Digestive Health

Decoding diverticulosis, diverticulitis and how to manage it

Two plus size multiracial men having fun at the park playing a bean bag toss game and smiling because they are managing diverticulosis.


Find out what diverticulosis is and how it's diagnosed and managed so you can get back to living your best life!


By Steven Gorelick, MD, System Chair Digestive Health Institute, Gastroenterology, Nuvance Health


Most people don’t realize they have diverticulosis until they experience painful symptoms which may land them in an urgent care or hospital. But diverticulosis is more common than you might think. Diverticulosis affects your colon and often goes unnoticed until you have a flare up. Get the facts about diverticulosis and diverticulitis so you can take back your digestive health, manage your symptoms and feel better again!


What is diverticulosis?


Diverticulosis is a condition that occurs when small pouches, or sacs called diverticula form and push outward through weak spots in the wall of your colon. These pouches form mostly in the lower part of your colon, called the sigmoid colon. Diverticulosis is widespread and frequently found in people aged 50 and older. However, over the years, studies have shown that diverticulosis in patients younger than 50 has increased from 18% to 34%.


Various factors contribute to diverticulosis, including aging, a low-fiber diet, obesity, a sedentary lifestyle, smoking and certain medications like NSAIDs. Recognizing the symptoms is an essential first step in finding out how diverticulosis is diagnosed.


Related content: How fiber can help manage your weight and feel full


Identifying diverticulosis symptoms


Those who have diverticulosis may not ever experience symptoms until they end up in an urgent care or hospital. But some people may exhibit signs like intense abdominal pain (usually on the lower left side), bloating, irregular bowel movements, rectal bleeding and unexplained weight loss. It’s critical to understand that diverticulosis can lead to more serious issues such as an infection called diverticulitis, abscesses, perforation, fistulas and intestinal obstruction.


How is diverticulosis diagnosed?


Diagnosing diverticulosis involves a careful evaluation of your medical history, a thorough physical examination and specific diagnostic tests. Your gastroenterologist will assess your abdomen for tenderness or swelling and gather information about your symptoms, medical history and any family history of gastrointestinal conditions.


Following the physical examination, your gastroenterologist may suggest diagnostic tests like a colonoscopy, CT scan or MRI to confirm the diagnosis and determine the extent of the condition. Understanding how diverticulosis is diagnosed is an essential step toward appropriate treatment.


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Diverticulitis treatment and management


Diverticulitis is an infection that happens to individuals who already have diverticulosis. This occurs when sacs called diverticula inside your colon become inflamed or infected, sometimes with passing stool that becomes stuck or lodged inside the pockets. This is often referred to as a diverticulitis flare up and can be painful but usually goes away after a course of antibiotics and a few days on a liquid diet prescribed by your doctor. 


Learn more about colonoscopies in this video: See what it’s like to get a colonoscopy screening


Treatment for diverticulosis and diverticulitis includes lifestyle changes, dietary modifications, medications and in severe cases, surgical intervention. Regular exercise, maintaining a healthy weight, avoiding smoking and eating a high-fiber diet can significantly aid in managing diverticulosis.


In some cases, medications like pain relievers and antibiotics may be prescribed. Surgical options are reserved for severe cases and may involve removing the affected part of the colon or creating a colostomy. Effective treatment is crucial for managing this condition.


Related content: Navigating your road to recovery after colorectal surgery


Diverticulosis prevention


Although it is not known whether diverticulosis can be prevented, individuals who are overweight are more likely to have diverticulosis. According to a study, waist circumference was positively associated with diverticulitis and diverticular bleeding. Smoking may also increase the chance of developing diverticulosis. Therefore, maintaining a healthy weight and not smoking may prevent diverticulosis. Once diverticula have formed, they do not go away. Eating a high-fiber diet, maintaining regular physical activity and staying hydrated can significantly lower the chances of developing diverticulosis. Contrary to popular belief, new evidence does not support the idea that seeds, nuts and popcorn cause diverticulitis.


Related content: Learn what makes this homemade trail mix recipe so health


If you suspect you may have diverticulosis or are experiencing symptoms, it’s crucial to consult your gastroenterologist for an evaluation receive appropriate treatment. They will examine you and suggest tests to get an accurate diagnosis for your digestive health concern and then provide a comprehensive, personalized care plan.


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The bottom line: Diverticulosis is a common condition, especially in older adults, often going unnoticed until you have a flare. Recognizing symptoms like abdominal discomfort, bloating and changes in bowel habits is crucial for early diagnosis and management. By adopting a high-fiber diet, maintaining regular physical activity and staying hydrated, you can significantly reduce the risk of diverticulitis flare ups or complications. If you suspect you have diverticulosis or are experiencing symptoms, consult your gastroenterologist for proper diagnosis and treatment to effectively manage the condition and maintain your well-being.