diverticulosis and diverticulitis

Diverticulosis and Diverticulitis: Causes and Treatment

Diverticulosis and diverticulitis, a complication of the condition, affects your gut. Individuals with the condition experience bulging pouches, or diverticula, on the colon’s wall.

Most diverticula are small, between 3 and 19 millimeters in size. However, large diverticula can measure more than 4 centimeters and extra-large over 25 centimeters. Most people tend to have multiple diverticula. Diverticulitis occurs when the diverticula become inflamed or infected.

Most cases of diverticulosis do not cause any symptoms and treatment is not required. However, if the diverticula bleed or become infected, you’ll need treatment and investigation.
Diagnosis of diverticulosis and diverticulitis involves many tests including:

  • Colonoscopy
  • Endoscopy
  • Barium enema
  • MRI
  • CT scans

In this article, we’ll discuss the causes and treatment of diverticulosis and diverticulitis.

diverticulosis and diverticulitis - man sitting on couch eating chips

Causes of Diverticulosis and Diverticulitis

The exact cause of diverticulosis is still unknown. There do seem to be several factors involved, though.

Diverticulitis is a complication of diverticulosis. Other complications include diverticular bleeding or segmental colitis associated with diverticular disease (SCAD), a rare condition.

There are some known factors that contribute to the development of diverticulosis and diverticulitis, though.


For decades, researchers believed a diet low in fiber is a risk factor for these conditions. Yet, more recent studies suggest this may not be the case. In fact, there’s a link between high fiber diets and increase bowel movements. Therefore, it may actually increase the risk of diverticulosis.

For your overall health, it’s important to include a healthy amount of fiber in your diet. The latest guidelines for Americans recommend having 14 grams of fiber for every 1,000 calories consumed. So, someone with a 2,000 calorie daily diet needs 28 grams of fiber. Pay attention to your fiber intake as most adults do not get more than 15 grams a day.

Eating high amounts of red meat shows an increased risk of diverticulosis. Gastroenterologists believe diverticulosis is a disease of the Western diet. This diet involves eating large amounts of animal products and small amounts of beneficial plant food rich in fiber.

Medical professionals emphasize the benefits of prebiotics. These special fibers feed the friendly bacteria in the gut. Natural sources of prebiotics include:

  • Asparagus
  • Garlic
  • Onions
  • Sugar beet
  • Chicory
  • Jerusalem artichoke
  • Carrots
  • Seaweed

Be sure to start adding some of these into your diet to get your daily source of fiber and prebiotic.

Sedentary Life and Smoking

Many of us sit in front of a computer for hours at a time due to our jobs. This sedentary lifestyle leads to obesity, a risk factor for developing diverticulosis.

Smoking is yet another important risk factor for the condition. If you are a smoker, quit as soon as possible for your gut and overall health.


There are some drugs that may cause the development of diverticulosis. More specifically, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and opiates are frequently linked.

Genetic Variations

Certain genetic variations, changes in the colon’s wall structure, and motility are possible causes. Very large diverticula seem to develop from smaller diverticulums that change over time.

Inflammation and Infection

Inflammation and infection can cause the complication of diverticulitis in the diverticula. Experts believe that bacteria or stool trapped in pouches are the starting point. This leads to alterations of the normal flora with a decrease in friendly bacteria. Instead, there is an increase in pathogenic (disease-causing) bacteria, which promotes diverticulitis.

diverticulosis and diverticulitis - woman holding stomach

Best Treatment for Diverticulosis

For the most part, diverticulosis is asymptomatic. So, individuals usually don’t need treatment. Simply keep an eye on the condition with regular follow-ups with your doctor.

We refer to this method as the “watch and wait” approach. An estimated 80% of cases either do not cause symptoms or intermittent constipation.

In some cases, diverticulosis can cause symptoms. These include:

  • Bloating
  • Severe constipation
  • Diarrhea
  • Abdominal pain
  • Cramps in the lower abdomen

You can manage these symptoms with fiber supplements. Remember to introduce these gradually. Probiotics and drugs like mesalazine and rifaximin are also helpful.

diverticulosis and diverticulitis - doctor with endoscope

How is Diverticulitis Treated?

Symptoms of diverticular bleeding include bright red (fresh blood) or maroon-colored stool. Although the bleeding is painless, it may not stop until you start treatment.

Using colonoscopy or CT scans, a doctor will locate the bleeding site. If the bleeding doesn’t stop with conservative measures, you may need a colon resection. This surgery may involve a temporary colostomy. Several months later, a second surgery will rejoin the ends of the colon and close the abdomen.

Doctors treat mild forms of diverticulitis with rest and oral antibiotics. Sometimes you may need to go on a liquid diet temporarily to rest your digestive system.

Severe cases may require hospitalization with IV antibiotics and a few days without food or liquids. After this fasting, you can consume liquid food with carbohydrates, protein, fat, vitamins, and minerals through a feeding tube.

Cases of diverticulitis are closely monitored due to the risk of complications. These complications include:

  • Abscesses
  • Perforation
  • Peritonitis
  • Fistula
  • Intestinal obstruction

All of these complications will likely require surgery.

How to Avoid Diverticulosis and Diverticulitis

In the past, doctors recommended avoiding certain foods like nuts, seeds, and corn. But, more recent studies show these foods don’t increase the risk of diverticulosis and diverticulitis. While there is no list of foods you should avoid, every person is unique with their symptoms when eating certain foods.

A dietician or nutritionist can help identify problematic foods. From this, they can help you create a nutrient-rich dietary plan that is good for your gut.