Generally diverticulosis of the colon is most common in the sigmoid colon in US populations whereas the location is primarily right sided in Asian populations. Diverticulitis is the most common complication of diverticulosis and occurs when increased intraluminal pressure and inspissated food particles leads to inflammation and focal necrosis. Additionally micro and macro- perforations may complicate diverticulitis. Etiologic factors in diverticulosis include increased luminal pressure, lack of dietary fiber, weakening of the bowel wall and hypersegmentation.
Diverticulosis often presents with abdominal pain, excessive flatulence, and irregular defecation.
Diverticulosis can be visualized during sigmoidoscopy and colonoscopy, however there is no role for BaE nor endoscopy in acute diverticulitis. In the weeks preceding the attack, patients may experience a prodrome of obstipation or diarrhea. Patients may also complain of dysuria, frequency and urgency indicating irritation of the bladder and ureters by the inflamed colon. Because diverticulitis is the most common cause of colo-vesicular fistula, patients may also present with pneumaturia and fecaluria. In these cases broad spectrum antibiotics either orally or parenterally, fluids and analgesia, preferably with meperidine may be all that is required.