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Diverticulosis

Condition Basics

What is diverticulosis?

Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the colon (large intestine). These pouches are usually very small (5 to 10 millimetres) in diameter. But they can be larger.

In diverticulosis, the pouches in the colon wall don't cause symptoms. The condition may not be found unless symptoms occur, such as in painful diverticular disease or in diverticulitis. As many as 80 out of 100 people who have diverticulosis never get diverticulitis.footnote 1 In many cases, diverticulosis is discovered only when tests are done to find the cause of a different medical problem or during a screening examination.

What causes it?

The reason pouches (diverticula) form in the colon wall is not completely understood. Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall.

Normally, a diet with adequate fibre (also called roughage) produces stool that is bulky and can move easily through the colon. If a diet is low in fibre, the colon must exert more pressure than usual to move small, hard stool. A low-fibre diet also can increase the time stool remains in the bowel, adding to the high pressure.

Pouches may form when the high pressure pushes against weak spots in the colon where blood vessels pass through the muscle layer of the bowel wall to supply blood to the inner wall.

What are the symptoms?

Most people don't have symptoms. You may have had diverticulosis for years by the time symptoms occur (if they do). Over time, some people get an infection in the pouches (diverticulitis).

Your doctor may use the term painful diverticular disease. It's likely that painful diverticular disease is caused by irritable bowel syndrome (IBS). Symptoms include diarrhea and cramping abdominal (belly) pain, with no fever or other sign of an infection.

How is it diagnosed?

In many cases, diverticulosis is discovered only when tests, such as a barium enema X-ray or a colonoscopy, are done to find the cause of a different medical problem or during a screening examination.

How is diverticulosis treated?

The best way to treat diverticulosis is to avoid constipation. Here are some ideas:

  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre.
  • Drink plenty of fluids.
  • Get some exercise every day. Try to do moderate to vigorous activity at least 2½ hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
  • Take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when you are having a bowel movement.

This treatment may help reduce the formation of new pouches (diverticula) and lower the risk for diverticulitis.

How can you prevent it?

Eating a high-fibre diet, getting plenty of fluids, and exercising regularly may help prevent diverticulosis.

References

Citations

  1. Davis BR, Matthews JB (2006). Diverticular disease of the colon. In M Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 855–859. Philadelphia: Saunders Elsevier.

Credits

Current as of: June 6, 2022

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Jerome B. Simon MD, FRCPC, FACP - Gastroenterology

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