Center for Digestive Diseases

UNM Hospitals Center
for Digestive Diseases

Address:
1001 Martin Luther King Ave. NE
Albuquerque, New Mexico 87106

Appointments:
(505)272-2530 or
(505)925-6000

Facsimile:
UNMH: (505)272-6839
CDD: (505)925-7849

Diverticulosis and Diverticulitis


What is diverticulosis?

Diverticulosis is a very common condition in which small outpouchings occur in the colon wall.  The sigmoid portion of the colon is the most common area of involvement in Western populations.  Diverticulosis is more common with increasing age.


What is diverticulitis?

Diverticulitis is a complication occurring in 15-20% of persons with diverticulosis.  Diverticulitis involves a small perforation of a diverticulum resulting in acute infection and inflammation extending in and around the colon wall.


What are the symptoms of diverticulosis and diverticulitis?

The majority of individuals (~70%) with uncomplicated diverticulosis remain asymptomatic.  Diverticulosis and diverticulitis can manifest as pain located in left lower quadrant of the abdomen.  Sometimes there can be associated loose stooling.  A small percentage (~5-10%) of patients with diverticulosis can have bleeding from one of their diverticula.   With diverticulitis, a patient may have a fever or other symptoms of infection.


What causes diverticulosis and diverticulitis?

It has long been felt that increased pressure in the colon is the driving force for diverticula formation.  This led to the assumption that chronic constipation may predispose individuals to diverticulosis.  Epidemiologic studies also suggest that diverticulosis is more common with a highly-refined, low fiber diet.   Other studies have suggested that the nerves in the colon may be different in individuals with diverticulosis, so potentially there may be a genetic component as well.


How is diverticulosis and diverticulitis diagnosed?

Diverticulosis is frequently identified during a colonoscopy.  It can also be seen on radiology imaging, such as a contrast enema or a CT scan.  A fever, an elevated white blood cell count, and a CT scan showing a focus of inflammation around the colon are generally required for the diagnosis of diverticulitis.


What is the treatment for diverticulosis and diverticulitis?

Traditionally, fiber has been advocated for diverticulosis, but there is not convincing evidence that this changes the severity or progression of the disease.  However, it may be effective in helping with regularity and may also help with colonic spasm.    Following the traditional recommendation of avoiding seeds and nuts is no longer felt to be necessary or helpful.  Antibiotics are often necessary to treat the infection associated with diverticulitis.   Surgery is often required to treat the complications of diverticulitis (e.g. abscess, fistula, etc.) or after recurrent episodes.