Diverticular Disease

Most people with diverticulosis don’t have any symptoms (asymptomatic) and may never know they have the condition. It’s commonly found by chance during tests such as a CT scan or colonoscopy. 

Occasionally, diverticulosis can cause symptoms such as bloating, constipation, and abdominal pain. This is known as symptomatic uncomplicated diverticulosis (SUDD).

The main symptom of diverticulitis is abdominal pain, usually on the left side, but pain can sometimes occur on the right side. 

Other symptoms of diverticulitis include: 

• fever

• change in bowel habit

• bleeding or passing slime (mucus) from your bottom

It isn’t fully understood what causes diverticular disease, but it appears to be related to long-term constipation. 

When you’re constipated, the muscles in your colon strain to move hard stools, resulting in pressure that can cause the weak spots in your colon to bulge out. These bulging pockets are known as diverticula.

It isn’t clear what causes the diverticula to become inflamed during diverticulitis, but it may occur when faeces or bacteria become trapped in the diverticula.

Possible causes of diverticular disease include: 

• genetics 

• a low-fibre diet

• a diet high in red meat (particularly unprocessed red meat)

• low levels of vitamin D

• obesity

• ageing (the colon wall weakens over time)

• smoking

• lack of physical activity

• some medications 

• chronic low-grade inflammation in the gut 

• a history of gallstones 

Diverticulosis is commonly diagnosed following a CT scan or a colonoscopy to investigate another condition or during routine screening. 

If you have symptoms of diverticulitis, your consultant gastroenterologist will start by asking you about your symptoms, general health, family and medical history and any medications you take regularly. They’ll also perform a physical examination. 

Your consultant will likely order some tests to confirm your diagnosis or rule out another condition that could be causing your symptoms. These may include blood tests, imaging scans such as an ultrasound, CT scan, or MRI scan or investigative procedures like a colonoscopy or sigmoidoscopy. 

The main way to prevent diverticular disease is to reduce the risk of constipation. 

You can do this by eating a high-fibre diet, taking regular exercise, maintaining a healthy weight, drinking plenty of water, and limiting red meat and alcohol. 

Diverticulosis is common, and complications are rare. However, in some cases, the condition can result in diverticulitis that can lead to serious complications. Diverticulitis with complications is known as complicated diverticulitis. 

Complications of diverticulitis include: 

• abscess (a collection of pus in the bowel wall) 

• bleeding

• bowel obstruction (blockage)

• bowel perforation – the weakened bowel wall may rupture 

• peritonitis – following bowel perforation, the bowel contents can leak into the abdominal cavity 

• fistulas – the formation of an abnormal tunnel between the bowel and another organ, such as the bladder or vagina

Treatment for diverticular disease depends on whether you have diverticulosis or diverticulitis and whether your condition is uncomplicated or complicated by other issues. 

If you have diverticulosis and don’t have symptoms, you can help manage your condition and reduce the risk of developing diverticulitis by making the following lifestyle changes: 

• increase the amount of fibre in your diet. Aim for at least 30g of fibre per day. Increase your fibre intake slowly by 5g each day over a week until you reach the recommended daily amount to prevent bloating 

• exercise regularly

• maintain a healthy weight 

• don’t smoke 

• reduce the amount of red meat in your diet 

• ensure you’re getting enough vitamin D – a doctor can check your levels 

• keep hydrated 

• see a doctor if you have long-term or frequent constipation

If your diverticula are inflamed or infected (diverticulitis), your consultant will recommend treatment based on your symptoms, the cause of your diverticulitis and whether your diverticulitis is uncomplicated or complicated. 

Treatment for uncomplicated diverticulitis may include: 

• painkillers 

• oral antibiotics 

• anti-spasmodic medicines to manage muscle spasms

Treatment for complicated diverticulitis may include: 

• IV (into a vein) antibiotics 

• a clear liquid diet for a short time to rest your colon, gradually adding solid foods as your symptoms improve

• abscess drainage 

• surgery to treat any complications, such as bleeding or obstruction and remove the damaged part of your colon 

At Welbeck, our gastroenterologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.