Diverticular Disease Prevention And Treatment

Overview

Diverticular disease is a condition that affects the large bowel, also called the colon. Small pouches can form in the wall of the colon. These pouches are called diverticula. When the pouches are present but not inflamed, it is called diverticulosis. When one or more pouches become inflamed or infected, it is called diverticulitis. Diverticular disease is the general name for these related problems.

Yes. Diverticular disease is very common, especially in older adults. Many people learn they have diverticula during tests done for other reasons and have never had symptoms.

It becomes more common as people get older. It affects both men and women. Some people are more likely to have problems if they have a low-fiber diet, are overweight, smoke, are not very active, or have a family history of diverticular disease.

Symptoms

Common symptoms

• Often no symptoms at all
• Mild cramping or bloating in the lower belly
• Constipation or diarrhea
• Changes in bowel habits
• A feeling of fullness or discomfort in the lower belly

Symptoms in children

• Diverticular disease is uncommon in children.
• If a child has severe belly pain, fever, vomiting, or blood in the stool, get medical help promptly.
• Children with ongoing bowel changes should be checked by a healthcare provider.

Symptoms in older adults

• Diverticular disease is more common in older adults.
• Symptoms may be milder or less typical, so it is important not to ignore new belly pain or fever.
• Older adults may have a higher risk of complications, so early review by a healthcare provider is wise.

Causes

Main causes

• Diverticula form where the wall of the colon is weaker and pressure inside the bowel is higher.
• Straining to pass hard stool and a diet low in fiber may increase pressure in the colon over time.
• Age-related changes in the bowel wall can make pouches more likely.
• Diverticulitis happens when a pouch becomes inflamed or infected, but the exact trigger is not always clear.

Risk factors

• Getting older
• A diet low in fiber
• Not drinking enough fluids
• Being overweight
• Not being physically active
• Smoking
• A family history of diverticular disease
• Taking some medicines, such as certain painkillers or steroids, which can affect the bowel or increase risk
• Having had diverticulitis before

When to see a doctor

See a doctor urgently if:

• Severe or worsening belly pain
• Fever with belly pain
• Blood in the stool or black stools
• Vomiting and unable to keep fluids down
• A hard or rigid belly
• New urinary symptoms with belly pain

Book a routine appointment if:

• Ongoing changes in bowel habits
• Mild belly discomfort that keeps coming back
• Bloating or cramping that does not settle
• You have been told you have diverticulosis and want advice on prevention
• You want to discuss diet, fiber, or lifestyle changes

Diagnosis

Your healthcare provider will ask about your symptoms, bowel habits, diet, medicines, and family history. They will examine your belly. They may arrange blood tests, stool tests, or imaging. Diverticulosis is often found during a colonoscopy or scan done for another reason. Diverticulitis is usually diagnosed from your symptoms and a scan.

Tests that may be done

• Physical examination of the belly
• Blood tests
• Stool tests to check for infection or blood
• CT scan, which is a detailed picture of the belly
• Ultrasound scan in some cases
• Colonoscopy later on, after inflammation has settled, to check the colon

What to expect at your appointment

Tests depend on your symptoms and your healthcare provider's judgement. Some tests need preparation, such as drinking a special liquid or changing your diet for a short time. Ask your provider or pharmacist for clear instructions. A colonoscopy is usually not done during active diverticulitis because of the risk of injury to the bowel.

Treatment

Treatment depends on whether you have diverticula without inflammation, mild diverticulitis, or a complication. Most people with mild diverticulitis can be cared for at home with guidance from a healthcare provider. Severe cases may need hospital care. The goal is to settle symptoms, prevent flare-ups, and watch for complications.

Self-care at home

• Follow your healthcare provider's advice about rest, fluids, and food.
• Drink enough fluids, especially water, unless you have been told to limit them.
• Eat fiber gradually if advised, and increase it slowly to avoid bloating.
• Avoid straining when passing stool.
• Stay physically active as you are able.
• Keep a note of symptoms and triggers so you can discuss them at appointments.
• Do not use leftover medicines or another person's medicines.

Medical treatments

Your healthcare provider may advise rest, fluids, pain relief, and a temporary change in diet. If infection is suspected, they may recommend infection-fighting medicines. Severe cases may need hospital care with fluids, close monitoring, and sometimes a procedure to drain a collection of pus. Surgery is used for some complications or repeated severe attacks. Always follow your healthcare provider's plan and ask questions if anything is unclear.

When is surgery considered?

Surgery may be considered if you have repeated severe attacks, complications such as an abscess (a pocket of pus), a perforation (a hole in the bowel), a fistula (an abnormal tunnel between organs), or a stricture (narrowing of the bowel). It may also be considered if tests cannot rule out another serious bowel condition. Your surgical team will explain the risks and benefits.

Living with this condition

Many people live normal lives with diverticular disease. Learn what seems to trigger your symptoms, keep your bowels regular, and do not strain. Follow up with your healthcare provider if symptoms change. Most flare-ups can be managed with advice and support.

Lifestyle tips

• Eat a healthy diet with plenty of fiber from fruits, vegetables, whole grains, and beans, unless your provider advises otherwise.
• Drink enough fluids every day.
• Stay active with walking or other gentle exercise.
• Maintain a healthy weight.
• Do not smoke, and get help to quit if you do.
• Avoid straining on the toilet and go when you feel the urge.
• Manage stress and get enough sleep.

Diet and exercise

Fiber helps keep stool soft and easy to pass. Increase fiber slowly so your body can adjust, and drink more fluids as you do. Regular movement, such as walking, helps the bowel work well. You do not usually need to avoid nuts, seeds, or popcorn unless your healthcare provider tells you to. Ask your provider or a dietitian for advice that fits you.

Mental health and emotional wellbeing

Living with a bowel condition can cause worry, embarrassment, or stress, especially if symptoms are unpredictable. These feelings are common and worth discussing. If you feel overwhelmed or have thoughts of harming yourself, contact your local crisis support or emergency services immediately.

Prevention

You cannot change getting older or your family history, but healthy habits may lower the chance of diverticular problems and flare-ups. A high-fiber diet, enough fluids, regular activity, not smoking, and a healthy weight are all helpful.

Vaccines

There is no vaccine for diverticular disease.

Screening programmes

There is no routine screening test for diverticular disease. Colonoscopy may be used for bowel cancer screening or to check symptoms. Ask your healthcare provider about bowel cancer screening that is right for your age and region.

Complications

If left untreated

• An abscess (a pocket of pus) near the bowel
• A perforation (a hole in the bowel), which can let bowel contents leak
• Peritonitis (infection of the lining of the belly), which is serious and needs emergency care
• A fistula (an abnormal tunnel between the bowel and another organ)
• A stricture (narrowing of the bowel) that can cause blockage
• Bleeding from the bowel
• Bowel obstruction (blockage) in some cases

Long-term outlook

The outlook is usually good. Most people with diverticulosis never have serious problems, and most mild cases of diverticulitis settle with care. Seeking help early for severe pain, fever, or bleeding helps catch complications quickly. Many people manage well with lifestyle changes and a clear plan from their healthcare provider.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.