What is Diverticular Disease?

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Question: What is Diverticular Disease?

I just turned 50 and had my first colonoscopy. The doctor said I didn't have cancer or polyps, but she said that I do have a mild case of diverticulosis. What is that, and how did I get it?


First, congratulations on following through with your colonoscopy, and happy birthday! I can think of no better way to celebrate your birthday than to make sure you will have many, many more by having your wellness exams.

Second, although the disease is sometimes associated with people older than 40 or who eat a low fiber diet, you probably didn't do anything to get diverticular disease. It's not transmittable or catchable, like the common cold. Diverticulosis, along with diverticulitis — a more serious condition — are simply things that happen within the colon of about 10 percent of adults who are older than 40, and almost half of adults over age 60.

Like many people waking up from the haze of colonoscopy sedation, once you heard that you were cancer-free, your ears probably tuned out further discussion. After all, that is the best-case scenario following the exam: finding out you don't have cancer. However, the endoscope (camera) used during the procedure can help your doctor see more than just cancer. During the procedure, your gastroenterologist may find:

  • Benign (non-cancerous) polyps
  • Diverticulum (singular) and diverticula (more than one)

What is a Diverticulum?

A diverticulum is a small out-pouching of the wall of your colon.

The membrane is usually weak, and the pouch can collect fecal material and partially digested food, such as fine seeds or nuts. If you have more than one pouch, they are collectively called diverticula, and you will be diagnosed with diverticulosis or diverticular disease. When these pouches become inflamed or infected, the disease becomes something slightly more serious, called diverticulitis. This condition can cause tenderness and pain, nausea and vomiting, and require antibiotic treatment or, in a worst case scenario, surgery.

How is It Diagnosed?

Diverticula are typically found during routine screening exams or diagnostic procedures, such as a colonoscopy or double-contrast barium enema. The majority of people with diverticular disease learn of it by accident: they had little or no symptoms heralding the disease. Occasionally, people with diverticula complain of bloating, constipation or irregular bowel habits, but this is rare. When in doubt, if you suffer chronic symptoms, it is important to see your doctor so that he or she can complete a physical assessment and order any tests deemed necessary to discover the cause of your symptoms.


For the most part, people with diverticulosis can continue to lead normal, healthy lives. In the past, many physicians encouraged dietary changes to help reduce the risk of developing diverticulitis, which included avoidance of small seeds and nuts. However, it is now common thought that nuts and seeds are okay in moderation, and the main form of treatment for diverticular disease is to drink plenty of water and maintain a high fiber diet. Ask your doctor if you are unsure how much fiber you should be consuming, but a rule of thumb is to try for at least 25 to 30 grams of this nutrient daily. Eating more beans, dry cereal, fruits and vegetables (edible skins on) is a good way to start increasing the natural fiber in your diet.

Don't Ignore Your Symptoms

If you've been diagnosed with diverticular disease, it's important that you report any unusual signs or symptoms to your doctor. About 25 percent of adults who have diverticulosis will at some point develop diverticulitis and require treatment. Untreated, diverticulitis can cause infections, perforations (holes in the bowel which can lead to a life-threatening infection called peritonitis), and bowel obstructions. A fever, abdominal pain or tenderness, vomiting, or rectal bleeding should be reported to your doctor immediately so that he or she can investigate the cause and help you obtain the treatment you need. Rarely, the bowel will become so inflamed and diseased from the diverticulitis that a small portion of your colon will need to be surgically removed, and you will be given a colostomy while your bowel rests. In most cases, the colostomy can be reversed once your colon has healed and the inflammation is resolved.


American Cancer Society. (2006). American Cancer Society's Complete Guide to Colorectal Cancer. Clifton Fields, NE: American Cancer Society.

American Society for Gastrointestinal Endoscopy. (n.d.). Understanding Diverticulosis. Accessed online April 22, 2013.

National Digestive Diseases Information Clearinghouse. (n.d.). Diverticulosis and Diverticulitis. Accessed online April 22, 2013.

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