Diverticulitis vs. ulcerative colitis: A comparison

Diverticulitis refers to inflammation of the diverticula, which are small pouches that form in the colon lining. Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) where people develop inflammation and ulcers in the lining of the large intestine.

In this article, we compare symptoms, diagnosis, treatment, complications, and outlook of both conditions.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Small pouches called diverticula can form in the colon lining and push out through weak spots in the outer wall of the colon. If a person has diverticula in their colon, they have what health experts refer to as diverticulosis.

Diverticulitis is a condition where the diverticula become inflamed. Around 10–25% of individuals with diverticulosis may have diverticulitis.

People may also use the term “diverticular disease” for diverticulitis or diverticular bleeding or if diverticula cause chronic symptoms.

UC is an IBD where an overreactive immune system causes inflammation and ulcers to develop in the lining of the large intestine.

UC is a chronic condition, and people may go through periods of remission, when they experience no symptoms of UC.

In the table below, we compare the two conditions:

	Diverticulitis	UC
Definition	Diverticulitis is a condition where small pouches form in the intestinal lining and become inflamed.	UC is a type of IBD where an overactive immune response causes inflammation and ulcers in the intestinal lining.
Symptoms	Symptoms can include: • abdominal pain on one side • constipation • diarrhea • nausea • vomiting • fever • chills • rectal bleeding	Symptoms can include: • diarrhea • an urgent need for bowel movements • blood or mucus in stool • abdominal pain and cramping
Causes	There is no known cause, but the following may play a part: • genetics • diet low in fiber and high in red meat • immune system problems • changes in the microbiome • bacteria trapped in the diverticula	There is no known cause, but the following may play a role: • genetics • unusual immune system reactions • microbiomes in the digestive tract • environmental factors
Triggers	Low fiber consumption and high red meat intake may increase the risk of diverticulitis and complications.	Certain foods, such as spicy foods, lactose, and sugary foods, may trigger UC flares.
Treatment	Treatment options include: • antibiotics • a temporary clear liquid diet • pain relief medication • surgery to remove part of the colon, in some cases	Treatment can include medications to reduce inflammation, and, in some cases, surgery to remove the colon and rectum.
Cancer risk	There may be a slightly increased risk of colorectal cancer, with older adults and those with complicated diverticulitis being at higher risk.	There is an increased risk of developing colorectal cancer.
Complications	Complications can include: • pelvic abscess • intestinal perforation • fistulas • peritonitis • bowel obstruction • sepsis • rectal bleeding	Complications can include: • rectal bleeding • iron deficiency anemia • expansion or tears in the colon • blood clots • primary sclerosing cholangitis (PSC) • toxic megacolon • intestinal perforation
Outlook	The outlook depends on a person’s age and overall health and the severity of diverticulitis. Treatment may result in none to mild symptoms in two-thirds of people.	UC requires long-term management. Treatment can help people maintain remission and live a relatively normal life.

In the sections below, we outline the symptoms of diverticulitis and UC.

Diverticulitis

Symptoms of diverticulitis may include:

• abdominal pain
• constipation or diarrhea
• fever
• chills
• nausea or vomiting
• increased urgency, frequency, or discomfort when urinating, if an inflamed part of the colon comes into contact with the wall of the bladder
• rectal bleeding

People with diverticulitis usually experience severe and sudden abdominal pain, but they may also have mild pain that worsens over several days. The pain may be constant or come and go. Also, over time, the pain intensity may vary.

UC

Symptoms of UC can be mild to severe and can include:

• persistent diarrhea
• rectal bleeding or blood in stool
• cramping or abdominal pain
• mucus or pus in stool
• an urgent need to have a bowel movement
• a persistent urge to have a bowel movement, even if bowels are empty

UC symptoms can come on suddenly or start gradually and then worsen over time.

Most people with UC have flares, which is when symptoms are present, and periods of remission, which is when no symptoms occur. Remission may last for weeks or years.

Healthcare professionals do not know the exact cause of either condition. However, they are aware of factors that can increase the likelihood of developing diverticulitis or UC.

Diverticulitis

There is no known cause of diverticulitis. Certain factors, however, may increase the risk of diverticular disease or cause its development. These include:

• genetics
• stool or bacteria becoming trapped in a pouch in the colon
• a change to the microbiome in the intestines
• issues with muscles, nerves, or connective tissue in the colon
• issues with the immune system

Lifestyle factors may also play a role, including:

• following a low fiber diet
• eating a diet high in red meat
• not engaging in physical activity
• taking nonsteroidal anti-inflammatory drugs and steroids
• having obesity
• smoking

Diverticulitis affects both males and females. It is more common in males under the age of 50 years and in females aged 50–70 years. In people over 70 years, diverticulitis is more common in females.

