Diverticulosis is a condition in which pockets or out-pouchings develop on the wall of the colon. These most commonly occur on the left side of the colon known as the sigmoid colon. The incidence of diverticulosis increases with age and the condition is more common in western society, such as the United States.
Most patients with diverticulosis have no symptoms and the condition is found, incidentally, when they undergo diagnostic testing, such as a colonoscopy. When a diverticular pocket becomes infected, the condition is known as diverticulitis. This will often cause pain in the left lower abdomen, fever and constipation. Diverticula can also occasionally bleed. This typically results in profuse, painless rectal bleeding.
Diverticulosis is typically diagnosed at colonoscopy, barium enema x-ray, or by CT Scan. An infected diverticula, or diverticulitis, can be diagnosed by typical symptoms and physical findings. An elevated white blood cell count will often be present on a complete blood count. The diagnosis can be confirmed by a CT scan of the abdomen and pelvis.
People with asymptomatic diverticulosis do not require any specific treatment. It is recommended that they consume a high fiber diet. It is no longer recommended that people with diverticulosis avoid specific foods such as seed or nuts. Diverticulitis is usually successfully treated by antibiotic therapy. Infection unresponsive to antibiotic therapy may require surgery. Bleeding from diverticulosis is usually self-limited and will subside with observation in the hospital. Persistent bleeding can often be controlled by performing a colonoscopy and injecting medication, or clipping the bleeding diverticulum. Severe bleeding uncontrolled by these measures may require surgery.