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Diverticulitis

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Contents of this page:

Illustrations

Colonoscopy
Colonoscopy
Digestive system
Digestive system
Colon diverticula - series
Colon diverticula - series

Definition    Return to top

Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall, usually found in the large intestine (colon). The presence of the pouches themselves is called diverticulosis.

Causes, incidence, and risk factors    Return to top

Small protruding sacs of the inner lining of the intestine (diverticulosis) can develop in any part of the intestine. They are most common in the colon, specifically the sigmoid colon. These sacs, called diverticula, occur with increasing frequency after the age of 40. When they become inflamed, the condition is known as diverticulitis. Diverticula are thought to develop as a result of high pressure or abnormal pressure distribution within the colon. High pressure exerted against the colon wall causes pouches of the intestinal lining to bulge outwards through small defects in the colon wall.

Diverticulosis is very common, being found in more than half of Americans over age 60. Only a small percentage of these people will develop the complication of diverticulitis. Diverticulitis is caused by inflammation, or (sometimes) a small perforation within a diverticulum. If the perforation is large, stool in the colon can spill into the abdominal cavity, causing an abscess or peritonitis.

Direct risk factors for diverticulitis are not known. Risk factors for diverticulosis may include older age or a low-fiber diet.

Symptoms    Return to top

Signs and tests    Return to top

Tests showing diverticulitis may include:

Tests such as colonoscopy, sigmoidoscopy, and barium enema are usually not performed if diverticulitis is suspected.

Treatment    Return to top

Acute diverticulitis requires antibiotic therapy.

Recurrent attacks or presence of perforation, fistula (abnormal tube-like passage), or abscess requires surgical removal of the involved portion of the colon.

After the acute infection has stabilized, diverticulitis is treated by increasing the bulk in the diet with high-fiber foods and bulk additives such as psyllium.

Expectations (prognosis)    Return to top

Usually, this is a mild condition that responds well to treatment.

Complications    Return to top

Calling your health care provider    Return to top

Call your health care provider if symptoms of diverticulitis occur.

Also call if you have diverticulitis and symptoms worsen or new symptoms develop.

Prevention    Return to top

A high-fiber diet may prevent development of diverticulosis. Many people, including doctors, tell patients with a history of diverticulitis to avoid nuts and seeds in the diet. However, there is no evidence that this is helpful to prevent the disease.

Update Date: 5/14/2004

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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