Diverticulitis

Medically reviewed by: Gary H. Hoffman, MD

Diverticulosis is a condition marked by the formation of small, abnormal pockets in the lining of the colon. Diverticulosis is common with age and generally does not produce symptoms, but if these pouches (diverticula) become inflamed or infected, a much more painful complication known as diverticulitis can develop. At Los Angeles Colon and Rectal Surgical Associates, we offer diagnostic procedures and treatment options to help you find relief from these conditions.

What is Diverticulosis?

Diverticula form largely due to increased pressure in the colon, which is believed to be the result of insufficient fiber intake. Diverticulosis begins to develop in most people as they age, affecting more than half of Americans by 65 and nearly everyone by age 80.

Typically, diverticulosis is asymptomatic, but it may cause cramping, bloating and abdominal spasms, typically in the lower left of the abdomen. In rare cases, diverticulosis may also cause gastrointestinal bleeding. This bleeding typically stops on its own, but may otherwise require blood transfusions or operation.

A small number of those with diverticulosis will experience a complication known as diverticulitis in which one of the diverticula becomes inflamed and infected. When a small hole or perforation develops in the diverticula, it can release infected material, causing symptoms like:

  • Serious abdominal pain
  • Fever and chills
  • Vomiting and nausea
  • Lack of appetite
  • Gas and bloating

In serious cases of diverticulitis, more severe complications may develop, including:

  • Abdominal abscesses
  • Colon perforation
  • Fistulas to bladder or vagina
  • Blockage or narrowing of intestine

How are Diverticulosis and Diverticulitis Treated?

If your doctor believes you may be suffering from diverticulosis or diverticulitis, diagnostic testing will likely be necessary. This typically amounts to a CT scan, ultrasound or X-ray of the abdomen, or a blood test to determine if you have an infection.

For most people who suffer from diverticulosis, increasing dietary fiber intake is effective at relieving pressure in the colon, preventing further diverticula formation and reducing risk of complications. Your colorectal specialist may recommend fiber supplements and a diet high in unprocessed grains like bran.

If you develop diverticulitis, the nature of your treatment will depend on the severity of symptoms. Most mild cases respond well to conservative treatments like antibiotics and bowel rest. When severe cases cause abdominal abscess, they can be drained using X-ray guidance, but may also require surgery. In serious cases that result in fistula, perforation or blockage, operative intervention is commonly necessary.

Once diverticula have formed, they are permanent and will always carry a risk of complications. Though dietary fiber is effective at minimizing this risk, those who have recurrent episodes of diverticulitis or abdominal bleeding may require surgery to remove the affected segment of the colon.

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