UC

Health experts do not know the exact cause of UC. They think, however, that the following may play a role:

• Genetics: UC can run in families, so having certain genes may increase the risk of developing UC.
• Overactive immune system: The immune system creates temporary inflammation to help protect and heal the body from infection or illness. With UC, inflammation continues for longer than necessary, leading to chronic inflammation and ulcers in the intestinal lining.
• Microbiome: There may be differences between the microbiomes in the digestive tract of people with IBD and individuals without IBD.
• Environment: External factors and surroundings may affect a person’s genes, immune system, and microbiome, potentially playing a role in IBD.

People with UC or diverticulitis need to be careful about their dietary choices.

Diverticulitis

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a diet low in fiber and high in red meat may increase the risk of diverticulitis.

Consuming more fiber and reducing red meat intake may lower the risk of diverticulitis and complications.

There is no evidence to suggest a link between eating nuts, seeds, or popcorn and an increased risk of diverticulitis or diverticular bleeding.

Learn more about the best foods for diverticulitis here.

UC

People may find that certain foods can trigger or worsen symptoms of UC.

Although different for each person, the following foods may trigger symptoms in some individuals:

• insoluble fiber, such as raw cruciferous vegetables, whole nuts, and whole grains
• lactose
• sugary foods
• high fat, fried, or greasy foods
• alcohol and caffeine
• spicy foods

Learn more about foods to eat and avoid with UC here.

Healthcare professionals may recommend the following treatment options:

Diverticulitis

Treatment for diverticulitis may include:

• antibiotics
• a temporary clear liquid diet, to allow the colon to rest
• pain relief medication, such as acetaminophen

In severe cases, people may require surgery to remove a section of the colon.

UC

Treatment for UC may include long-term use of medications to control inflammation, such as:

• immunosuppressants
• biologics
• corticosteroids
• aminosalicylates

A person may require surgery to remove the colon and rectum if their symptoms do not improve or if they have colorectal cancer or any serious complications.

Surgeons may also perform an ileostomy. They will attach the end of the ileum, which is a part of the small intestine, to an opening in the abdomen called a stoma. This allows the body to store and remove stools in an alternative way.

To diagnose each of the two conditions, doctors may carry out a physical examination and order the following:

• blood tests
• stool tests
• imaging tests, such as a CT scan, an MRI scan, and an ultrasound
• colonoscopy

A healthcare professional may order a colonoscopy to help diagnose diverticulitis and an endoscopy to diagnose UC.

Diverticulitis and UC can cause the following complications:

Diverticulitis

Complications of diverticulitis may include:

• a pelvic abscess, when an infection causes a pus-filled pocket in the pelvic area
• an intestinal perforation, which is a hole in the wall of the intestine
• a fistula, which is an abnormal opening that allows contents to leak out
• peritonitis, an infection in the lining of the abdomen
• a blockage in the intestines
• sepsis
• rectal bleeding

According to a 2020 meta-analysis, there is a small risk of colorectal cancer with diverticulitis. Older adults and those with complicated diverticulitis have a higher risk of developing this type of cancer.

UC

Complications of UC may include:

• rectal bleeding
• iron deficiency anemia
• expansion or tears in the colon
• blood clots
• PSC

Moreover, toxic megacolon and perforation are potential complications that may warrant emergency surgery and colectomy.

In long-term cases of UC, there is an increased risk of precancerous changes and colorectal cancer. PSC can also increase the risk of bile duct cancer.

People can take the following steps to help prevent UC and diverticulitis from developing:

Diverticulitis

Factors that may help lower the risk of developing diverticulitis include:

• eating a diet high in fiber and low in red meat
• engaging in regular physical activity
• avoiding smoking
• reaching or maintaining a moderate body weight

If people have diverticulitis without any complications, a doctor may suggest surgery to remove part of the colon to prevent diverticulitis from reoccurring.

UC

Preventive measures for UC include:

• avoiding smoking
• getting regular exercise
• eating a balanced diet
• avoiding trigger foods

The outlook for each condition can depend on a variety of factors.

Diverticulitis

The outlook for people with diverticulitis can depend on a range of factors, including:

• severity of the condition
• a person’s age and overall health
• any coexisting conditions

Most people with uncomplicated diverticulitis will have a positive response to treatment. Around 15% of people may require surgery to treat diverticulitis. After successful treatment, one-third of people will not have any symptoms, one-third will experience mild symptoms, and one-third will have recurrent diverticulitis.

