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Diverticulosis and Diverticulitis

Background Information

If you are like many people, your colon (the large intestine) is not in perfect condition. Over time, small pouches may have formed in your colon wall. This is called diverticulosis. If these pouches become infected or inflamed, a painful and more serious problem called diverticulitis develops. Although aging may contribute to colon problems, what you eat makes the real difference in the health of your colon. We rarely see diverticular problems in countries where people eat plenty of unprocessed, high fiber foods.

A healthy colon is a flexible tube lined with muscles. These muscles help move stool through your colon into your rectum (the lower part of the colon) and out of your body. With enough fiber and water, the stool stays soft and passes smoothly through the colon.


Without enough fiber and water in your digestive system, stool becomes harder. the colon’s muscles have to squeeze more to move the harder stools through your colon. That extra pressure can cause the lining of the colon to bulge out into pouches called diverticula. This usually occurs in the colons muscular, lower left section (sigmoid), though it can also occur in other parts of the colon. Diverticula may take years to develop, and you often feel no symptoms at all. If you do have symptoms, they might include mild cramping, bloating, constipation, diarrhea.


Diverticulitis occurs when the diverticula become infected or inflamed. The cause of these infections is unknown, but it is possible that they occur when small particles such as seeds or undigested food lodge in the diverticula. Infection can lead to complications such as swelling or rupture of the diverticula. Symptoms often include pain, fever, chills, cramping, diarrhea, or constipation.

Your Evaluation

To diagnose your colon problem, your doctor will take your medical history, conduct an examination, and may recommend one or more diagnostic tests. After the evaluation, your doctor will talk with you about a treatment plan to control your condition.

Diagnostic Tests

Diagnostic tests may be used to pinpoint your problem or rule out other colon disorders. A CT scan can evaluate for diverticulitis. A barium enema is an x-ray that allows visualization of the colon after filling it with barium. It can show narrowing of the colon, growths, or pouches in the colon wall. A colonoscopy involves the use of lighted tube to look directly into the colon.

Managing Your Condition

Treatment for your diverticular problem depends on its severity. If you have a mild case of diverticulitis, changing your diet may be all you need to do to keep the condition under control. Your doctor may also prescribe medications to help relax your colon and relieve pain. Diverticulitis often requires additional treatment.

If your diverticulitis symptoms are mild, your doctor may begin treatment with a temporary liquid diet and oral antibiotics. A high fiber diet may be started once symptoms are relieved. If your diverticulitis is severe, you may need hospitalization and intravenous antibiotics. Surgery may be necessary if other types of treatment do not successfully control your problem, or to prevent recurrence and complications of the diverticulitis.

If You Need Surgery

If your symptoms do not improve with nonsurgical treatment, you may need surgery to remove the diseased portion of your colon. In some severe cases of infection or rupture, emergency surgery may be necessary. Generally, if you have had two or three bouts of diverticulitis, you are likely to continue having the problem and should consider surgery to remove the diseased portion of the colon.

Keys to Colon Health

Get Enough Fiber: You need 25-50 grams of fiber each day to keep your colon working at its best. Choose food like whole wheat bread, brown rice, bran, or raw vegetables. Daily fiber supplements such as Metamucil and Fibercon are also helpful.

Drink Enough Water: Most people should drink at least 8 glasses of water each day.

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