What I need to know about
 

Diverticular Diverticular Disease
 Disease

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases Information Clearinghouse 

U.S. Department 

of Health and 

Human Services

What I need to know about 

Diverticular Disease 

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases Information Clearinghouse 

Contents 

What is diverticular disease? .................................. 1
 

What causes diverticular disease?.......................... 2
 

Is diverticular disease serious? ............................... 2
 

What are the symptoms of diverticular 


disease?..................................................................... 3
 

Who gets diverticular disease? ............................... 3
 

How does the doctor test for diverticular 


disease?..................................................................... 4
 

How is diverticular disease treated? ...................... 6
 

How is diverticulosis treated?................................. 6
 

How is diverticulitis treated?.................................. 7
 

What can I do about diverticular disease? ............ 8
 

Points to Remember.............................................. 10
 

Pronunciation Guide............................................. 10
 

For More Information........................................... 11
 

Acknowledgments ................................................. 12
 

What is diverticular disease? 

Diverticular* disease affects the colon. The colon 

is part of the large intestine that removes waste 

from your body. Diverticular disease is made up 

of two conditions: diverticulosis and diverticulitis. 

Diverticulosis occurs when pouches, called 

diverticula, form in the colon. These pouches 

bulge out like weak spots in a tire. Diverticulitis 

occurs if the pouches become inflamed. 

This close-up shows a section of 

the colon where pouches have 

formed. The pouches are called 

diverticula. 

The shaded area is the colon. 

*See Pronunciation Guide on page 10. 

1 
What causes diverticular disease? 

Doctors are not sure what causes diverticular 

disease. Many think a diet low in fiber is the main 

cause. Fiber is a part of food that your body 

cannot digest. It is found in many fruits and 

vegetables. Fiber stays in the colon and absorbs 

water, which makes bowel movements easier to 

pass. Diets low in fiber may cause constipation, 

which occurs when stools are hard and difficult 

to pass. Constipation causes your muscles to 

strain when you pass stool. Straining may cause 

diverticula to form in the colon. If stool or bacteria 

get caught in the pouches, diverticulitis can occur. 

Is diverticular disease serious? 

Most people with the disease do not have serious 

problems, but some people have severe symptoms. 

Diverticulitis can attack suddenly and cause 

●	 bleeding 

●	 serious infections 

●	 rips in the pouches 

●	 fistula, which is a connection or passage between 

tissues or organs in the body that normally do 

not connect 

●	 blockage in your digestive system 

●	 an infection in which the colon ruptures causing 

stool to empty from the colon into the abdomen 

2 
What are the symptoms of diverticular 

disease? 

The symptoms for diverticulosis and diverticulitis 

are different. 

Diverticulosis. Many people don’t have symptoms, 

but some people have cramping, bloating, and 

constipation. Some people also have bleeding, 

inflammation, and fistulas. If you are bleeding, 

bright red blood will pass through your rectum. 

The rectum is the end of the colon that connects 

to the anus. The rectum and anus are part of the 

gastrointestinal tract, which is the passage that 

food goes through. Rectal bleeding is usually 

painless, but it can be dangerous. You should see 

a doctor right away. 

Diverticulitis. People with diverticulitis can have 

many symptoms. Often pain is felt in the lower 

part of the abdomen. If you have diverticulitis, 

you may have fevers, feel sick to your stomach, 

vomit, or have a change in your bowel habits. 

Who gets diverticular disease? 

Many people get diverticular disease. Starting at 

age 40, the chance of getting it increases about 

every 10 years. About half of people between the 

ages of 60 and 80 have diverticular disease. Almost 

everyone over 80 has it. 

3 
How does the doctor test for
 

diverticular disease?
 

The doctor can test for diverticular disease many 

ways. A CT scan is the most common test used. 

The doctor will inject a liquid in a vein in your arm 

that better highlights your organs on x rays. You 

may be asked to drink liquid called barium instead 

of getting an injection. You are then placed in a 

large doughnut-shaped machine that takes x rays. 

Other tests include 

●	 Medical history. The doctor will ask about your 

health and symptoms such as pain. You will be 

asked about your bowel habits, diet, and any 

medications you take. 

●	 Blood test. This test can help detect infections. 

●	 Stool sample. This test may show bleeding in 

the digestive tract. 

●	 Digital rectal exam. The doctor will insert a 

gloved finger into your rectum to check for pain, 

bleeding, or a blockage. 

●	 X ray and barium enema. The doctor will insert 

liquid called barium in the large intestine 

through your anus. The anus is the opening 

where stool leaves the body. The barium makes 

the diverticula show up on an x ray. 

4 
●	 Colonoscopy. The doctor will insert a small tube 

through your anus. A tiny video camera is in the 

tube and will show if there are any pouches. 

5 
How is diverticular disease treated? 

Treatment for diverticular disease depends on 

how serious the problem is and whether you are 

suffering from diverticulosis or diverticulitis. 

Most people get better by changing their diet. 

If you have rectal bleeding, you need to go to the 

hospital so a doctor can find the part of your colon 

that is bleeding. The doctor may use a special drug 

that makes the bleeding stop. The doctor may also 

decide to operate and remove the part of the colon 

that is bleeding. 

How is diverticulosis treated? 

