Diverticular disease is a condition that can occur in any part of the gastrointestinal (GI) tract. However, it is most common in the sigmoid colon (the S-shaped part of the intestine), where about 95% of patients with diverticulosis develop it.

In diverticular disease, or diverticulosis, pouches called diverticula form in weak areas of the lining of the digestive tract.

Diet, genetics, and several other issues play a role in the formation of diverticula. This disease commonly occurs in people from developed and Western countries, probably due to the Western diet.

This article describes the symptoms, causes, diagnosis, and treatment options of diverticular disease, as well as the differences between diverticulitis and diverticular disease.

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Diverticulitis and diverticulosis

Diverticulosis, or diverticular disease, is the name given to a group of problems that result from the formation of diverticular sacs. Diverticulosis is a chronic disease that occurs throughout most people’s lives, with diverticulum formation increasing after the age of 40.

Diverticulitis is a more acute form of diverticular disease in which sacs that form in the gastrointestinal tract become inflamed or infected. Less than 5% of people with diverticular disease develop diverticulitis. However, this form of diverticular disease results in approximately 200,000 hospitalizations per year in the United States.

Symptoms of diverticular disease

For many people, diverticular disease can develop over time without any symptoms. It occurs in less than 20% of people under age 40, and prevalence increases to approximately 40-60% by age 60 and 75% by age 80. Because diverticular disease is not something people are aware of, it is usually diagnosed only during a routine colon exam or when symptoms occur.

Symptoms of diverticulosis

Most people with diverticulosis do not notice any symptoms, and only about 25% develop the disease.

When symptoms occur, they are often vague or shared with other gastrointestinal problems. Examples include:

More severe diverticulosis can cause problems such as:

symptoms of diverticulitis

Diverticulitis is a specific acute form of diverticular disease that occurs when the diverticular sacs become inflamed, inflamed, or infected.

The most common symptoms reported with diverticulitis are:

  • Abdominal pain and/or tenderness (usually on the left side)
  • heat
  • nausea
  • vomiting
  • cold
  • convulsions
  • constipation
  • Changes in bowel habits

Symptoms of segmental colitis with diverticulosis (SCAD)

Segmental colitis associated with diverticulosis (SCAD) is a rare form of inflammation that affects part of the colon. Symptoms of SCAD can be similar to those of IBD, such as abdominal pain, bleeding, diarrhea, and fever.

The exact cause of SCAD is not completely understood. However, some data suggest that there may be some overlap in the underlying causes of SCAD and IBD.

SCAD usually occurs without symptoms of IBD or similar symptoms such as fever or other signs of infection. There are several differences between the two conditions, including disease progression, complications, and the need for long-term treatment.

SCAD can also cause many complications, including:

  • bleeding
  • intestinal perforation
  • inflammation
  • Abscess formation

What causes diverticular disease?

Although several factors are involved in the formation of diverticular sacs, the prevailing theory is that the formation of diverticular sacs is due to a low-fiber diet and constant pressure from straining during defecation.

Other factors include genetic and connective tissue disorders, hormonal changes, and neuromuscular disorders that can cause hernias (ruptures) of the lining of the gastrointestinal tract.

Although no specific bacteria has been found to cause the infection and inflammation of diverticulitis, diet and lifestyle choices are thought to play a major role. Specifically, low-fiber diets, smoking, and lack of exercise are factors that increase the risk of developing diverticular disease and inflammation.

What are the risk factors for diverticular disease?

Low-fiber diets, eating too much red meat, and other dietary choices associated with the Western diet are associated with increased prevalence of diverticular disease. Additionally, lack of exercise and smoking can also increase your risk.

Gender and hormones may also be involved. In general, men are more likely to develop diverticular disease, but women’s risk increases if they are receiving hormone therapy, such as treatment for menopause.

Additionally, although diverticulosis is more common in Caucasians, African Americans are more likely to develop complications such as diverticular bleeding.

The use of certain drugs may increase the chance of developing diverticulosis or diverticulitis. This includes the regular or continued use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and immunosuppressants.

Diagnosis of diverticular disease

The diagnosis of diverticular disease is often made by chance, and health care providers are not intentionally looking for the disease because of specific symptoms. Diagnosis is often made with a routine colonoscopy, but some colonoscopies can help diagnose symptoms that may be associated with diverticular disease, such as bleeding.

Diverticular sacs may also be seen on imaging tests such as barium x-rays or computed tomography (CT) scans.

How is diverticular disease treated?

If diverticular disease develops without symptoms, treatment is rarely required. Diverticulitis that causes symptoms or other complications is usually treated with medications, lifestyle changes, and sometimes surgery.


The drugs most commonly used to treat diverticular disease include drugs that reduce blockage, inflammation, and inflammation in the intestinal lining.

Examples of drugs that can treat this condition include:

Are antibiotics necessary?

Antibiotics were once the main treatment for diverticulosis, but research has not identified a specific bacterial cause of the condition. Therefore, antibiotics may not be prescribed unless an infection develops in the diverticulum.


The main diet recommended for people with diverticular disease is a high-fiber diet. Fiber-rich foods loosen stools, making them easier to pass and reducing strain on the intestinal wall.

Fiber-rich foods that can help improve diverticular disease include:

  • beans
  • brown rice
  • whole grain
  • fruits
  • vegetables

Previously, health care providers recommended that people with diverticular disease avoid certain foods that tend to clog diverticula, such as nuts, seeds, and popcorn. However, recent research suggests that these foods pose no risk to people with diverticulitis or diverticular disease.


Surgery is usually not indicated for most people with diverticular disease, but more complex cases may require surgery. Examples of surgeries that can address complications of diverticulosis or diverticulitis include:

What are the complications of diverticular disease?

Complications of diverticular disease are less common but may include:

  • Perforation or tear in the intestinal wall
  • bleeding
  • infection
  • Formation of an abscess (pus-filled pocket)

Approximately 12% of people with diverticular disease develop the complications listed above.

When to receive treatment for diverticular disease

Many people with diverticular disease develop the condition over many years without any obvious symptoms. There are several conditions that can cause problems within the gastrointestinal tract, so it’s important to see your doctor if you experience any of the following problems:

Tips for managing diverticular disease

The key to managing diverticular disease is maintaining good intestinal health. This means limiting or avoiding smoking and alcohol, eating a healthy diet rich in fiber-rich foods, and exercising regularly. If you are at risk for developing diverticular disease, your health care provider may recommend medications such as laxatives to prevent flare-ups and other complications.


Diverticular disease is a disease that occurs when the walls of the intestine weaken, causing bulges or pockets of tissue to form. These pockets rarely cause symptoms, but if the tissue becomes inflamed or infected, problems such as cramps and abdominal pain may occur. When this happens, a diagnosis of diverticulitis is usually given.

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