diverticulosis A condition in which small bulging sacs (diverticula) develop in the lining of the intestine. diverticulitis It occurs when these sacs become inflamed or infected. Both are known as diverticular disease.
The main difference between diverticulosis and diverticulitis is that diverticulosis usually does not cause symptoms or require treatment other than dietary changes. Diverticulitis usually causes persistent pain in the lower left quadrant. It can also cause nausea, vomiting, constipation, diarrhea, and fever, and treatment depends on its severity.
This article explains the difference between diverticulosis and diverticulitis. We also explain how to diagnose and treat both, and how to prevent diverticulitis from becoming diverticulitis.
Illustration by Theresa Chiechi from Verywell Health
What causes diverticulosis and diverticulitis?
As you get older, the walls of your colon (large intestine) may weaken in some areas. This is a normal and common phenomenon and can cause pockets to form in the colon wall. These pockets bulge outward through the wall of the colon.
One of these pockets is called a diverticulum. Multiple diverticula are called diverticula. The condition in which diverticula form is called diverticulosis. Diverticula can occur anywhere in the small or large intestine.
The exact cause of diverticulosis is unknown.
low fiber diet
A popular theory is that a low-fiber diet can lead to the formation of diverticula.
- A low-fiber diet can cause constipation, which is when stools are difficult to pass or occur infrequently.
- Constipation can put too much pressure on your intestinal walls.
- The tension weakens parts of the colon, forming pockets (diverticula).
In general, regular, soft, easy-to-pass bowel movements (at least once every few days) are ideal for your health and for avoiding complications of diverticular disease.
inflammation and infection
Diverticulitis is a complication of diverticulosis. This occurs when one or more diverticula become infected or inflamed.
We don’t really understand why this happens. Stool usually contains a certain amount of bacteria. One theory is that the stool and the bacteria in it can enter the diverticulum. Once bacteria gets there, it can cause an infection.
The second theory is that diverticulitis is an inflammatory condition. Inflammation of the diverticulum can cause symptoms.A small proportion of patients have so-called smoldering diverticulitis. Their symptoms do not respond to treatment and cause ongoing problems.
Risk factor
Research suggests that genes may play a role in the development of diverticular disease. Lifestyle factors that can increase your risk include:
- Eat a diet low in fiber and high in red meat
- lack of physical activity
- obesity
- smoking
- Taking anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
Having diverticulosis is a major risk factor for developing diverticulitis. Other factors include:
- autoimmune disease
- Bacteria and feces become trapped in the diverticulum
- Changes in the gut microbiome
- Problems with connective tissue, muscles, or nerves in the colon
Diverticulosis vs. Diverticulitis: Symptoms
Diverticulosis is usually asymptomatic. However, patients with diverticulosis may experience mild and chronic symptoms, including:
On the other hand, the symptoms of diverticulitis can be severe. Symptoms of diverticulitis tend to appear suddenly and may include:
- abdominal cramps
- abdominal pain
- blood in stool
- Changes in bowel habits
- constipation
- diarrhea
- fever and chills
- nausea
- vomiting
Diverticulitis pain is usually acute and severe. However, for some people, the pain may be mild at first and worsen over a few days.
Diverticulosis that does not cause symptoms is not considered serious. However, symptoms of diverticulitis can range from bothersome to severe enough to require hospitalization.
complications
Approximately 12% of people with diverticular disease develop complications in their intestinal tract. These include:
Diverticulitis can also cause complications outside the colon, including: leukocytosis (increased white blood cell count) and sepsis (systemic response to infection).
Fortunately, most people with diverticulosis do not develop diverticulitis or other complications.
If you require emergency treatment
The following symptoms may indicate complications of diverticulitis. These require immediate medical attention.
- extreme pain or discomfort
- High fever (103°F or higher) with or without chills
- can’t keep food down
- severe diarrhea
Other symptoms that may require medical attention include unexplained weight loss, painful swelling of joints or lymph nodes, confusion, difficulty breathing, and changes in heart rate.
How are diverticulitis and diverticulosis diagnosed?
Diverticulosis usually does not cause symptoms, so it often goes undiagnosed. Diverticulosis may be found during testing for another disease or during a routine colonoscopy.
Diverticulitis is diagnosed based on symptoms and imaging tests, such as:
Your health care provider may also take blood tests or a stool sample to rule out other illnesses.
Treatment of diverticulosis and diverticulitis
Diverticulosis is usually not treated because it has no symptoms. If constipation is detected, your doctor may recommend changes to your diet to avoid constipation.
Dietary changes for diverticulosis include:
- add more fiber to your diet
- limit red meat
- Eat more fruits, vegetables, nuts, seeds, beans, and legumes
- Replace low-fiber foods like white bread and rice with whole grains
If you have symptomatic diverticulosis, your health care provider may recommend taking fiber supplements or probiotics. In some cases, prescription medications may be required.
Treatment of diverticulitis
Uncomplicated diverticulitis is usually treated with a combination of the following:
- Administering antibiotics by mouth or IV
- Clear liquid diet or intravenous fluids for several days
- Painkillers such as antispasmodics and acetaminophen
In cases of complicated diverticulitis, hospitalization may be required. Depending on the complications, surgery may be required to:
- remove intestinal obstruction
- drain an abscess
- remove large diverticulum
- Repair a fistula or intestinal perforation
Other potential diverticulitis treatments are also being investigated.
- Asacol (mesalamine), an anti-inflammatory drug used to treat ulcerative colitis, may help prevent diverticulitis from recurring. However, current research is unclear on this.
- Limosylactobacillus reuteri A probiotic that may help treat diverticulitis.According to research L. reuteri It may work by improving intestinal motility and suppressing immune system responses.
- Xifaxan (rifaximin), an oral antibiotic, has been found to be highly effective in reducing mild diverticulitis and uncomplicated diverticular disease. Usually three treatments are required.
Further research is needed before these therapies can be recommended for the treatment of diverticulitis.
Can diverticulitis and diverticulosis be prevented?
Diverticular disease is common. It may or may not be avoidable.
Preventing constipation and straining during bowel movements may help prevent diverticulosis and diverticulitis.
General recommendations to avoid constipation include:
- drink lots of water
- Eat enough fiber or take fiber supplements
- do daily exercise
- Maintain a healthy weight or lose weight if you are overweight or obese
- no smoking
People with diverticular disease are usually advised to eat more fiber and drink more water. This makes defecation easier. Some people find that certain foods can cause symptoms. This may be discovered through a process of trial and error.
Avoiding diverticulitis
These same methods are used to prevent diverticulosis from becoming diverticulitis.
People with diverticulitis are also advised to avoid red meat, which research has shown increases the risk of diverticulitis.
Should nuts and seeds be avoided?
Previously, people with diverticular disease were told to avoid foods such as nuts, seeds, corn, and popcorn to prevent diverticulitis. However, there is a lack of evidence to support this advice.
People with diverticular disease should avoid using drugs that cause gastrointestinal bleeding. These include:
summary
Diverticulosis is a condition in which bags form in the wall of the colon. When this sac becomes inflamed, it results in diverticulitis. Diverticulitis may have no symptoms, but diverticulitis can cause pain and bloody stools. The cause of both is unknown.
Diverticulosis often requires no treatment, but a diet high in fiber is recommended to prevent constipation. Diverticulitis may require treatment with antibiotics. It can cause several complications.