Who is at risk for diverticulitis

You will be given a metallic fluid called barium. Barium coats the organs, so that they can be seen on an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An X-ray of your belly will show if you have any narrowed areas strictures , blockages, or other problems.

Virtual colonoscopy. Flexible sigmoidoscopy. This test checks the inside of part of your large intestine. It helps to tell what is causing constipation. A short, flexible, lighted tube sigmoidoscope is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A tissue sample biopsy can be taken if needed. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores ulcers , or bleeding.

A long, flexible, lighted tube colonoscope is put into your rectum up into the colon. This tube lets your healthcare provider see the lining of your colon and take out a tissue sample biopsy to test it. He or she can also treat some problems that may be found. Experts suggest eating 20 to 35 grams of fiber each day.

Your healthcare provider may tell you to eat more foods that have fiber, such as:. You may need to stay in the hospital if you have a bad attack with severe pain or infection.

In some cases surgery may be needed. Diverticular disease is when symptoms happen from diverticulosis the pouches or diverticulitis infection or inflammation of the pouches. The most common sign that you have it is feeling tender around the left side of the lower abdomen. To see if you have diverticular disease, your doctor may order tests that look at your intestine from the outside such as CT scan or virtual colonoscopy or inside such as colonoscopy. Treatment may include eating more fiber.

However, during attacks of diverticulitis, you may be told to remain on clear liquids or low fiber foods for some time. Diverticular disease can cause other health problems such as infections, blockages, tears, or bleeding. At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

Health Home Conditions and Diseases. Diverticular disease includes these 2 health problems: Diverticulosis. When you have tiny pouches, or diverticula, in your colon. When the pouches in your colon get infected. What causes diverticular disease?

Most patients with uncomplicated diverticulitis respond well to antibiotics and bowel rest. The majority of patients with abscesses do well with drainage through a catheter, but patients with severe diverticulitis or threatening complications require surgery.

Here are some typical indications for diverticulitis surgery:. The timing and type of operation depend on the patient's individual circumstances. One traditional approach involves two separate operations, the first to remove the disease and divert the intestinal contents to a colostomy bag on the skin, and the second, several months later, to hook the colon and rectum back together see Figure 3.

In some cases, this can be accomplished with less-invasive laparoscopic surgery, and in milder cases, one operation may suffice. Still, the prospect of surgery makes a good case for eating plenty of fiber see below. Diverticulitis is one main complication of diverticular disease of the colon.

The other is diverticular bleeding. It occurs when a diverticulum erodes into the penetrating artery at its base see Figure 2. Because acute inflammation is absent, patients with diverticular bleeding don't have pain or fever. The most common symptom is painless rectal bleeding. Since diverticular bleeding occurs in the colon, it produces bright red or maroon bowel movements. In contrast, when bleeding occurs in the stomach, the blood is partially digested as it passes through the intestinal tract, so it appears as black, tar-like bowel movements.

In most patients, the bleeding is mild, and it usually stops on its own with bowel rest. But brisk bleeding is a life-threatening emergency. It requires expert hospital care with blood transfusions and IV fluids. It also requires aggressive attempts to locate the site of bleeding and to stop it. Several techniques are available; most experts recommend colonoscopy doctors can see the bleeding artery through the scope and cauterize or clip it to stop the bleeding or angiography doctors thread a catheter into the artery that supplies blood to the colon, inject dye to see the bleeding artery on x-rays, and then inject medication to constrict the artery and stop the bleeding.

If neither approach stops the bleeding, surgery may be needed. Diverticular disease of the colon is preventable. A high-fiber diet will sharply reduce the risk of developing diverticula — and even after the pouches form, dietary fiber will reduce the risk of diverticulitis and diverticular bleeding.

The Institute of Medicine recommends 38 grams of fiber a day for men age 50 and under and 30 grams a day for older men. For women, the recommended amount is 30 grams a day for those age 50 and under and 21 grams a day thereafter.

Most Americans get much, much less. The table lists the fiber content of some foods and supplements. Fiber is important for bowel function and general health, but it can be hard to get used to. Many people feel bloated and gassy when they start a high-fiber diet, but if they stick with it, these side effects usually diminish within a month or so. Still, it's best to ease into a high-fiber diet.

