgical Treatments

Surgery may be required for recurrent diverticulitis, complications, or when other treatments are ineffective. Surgical options include:

Resection: Removing the affected portion of the colon.
Colostomy: Creating an opening for waste to exit the body into a colostomy bag, typically a temporary measure.

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How Can Diverticular Disease Be Prevented and Managed Through Lifestyle Changes?

Preventing diverticular disease and its complications involves adopting a healthy lifestyle and dietary habits. Some recommendations include:

Increase Fiber Intake: Aim for at least 25-30 grams of fibre per day.
Stay Hydrated: Drink ample water to help fibre work efficiently in the digestive tract.
Exercise Regularly: Engage in physical activity to enhance bowel function.
Avoid Smoking: Smoking cessation can improve overall health and reduce disease risk.
Limit Use of NSAIDs: These medications can increase the risk of diverticulitis.

What are the Complications of Diverticular Disease?

While many individuals with diverticular disease remain asymptomatic, complications can arise, particularly in cases of diverticulitis. These complications can be severe and include:

Abscess

An abscess is a localized collection of pus that can form in the colon due to infection. It may require drainage or surgery if it does not respond to antibiotics.

Perforation

A perforation, or tear, in the colon wall can lead to peritonitis, a serious infection of the abdominal cavity. This is a medical emergency requiring immediate intervention.

Strictures and Obstructions

Chronic inflammation can lead to the formation of scar tissue, causing strictures (narrowing) of the colon, which may result in bowel obstruction.

Fistulas

A fistula is an abnormal connection between the colon and another organ, such as the bladder or skin. Surgical intervention is often necessary to correct this condition.

What is the Recovery Process for Diverticular Disease?

Recovery depends on the severity of the condition and adherence to treatment and lifestyle changes.

Gradual return to a high-fiber diet after recovery.
Maintaining hydration and balanced nutrition.
Regular physical activity to support digestion.
Following medical advice and completing prescribed medications.
Routine follow-ups to monitor condition and prevent recurrence.

Frequently Asked Questions

1. What are the symptoms of Diverticular Disease?

Symptoms may include abdominal pain, changes in bowel habits, and fever, indicating inflammation or complications of diverticula.

2. What causes Diverticular Disease?

Diverticular disease is caused by the formation of small pouches (diverticula) in the colon, often due to a low-fiber diet and increased pressure in the colon.