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Diverticulosis: Symptoms, Causes, and Prevention

Older adults can develop this condition that causes blood in the stool, though many don’t have symptoms. Learn more about its causes and how to treat it.

What is diverticulosis?

Pro Tip

They may sound alike, but there is a huge difference between diverticulosis—having diverticula, pouches in your intestine—and diverticulitis, which is an infection of a diverticula. —Dr. Shria Kumar

The walls of your large intestine can become weak in certain spots. A poor diet and not exercising enough are two reasons it can happen.

The inner part of the intestines starts to push on these weakened areas. The pressure makes the intestines bulge out. This creates small pouches called diverticula.

If this happens, you have diverticulosis. It usually happens in the colon, which is in the lower intestines. (Also known as the sigmoid colon because of its S-shape.)

It is more common in Western countries and in older adults. For most people, diverticulosis doesn’t create any symptoms or problems. But about 25% of people who get it will have some symptoms like blood in their stool.

In some cases, the diverticular can become infected. This is called diverticulitis. That can lead to complications.

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Most common symptoms

Most people don’t know they have diverticulosis. It never causes them trouble. Their doctor just notices the pouches during a routine colonoscopy or imaging of the abdomen (like an MRI or CT scan).

But 25% of people with diverticulosis do have symptoms. Usually, it’s blood in their stool. Or if they develop diverticulitis, it can cause fever, chills, and pain in their abdomen.

Main symptoms

  • Bleeding
  • If it’s infected, you'll get fever, chills, and pain in the abdomen

What makes you more likely to have diverticulosis?

  • Living in the Western world (Europe, Australia, New Zealand, North America, South America)
  • Getting older
  • A diet high in red meat
  • Obesity
  • Lack of exercise
  • Cigarette smoking
  • Having a family history of diverticulosis

Pro Tip

Most people in the US above age 65 have diverticulosis. And for most, it causes absolutely no symptoms or problems whatsoever. So just because you are told you have diverticula does not mean you should expect to have any symptoms from it. —Dr. Kumar

Next steps

If your stool is bloody or black, call your primary care doctor right away. Bloody stool can be caused by a number of reasons, and you need to get a proper diagnosis.

Also call your doctor if you get a fever along with pain in your abdomen. It could be a sign of an infection.

What is diverticulitis pain like?

Diverticulitis can be very painful, When you’re constipated, stool (poop) moves very slowly. It can get trapped in one of the pouches. Then the stool turns into a small, hard, stony mass. Eventually, this can lead to it becoming infected.

What is the main cause of diverticulosis?

Dr. Rx

If diverticulosis becomes diverticulitis, ask your doctor if you need a colonoscopy. If you haven’t had a recent colonoscopy, but have had an episode of diverticulitis, ask your doctor if you need a colonoscopy. You want to make sure the infection was not due to something else (inflammatory bowel disease, cancer, etc). —Dr. Kumar

It’s unclear what causes diverticulosis. When the wall of the intestines is weakened,  pouches (diverticula) form. Then they bulge, sometimes causing symptoms or becoming infected. There’s some evidence that a “Western diet,” or a diet low in fiber contributes to the problem.

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What is the best treatment for diverticulosis?

The treatment for diverticulosis is to relieve the symptoms caused by the pouches. You can’t fix the pouches. This may include eating a high-fiber diet, taking fiber supplements, or other medications that address the symptoms, like bloating and pain.

If you have blood in your stool, you may be admitted to a hospital depending on the severity of your bleeding and your overall health profile and condition. They’ll watch your blood counts. And give you more blood if you have heavy bleeding.

Antibiotics are needed for the infection. But it does not actually cure diverticulosis—the pouches in the colon.

In rare cases, diverticulosis can get very bad. Especially if you’ve had diverticulosis before or been in the hospital for bleeding. Then, your doctor may send you to a surgeon. They might need to remove the parts of your intestine with the most pouches.

Prevention

Do your best to reduce your risk factors. Lose weight if you’re overweight, exercise regularly, and quit smoking. It's not clear that a diet high in fiber will reduce the risk. But let your doctor know if you don’t have daily bowel movements.

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