Increase your daily intake by about 5 grams per week until you reach your goal, and be sure to have plenty of fluids as well. For most people, a high-fiber cereal is the place to start, but if breakfast isn't your thing, you can have it any time during the day. Until recently, doctors banned nuts, seeds, corn, and popcorn from the diet of diverticulosis patients. Although they had no real evidence that these foods were harmful, doctors worried that these small particles might pass into the colon undigested and then lodge in the mouth of a diverticulum, blocking the pouch and making things worse.

But a Harvard study put these fears to rest. During the year study, the men who ate the most nuts and popcorn actually had a lower risk of acute diverticulitis than the men who ate the least; there was no change in the risk of bleeding, for better or worse.

Scientists are experimenting with other ways to prevent attacks of diverticulitis and episodes of bleeding; among other things, long-term nonabsorbable oral antibiotics are under study. People with diverticular disease might be wise to avoid or minimize their use of nonsteroidal anti-inflammatory drugs, which may or may not increase the risk of trouble.

Even so, dietary fiber remains the key to preventing diverticulitis and its complications. And if that's not enough reasons to chow down lots of "roughage," consider the other benefits of a high-fiber diet. Dietary fiber fights constipation. Because it reduces straining that puts pressure on the abdomen and the veins, fiber reduces the risk of hernias, hemorrhoids , and even varicose veins. In some, but not all, studies, fiber has been linked to a reduced risk of colon cancer.

Fiber is filling, and it helps combat obesity. It improves blood sugar metabolism, lowering the chances of developing diabetes. It lowers blood pressure. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Recent Blog Articles. Health news headlines can be deceiving. Kim says. He notes that there are racial and geographical differences in where the pain manifests — while pain in the lower left abdomen is most common in Western countries, in Asian countries the pain usually comes from the right side of the abdomen, but why this is the case is not known. The pain may be accompanied by nausea and vomiting, he adds. The reason fiber is so important is that plant fiber binds water and salt, resulting in larger bowel movements.

Shafran says. It was once common wisdom that a high-fiber diet prevented the formation of diverticula in the first place. Consuming too much red meat: That includes pork, Kim notes, despite the marketing of pork as white meat.

Eating a diet high in saturated fats : This can cause constipation , creating opportunities for food and waste particles to become trapped in and inflame the diverticula, Shafran says. Not drinking enough water: Shafran notes that dehydration also contributes to constipation. Your genes: Although genetics are a known risk factor for diverticulitis, what genes are involved and who is most at risk is still unclear.

The presence of polycystic kidney disease: The development of diverticula and diverticulitis are more common in people with polycystic kidney disease, suggesting that diverticulitis is one manifestation of the disease. Being overweight or obese: Obesity is linked with chronic intestinal inflammation, as well as the presence of more harmful gut bacteria.

Taking corticosteroids or nonsteroidal anti-inflammatory drugs NSAIDs : 7 These drugs have been found to cause injury to the gastrointestinal tract, and NSAIDs may also prevent the formation of a compound that maintains intestinal tissue. Kim also notes that in the past, physicians had advised patients to avoid eating seeds and nuts, as it was thought that these contribute to diverticulitis, but this is no longer the case.

It was thought that small seeds, such as the ones found in tomatoes, cucumbers, and strawberries, or even the sesame seeds on a hamburger bun, could get lodged in the diverticula and inflame them. The following lifestyle factors are also associated with the condition: 7.

Not getting enough exercise: Besides contributing to weight loss, physical activity, particularly jogging and running, have been associated with faster transit of stool through the colon. Overall cardiorespiratory fitness is also associated with reduced diverticulitis risk.

Drinking too much alcohol: While the research is inconsistent in linking alcohol to diverticulitis, some studies suggest that alcohol can impair the motility of the colon, increasing the pressure within the colon.

Smoking cigarettes: Smoking impairs the blood supply to the colon and can increase pressure within the colon as well, potentially leading to perforation. The good news is, even if you already have diverticulosis, following the above advice can reduce your risk of developing diverticulitis by up to 50 percent, Kim says. If you do all the good stuff, you can significantly reduce your risk of getting diverticulitis.

That's good news indeed, as left untreated, diverticulitis can lead to complications serious enough to require surgery, including abscesses, or pockets of pus that can form inside of the diverticula; and fistulas, abnormal tunnels between the colon and adjacent organs, Kim and Shafran warn. Peritonitis , which occurs when an infected pouch ruptures and spills the contents of the intestine into the abdominal cavity, is also a possible complication, one that requires immediate medical attention.

Such complications occur in about 25 percent of people with diverticulitis. Follow the simple guidelines laid out above. Your gut will thank you.