Diverticular disease occurs when small pouches or sacs called diverticulae develop in weakened areas in the wall of the colon. The presence of these pouches is referred to as diverticulosis. When the pouches become inflamed or infected, it is called diverticulitis.
The colon and rectal specialists at UPMC provide expert diagnosis along with personalized surgical and nonsurgical treatment for diverticular disease and its related complications. We work closely with other medical specialists — including family doctors, gastroenterologists, and registered dietitians — to prevent complications, improve your quality of life, and deliver comprehensive diverticular disease treatment.
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What Is Diverticular Disease?
Diverticular disease occurs when small pouches or sacs called diverticulae develop in weakened areas in the wall of the colon. The presence of these pouches is called diverticulosis. When the pouches become inflamed or infected, it is called diverticulitis.
What are the types of diverticular disease?
There are two types of diverticular disease, including:
- Diverticulosis — Occurs when small pouches called diverticulae develop in weakened areas in the wall of your colon.
- Diverticulitis — Occurs when diverticulae become inflamed or infected, causing pain, fever, and bowel problems.
What is the difference between diverticular disease and diverticulitis?
Diverticular disease is a term that refers to both diverticulosis and diverticulitis. Diverticulitis is a complication of diverticular disease.
How common is diverticular disease?
According to the National Institute of Diabetes and Digestive and Kidney Diseases, diverticular disease is a common condition that affects more than 30% of people between the ages of 50 and 59, and more than 70% of people over age 80.
What causes diverticular disease?
Researchers aren’t sure what causes diverticular disease but it may be linked to:
- Changes in the bacteria in your digestive tract.
- Genetics.
- Immune system problems.
- Increased pressure on your colon related to constipation.
- Lifestyle factors, such as diet, exercise, medications, obesity, and smoking.
Diverticular disease risk factors
If you experience frequent constipation or straining during bowel movements, you may be at a higher risk of developing diverticular disease.
Diverticular disease is most common in people older than age 60. Eating a low-fiber diet that is high in red meat and fat can increase your risk of developing diverticular disease. People who smoke, are obese, or do not exercise regularly may be more likely to experience symptoms.
Complications of diverticular disease
Complications of diverticular disease may include:
- Diverticular bleeding — Occurs when a blood vessel in a pouch bursts, which can be severe and life-threatening.
- Diverticulitis occurs when diverticula become inflamed or infected. This can also lead to other complications, such as a narrowing or perforation (hole) in the colon and abnormal connections between the colon and other abdominal organs.
How can I prevent diverticular disease?
Maintaining good bowel habits can lower your risk of developing diverticular disease. Eating a diet rich in fiber, drinking plenty of water, and exercising regularly can help promote regular bowel movements and reduce the risk of constipation and straining.
What Are the Signs and Symptoms of Diverticular Disease?
In most cases, diverticular disease — particularly diverticulosis — does not cause symptoms.
Diverticulosis symptoms
Diverticulosis doesn’t usually cause symptoms.
However, you may experience:
- Bloating.
- Constipation.
- Cramping.
- Diarrhea.
- Pain in the lower abdomen.
Diverticulitis symptoms
If diverticulitis develops, you may experience sudden, severe symptoms or mild symptoms that get worse over several days, including:
- Abdominal pain, often in the lower left part of your abdomen.
- Diarrhea alternating with constipation.
- Fever and chills.
- Nausea or vomiting.
Diverticular bleeding may cause bright red rectal bleeding. The bleeding is usually painless but may be heavy. You may also experience lightheadedness or dizziness.
When should I see a doctor about my diverticular disease symptoms?
Diverticular disease is most often diagnosed during a routine screening colonoscopy to check for signs of colon cancer. Most people don’t realize they have diverticular disease, because it doesn’t cause symptoms.
If you have mild symptoms of diverticular disease, schedule an appointment with your doctor. If you have severe symptoms of diverticulitis, such as pain or bleeding, visit your nearest hospital emergency department.
How Do You Diagnose Diverticular Disease?
Your doctor may suspect you have diverticular disease based on your symptoms and may order testing to confirm the diagnosis.
What to expect during your visit
If your doctor suspects diverticular disease, they will:
- Ask about your symptoms.
- Perform a physical exam.
- Order other tests.
- Review your health history and medications.
Tests to diagnose diverticular disease
Tests to diagnose diverticular disease may include:
- Colonoscopy — A colonoscopy is a 20-30-minute outpatient procedure. It allows your doctor to see and examine the inside of your entire colon. The procedure usually is performed under anesthesia.
- Imaging tests — Your doctor may order a CT scan or other imaging tests to check your gastrointestinal tract for signs of diverticular disease.
Diverticular disease prognosis
Although diverticulosis doesn’t usually cause symptoms, you will have the condition for life after pouches develop. According to the National Institute of Diabetes and Digestive and Kidney Diseases, less than 5% of people with diverticulosis develop diverticulitis.
How Do You Treat Diverticular Disease?
Treatment options may include:
Dietary planning for diverticular disease
Your doctor may recommend following a special diet to help manage your condition. In addition to providing you with information about your dietary plan, your doctor may refer you to a registered dietitian for nutritional support.
Medication to treat diverticular disease
Your doctor will work closely with you, your gastroenterologist, and your family doctor to develop and coordinate your treatment plan, which may include medications to control inflammation, reduce symptoms, or treat infection.
Surgery for diverticular disease
Surgery for diverticular disease is typically only performed if your condition causes frequent or severe complications.
Our board-certified colon and rectal surgeons use open, laparoscopic, and robotic surgical techniques to treat diverticular disease. The focus is to preserve natural bowel function and avoid the need for a colostomy, which reroutes stool through a stoma, or an opening in the abdomen, where it is collected in a bag. Our surgeons will use minimally invasive techniques whenever possible to shorten recovery time, decrease pain, and improve outcomes.
Surgical procedures to treat diverticular disease include:
Colectomy for diverticular disease
A colectomy removes part of your colon. Colectomies can be performed using traditional open techniques or laparoscopically using small surgical instruments inserted into several half-inch incisions in your abdomen. In many cases, the unaffected parts of your colon are joined surgically, avoiding the need for a colostomy. However, if necessary, your doctor may also perform a colostomy.
Why Choose UPMC for Diverticular Disease Care?
When you choose UPMC for diverticular disease care, you will receive:
- Access to board-certified specialists — Our gastrointestinal and colon and rectal surgery specialists are experienced in caring for people with diverticular disease and related complications.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your risk of complications and improve your quality of life.
- A full range of treatment options — We use the latest nonsurgical, minimally invasive, and surgical techniques to provide comprehensive diverticular disease care.
