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Diverticulosis and Diverticulitis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Digestive System

Diverticulosis and Diverticulitis

Diverticulosis involves the formation of small pouches in the colon, while diverticulitis occurs when these pouches become inflamed or infected.

What is Diverticulosis?

Diverticula are small pouches, or sacs, that bulge outward through weak spots in your colon, mostly in the lower part. Diverticulosis is the condition of having these pouches. Most people with diverticulosis do not have symptoms, though the pouches can sometimes become inflamed.

What is Diverticulitis?

Diverticulitis is the condition that occurs when one or more of these pouches become inflamed. It may come on suddenly and can sometimes cause serious health problems.

What is Diverticular Disease?

Diverticular disease occurs when these pouches cause:

  • Chronic (long-term) symptoms
  • Diverticular bleeding
  • Diverticulitis or diverticulitis complications

Causes and Risk Factors

While the exact cause is unknown, researchers believe the following factors increase the risk:

  • Genetics: Certain genes may increase susceptibility.
  • Lifestyle factors:
    • Diets low in fiber and high in red meat
    • Lack of physical activity
    • Use of certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
    • Obesity
    • Smoking

Other factors under investigation include bacteria or stool getting caught in a pouch and changes in the intestinal microbiome.

Symptoms

Diverticulosis

Usually asymptomatic, but some may experience:

  • Bloating
  • Constipation or diarrhea
  • Cramping or pain in the lower abdomen

Diverticulitis

Symptoms are often severe and sudden, including:

  • Abdominal pain, most often in the lower left side
  • Constipation or diarrhea
  • Fevers and chills
  • Nausea or vomiting

Complications

Serious health problems can arise, including:

  • Diverticular bleeding: A blood vessel in a pouch wall bursts.
  • Abscess: A painful, pus-filled area caused by infection.
  • Fistula: An abnormal opening between the colon and another body part.
  • Intestinal obstruction: A blockage preventing movement through the intestines.
  • Perforation: A hole in the colon.
  • Peritonitis: An infection of the abdominal cavity lining.

Diagnosis

Providers review medical history, perform a physical exam, and may order:

  • Blood and stool tests
  • Imaging tests (CT scan, ultrasound, or MRI)
  • Colonoscopy

Treatment

For chronic diverticulosis, providers may recommend high-fiber diets, supplements, antibiotics, anti-inflammatory medicines, or probiotics.

For diverticulitis, treatment may include:

  • Antibiotics (except in very mild cases)
  • A clear liquid diet to rest the colon
  • Pain management (usually acetaminophen, as NSAIDs may increase complications)
  • Antispasmodic medicines

Surgery to remove part of the colon may be necessary if complications arise or if the condition does not improve.

Prevention

Lifestyle changes to prevent diverticulitis include:

  • Eating a diet high in fiber and low in red meat
  • Regular physical activity
  • Not smoking
  • Maintaining a healthy weight

Frequently Asked Questions

Uncomplicated diverticulitis is often managed at home with bowel rest, pain control, and sometimes oral antibiotics. Hospitalization is necessary if you cannot tolerate oral fluids, have uncontrolled pain, are immunocompromised, or develop complicated diverticulitis. Complications include an abscess (which may need catheter drainage), bowel perforation leading to peritonitis, a fistula into adjacent organs like the bladder, or a complete intestinal obstruction, all of which often require emergency or staged surgical resection.
No. Medical guidelines have updated previous advice regarding these foods. Extensive clinical research has demonstrated that nuts, seeds, berries, and popcorn do not lodge in diverticular pouches or trigger diverticulitis. Instead, patients are encouraged to eat a high-fiber diet rich in vegetables, legumes, whole grains, nuts, and seeds, as dietary fiber softens stool, reduces intracolonic pressure, and significantly lowers the likelihood of developing diverticulitis flares.
routine colonoscopy is typically scheduled 6 to 8 weeks after an episode of acute or complicated diverticulitis has completely resolved. Performing an endoscopy during an active flare poses a high risk of bowel perforation due to fragile, inflamed tissue. Once healed, the colonoscopy is essential to thoroughly evaluate the affected colon segment, verify that no stricture or persistent fistula remains, and definitively rule out underlying colon polyps or colorectal cancer, which can mimic diverticulitis symptoms on imaging scans.
During an acute diverticulitis episode, the colon needs rest to resolve inflammation. Clinicians usually recommend a temporary clear liquid diet (water, clear broth, electrolyte drinks) for 1 to 3 days, followed by a low-fiber, bland diet (white rice, eggs, poultry, applesauce) as symptoms improve. Once pain and inflammation fully resolve—typically after 2 to 4 weeks—patients should gradually transition to a high-fiber maintenance diet (25 to 35 grams daily) paired with adequate hydration to keep bowel movements regular.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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