Eating high-fiber foods can help relieve symptoms. 

Sometimes mild pain medications also help. 

6 
How is diverticulitis treated? 

A doctor may prescribe antibiotics and recommend 

following a liquid diet. Most people get better with 

this treatment. Some people may need surgery and 

other treatments. 

●	 Surgery. Serious problems from diverticulitis are 

treated with surgery. Surgeons can clean the 

abdomen after infections and remove bleeding 

pouches and fistulas. 

●	 Colon resection. If you get diverticulitis many 

times, your doctor might suggest taking out the 

part of the colon with diverticula. The healthy 

sections can be joined together. With the 

diverticula gone, you may avoid other infections. 

●	 Emergency surgery. If you have severe problems, 

you may need emergency surgery to clear the 

infection and remove part of the colon. Later, 

a second surgery rejoins the healthy sections of 

the colon. The colon is separated for a brief 

time between surgeries, because rejoining the 

colon during the first surgery is not always safe. 

A temporary colostomy is needed between the 

two surgeries. A colostomy is an opening made 

on the abdomen where a plastic bag is connected 

to collect stool after food is digested. The 

surgeon makes the opening, called a stoma, 

and connects it to the end of the colon. 

7 
What can I do about diverticular
 

disease?
 

Eat a high-fiber diet to help prevent problems. 

Talk to your doctor about using fiber products like 

Benefiber, Citrucel, or Metamucil. Daily use can 

help you get the fiber you need if you do not get it 

through your diet. 

Ask your doctor about which food choices are right 

for you. 

Eating foods high in fiber is simple and can help 

reduce diverticular disease symptoms and 

problems. 

High-fiber foods include fruits and vegetables. 

8 
Try eating more of the following: 

●	 Fruit. Raw apples, peaches, pears, and 

tangerines. 

●	 Vegetables. Fresh broccoli, squash, carrots, 

and brussels sprouts. 

●	 Starchy vegetables. Potatoes, baked beans, 

kidney beans, and lima beans. 

●	 Grains. Whole-wheat bread, brown rice, 

bran flake cereal, and oatmeal. 

Talk with your doctor about making diet changes. 

Learn what to eat and how to put more of these 

high-fiber foods in your diet. 

9 
Points to Remember 

●	 Diverticular disease is more common in people 

as they grow older. 

●	 A low-fiber diet is the most likely cause of the 

disease. 

●	 Most people are treated with a high-fiber diet 

and pain medication. 

●	 Add whole grain foods, high-fiber fruits, and 

vegetables to your diet. 

●	 Contact a doctor if you notice symptoms such as 

fever, chills, nausea, vomiting, abdominal pain, 

rectal bleeding, or change in bowel habits. 

Pronunciation Guide 

diverticula (DY-vur-TIK-yoo-luh) 

diverticular (DY-vur-TIK-yoo-lur) 

diverticulitis (DY-vur-TIK-yoo-LY-tiss) 

diverticulosis (DY-vur-TIK-yoo-LOH-siss) 

10
 
For More Information 

International Foundation for Functional
 

Gastrointestinal Disorders
 

P.O. Box 170864
 

Milwaukee, WI 53217–8076
 

Phone: 1–888–964–2001 or 414–964–1799
 

Fax: 414–964–7176
 

Email: iffgd@iffgd.org
 

Internet: www.iffgd.org
 

American Society of Colon and Rectal Surgeons 

85 W. Algonquin Road, Suite 550 

Arlington Heights, IL 60005 

Phone: 847–290–9184 

Fax: 847–290–9203 

Email: ascrs@fascrs.org 

Internet: www.fascrs.org 

The U.S. Government does not endorse or favor any specific 

commercial product or company. Trade, proprietary, or company 

names appearing in this document are used only because they are 

considered necessary in the context of the information provided. 

If a product is not mentioned, the omission does not mean or imply 

that the product is unsatisfactory. 

11 
Acknowledgments 

The National Digestive Diseases Information 

Clearinghouse (NDDIC) would like to thank the 

following individual for assisting with the scientific 

and editorial review of this publication. 

Joshua Katz, M.D.
 

George Washington University School 


of Medicine
 

Thank you also to Vicki L. McClelland, executive 

director of the Free Medical Clinic of the Northern 

Shenandoah Valley in Winchester, VA, for 

facilitating field-testing of this publication. 

12
 
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Information Clearinghouse 

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Phone: 1–800–891–5389 

Fax: 703–738–4929 

Email: nddic@info.niddk.nih.gov 

Internet: www.digestive.niddk.nih.gov 

The National Digestive Diseases Information Clearinghouse 

(NDDIC) is a service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). The NIDDK 

is part of the National Institutes of Health of the U.S. 

Department of Health and Human Services. Established 

in 1980, the Clearinghouse provides information about 

digestive diseases to people with digestive disorders and to 

their families, health care professionals, and the public. 

The NDDIC answers inquiries, develops and distributes 

publications, and works closely with professional and patient 

organizations and Government agencies to coordinate 

resources about digestive diseases. 

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this booklet to duplicate and 

distribute as many copies as desired. 

This booklet is also available at www.digestive.niddk.nih.gov. 
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Diabetes and 

Digestive and Kidney Diseases 

NIH Publication No. 07–5535 

June 2007