Diverticulitis: Why the Pain?

Medically reviewed by: Gary H. Hoffman, MD

Pain From Diverticulosis To Diverticulitis.

In Los Angeles, diverticulitis has become an increasingly common malady seen by proctologists, also known as colon and rectal surgeons, and emergency rooms such as Cedars-Sinai. When diverticulosis turns nasty, abdominal pain usually follows (rectal bleeding is rare in cases of diverticulitis).  At Los Angeles Colon and Rectal Surgical Associates, the surgeons are constantly treating patients with new, or recurrent  symptoms of diverticulitis.  But, why the pain?  What causes the abdominal pain?  What causes diverticulosis to evolve into diverticulitis?

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To understand the process, it is best to first learn about the colon and what can happen to the colon as we age.  The colon is a long intestinal tube that functions to absorb water, solidify our stool, store the stool (most commonly in the rectum), and then sense the need to release the stool.  Although this may sound basic, it is actually a complicated dance between anatomy, physics, nerves and the brain.


The colon is described by the location of its parts; the cecum (the beginning of the colon and also the location of the appendix), the ascending colon, the transverse colon, the descending colon, the sigmoid colon (so called because of its S shape), the rectum, and finally the anus.  Water resorption takes place early, and storage occurs in the rectum.  To move the stool forward, the colon is lined with muscles. And therein is the genesis of the problem.


As the stool is pushed forward by the muscles contracting, a process termed peristalsis, high pressures develop.  In the end of the colon, in the sigmoid, is a high pressure zone.  This is not a problem until you consider that blood vessels and nerves at many points along the sigmoid colon.  These normal anatomic openings create a weakness in the colon wall.  As the pressure builds, these walls may weaken over time and form sacs called diverticulae, hence, diverticulosis.  Not surprisingly, diverticulosis is most common in the sigmoid colon, on the left side of the abdomen.


It is believed that as these sacs occasionally swell, the cut off the blood supply to that are of the colon.  A decreased  blood supply leads to inflammation and pain.  Diverticulitis.  As of now, researchers are unclear as to why this happens all of a sudden.  There is no answer as to “Why now?”

If You Like Your Seeds And Nuts, You Keep Your Seeds And Nuts.

It is a common misconception that seeds and nuts become lodged in the sacs and lead to symptoms.  This has been disproven.  So, restricting your diet really has no effect on the development of symptoms, and only serves to deprive you of some enjoyable foods.

Los Angeles Colon and Rectal Surgical Associates

When diverticulosis becomes diverticulitis, patients should contact a colon and rectal surgeon as soon as possible.  The earlier the situation is stopped, with dietary changes and antibiotics, the better the chance to reverse it without an operation, such as a laparoscopic colon resection.

The surgeons at Los Angeles Colon and Rectal Surgical Associates are available to help with the new onset of diverticulitis.  A phone call is all that is necessary to begin the treatment process immediately.  (310)273-2310.

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