Regional Gastrointestinal Consultants

Diverticulosis and Diverticulitis

Diverticulosis and Diverticulitis

Diverticulosis and Diverticulitis


Diverticulitis is inflammation of the diverticular sac (caused by diverticulosis) which can result in phlegmon of the bowel wall, peritonitis, perforation, fistula, or abscess. Diverticulosis is the presence of small outpouchings (diverticula) in the muscular wall of the large intestine that form in weakened areas of the bowel. They usually occur in the sigmoid colon, the high-pressure area of the lower large intestine.

The cause of diverticulitis is considered to be mechanical, related to retention in the diverticula of undigested food residue and bacteria. Diverticulitis occurs when a micro or macro perforation develops in a diverticulum, releasing intestinal bacteria. The resultant inflammation remains localized in about 75% of patients. The remaining 25% may develop abscess, free intraperitoneal perforation, bowel obstruction, or fistulas.

Diverticular disease is very common and occurs in 10 percent of people over age 40 and in 50 percent of people over age 60 in Western cultures. It is often caused by too little roughage (fiber) in the diet. Complications of diverticular disease happen in about 10 percent of people with outpouchings. They include infection or inflammation (diverticulitis), bleeding, and obstruction.


The primary symptom of Diverticular disease is abdominal pain which usually manifests with pain or tenderness in the left lower quadrant of the abdomen and fever. Peritoneal signs (e.g., rebound or guarding) may be present, particularly with abscess or free perforation. Fistulas may manifest as pneumaturia, feculent vaginal discharge, or a cutaneous or myofascial infection of the abdominal wall, perineum, or upper leg. Patients with bowel obstruction have nausea, vomiting, and abdominal distention. Bleeding is uncommon.

Most people who have colonic diverticulosis have no symptoms and are unaware of the disorder. Some patients experience irritable bowel type symptoms (see Irritable Bowel Syndrome) associated with diverticulosis. Other complications may occur but the condition does not predispose to colon cancer.

Diverticulitis is characterized by fever, abdominal pain and muscle spasm. Some degree of constipation may occur if the inflammation is around the colon.


Treatment of diverticulitis includes antibiotics, increased fluids, and a special diet. Surgery is needed in about half the patients who have complications to remove the involved segment of the colon. Most patients with acute diverticulitis need bowel rest, intravenous fluids, and antibiotics. Repeated attacks of diverticulitis in the same area generally requires surgery.


We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.