Question:

What is diverticulosis, and how is it different from diverticulitis? 

Answer from colon and rectal surgeon Matthew Fuglestad, MD:

Diverticulosis is the formation of small outpouchings, called diverticula, outside the colon wall. It is very common, around 60% of people will have diverticulosis by age 60. Most people with diverticulosis have no symptoms.

Diverticulosis can progress to a more serious condition called diverticulitis. This is when the diverticula become inflamed, leading to symptoms like:

• Pain in the lower left abdomen 

• Fever 

• Low energy

• Low appetite

• Nausea

• Changes in bowel habits – having looser or no bowel movements, depending on the degree of inflammation.

Diverticulitis can be diagnosed based on history, exam findings, labs and imaging tests like CT scans. It is often treated with antibiotics in mild, uncomplicated cases. However, there are circumstance where antibiotics may not be needed. Diverticulitis can lead to complications such as: 

• Infection (abscess formation)

• Chronic abdominal pain

• Narrowing of the colon or colonic obstruction

• Perforation of the colon 

Colon cancer can also mimic some of the findings of diverticulitis. So, once a patient recovers from their first episode of diverticulitis, a colonoscopy may be recommended to check for colon cancer. 

Factors that can increase a person’s diverticulitis risk:

• Diet high in red meat

• Not eating enough fiber

• Smoking

• High alcohol use

• Low activity level

• High body mass index (BMI)

In the past, diverticulitis patients were told not to eat seeds, nuts or popcorn for fear it would get stuck in the diverticula. However, these foods can actually lower a person’s risk of diverticulitis because they’re part of a high fiber diet.