Diverticulitis

Am Fam Physician. 2013;87(9):online

See related article on diverticulitis.

What is diverticulosis?

Diverticulosis (di-ver-tik-u-LO-sis) is when you have pouches in the colon that bulge out. These pouches are called diverticula (di-ver-TIK-u-lah). They are caused by pressure in the colon that weakens the bowel wall. Not eating enough fiber, not exercising enough, and taking nonsteroidal anti-inflammatory drugs like ibuprofen can cause diverticulosis.

What is diverticulitis?

Diverticulitis (di-ver-tik-u-LI-tis) is when diverticula are inflamed or infected. One in four people with diverticulosis will get diverticulitis.

What are the symptoms?

Symptoms vary and can include stomach pain (usually on the left side), fever, constipation or diarrhea, and nausea.

How is it diagnosed?

Your doctor will ask you questions about your symptoms and examine you. He or she may also do blood tests, a computed tomography (CT) scan, or an ultrasound. A CT scan takes detailed pictures of your body. You may need to drink a dye that will help the doctor see the pictures better. Ultrasound uses sound waves to create pictures of your body. You will not need to drink a dye if you get an ultrasound.

How is it treated?

If you have mild diverticulitis, your doctor may send you home. You should not eat and should drink only clear liquids. Then, in two or three days, you should go back to see your doctor. Some patients may also need antibiotics. If you have moderate or severe diverticulitis, you may need to stay in the hospital for IV antibiotics.

Will I need a colonoscopy?

Most people will not need one. But, if you have severe diverticulitis, your doctor may tell you to get a colonoscopy four to six weeks after your symptoms have gone away.

Will I need surgery?

Most people do not need surgery.

Can diverticulitis come back?

Yes, but in most people (nine out of 10), diverticulitis does not come back. You can decrease your chances of getting diverticulitis again by eating a lot of fiber. Fruits, vegetables, whole grains, and beans are high in fiber. Exercising, losing weight if you are overweight, and stopping smoking if you smoke also decrease your chances of getting it again.

Should I avoid certain foods?

Although it was once thought that certain foods (nuts, seeds, or popcorn) may get stuck in the diverticula and cause inflammation, new research proves this is not true. You no longer need to avoid these foods.