UC

UC is a chronic condition that a person will need to manage throughout their life.

Managing flare-ups and uncomfortable symptoms can be difficult for some individuals, but effective treatment can help people lead a relatively normal life.

By managing their condition, some individuals with UC may experience remission for weeks or even years.

Diverticulitis is a condition where small pouches form in the intestinal lining and become inflamed. UC is a type of IBD in which an overactive immune response causes inflammation and ulcers in the large intestine.

Medication and lifestyle factors can help manage both conditions, which in turn may help a person relieve symptoms or maintain remission.

In severe cases, people may require surgery to remove part of the colon or rectum.

Ulcerative Colitis vs. Diverticulitis: What’s the Difference?

Written by Shishira Sreenivas

• Ulcerative Colitis and Diverticulitis: Similarities and Differences
• How Are Symptoms the Same and Different?
• How Are Causes and Risk Factors the Same and Different?
• How Is Diagnosis the Same and Different?
• How Is Treatment the Same and Different?
• Ulcerative Colitis and Diverticulitis: What’s the Outlook?
• More

If you’ve had stomach pain for a while and see blood when you poop, you might have ulcerative colitis (UC) or diverticulitis. The two conditions are different, but some of their symptoms can be the same because they’re both conditions in the large intestine or colon.

UC is a type of inflammatory bowel disease (IBD) that irritates the lining in your large intestine (also known as the colon). This causes tiny open sores, called ulcers, that produce pus and mucous.

Diverticulitis is a condition that you have when one or more tiny, bulging pouches (called diverticula) form over weak spots in the colon wall, and then tear and become infected or inflamed. Diverticula are usually pea-sized and can form anywhere throughout the colon. But they’re commonly found in the lower-left side of your large intestine called the sigmoid colon.

UC and diverticulitis both start out in the large intestine and share symptoms like belly pain and bloody poop. Both conditions are more likely the older you get, and both can range from mild to severe and vary for each person. But they differ in terms of what causes them and how your doctor might treat them.

UC is a lifelong condition that can lead to life-threatening problems. About a million Americans are affected by it. It can affect people at any age, including those in their 20s and 30s. If you have UC, you also might have weight loss or arthritis.

Diverticulitis, not a lifelong condition, is a complication of “diverticulosis.” It’s the term doctors use when one or more of the small bulging sacs grow on your colon wall. It usually starts in middle age and it’s common in older people. Diverticulitis can happen to you once and never happen again, or it might come and go. About 50% of those over the age of 60 have it, and almost everyone above 80 has it, too. Most are mild cases that don’t cause any symptoms and aren’t reasons to worry. Up to 30% of the people with diverticulosis go on to have diverticulitis. And among them, anywhere between 5%-15% will have symptoms like bloody poop.

UC and diverticulitis have some of the same symptoms, but they also have some that are different.

Shared ones include:

• Belly pain
• Cramping
• Diarrhea
• Bleeding
• Fever

If you have one or more of these symptoms, talk to your doctor. UC symptoms also include:

• Urgency to poop
• Trouble pooping despite the urgency
• Weight loss
• Fatigue
• Lack of growth in children

Diverticulitis symptoms also include:

• Nausea
• Vomiting
• Swelling or bloating
• Constipation

It’s important to note that if you have diverticulitis, you’re more likely to have constipation than diarrhea.

Doctors aren’t sure what causes you to get UC or diverticulitis, but the two conditions have some common risk factors:

• Age. Your odds for either condition go up as you get older.
• Race. White people are more likely than those of any other race to have UC or diverticulitis.

UC might be caused by an abnormal immune response in your body. This means that if your immune system is fighting off a virus or bacteria, it may mistakenly attack cells in your digestive tract, too.

Genes might also play a role. If a close relative like your parent or sibling has UC, you’re more likely to have it, too. If you’re of Ashkenazi Jewish descent (ancestors came from Eastern or Central Europe), your risk is even higher. Diet and stress don’t cause UC, but they may trigger your symptoms and cause flare-ups.

As for what causes diverticulitis, experts believe bacteria found in your poop might get pushed into the bulging sacs as it passes through the colon. This causes the sacs to become infected or inflamed. Another theory is that your poop, especially if you’re constipated, might put a lot of pressure against the colon walls as it passes through. This can cause tears in the sacs and increase your chances of an infection.

Other risk factors for diverticulitis include:

• Obesity
• Smoking
• Lack of exercise
• Diet low in fiber and high in animal fat
• Certain medications (like steroids, opioids, and nonsteroidal anti-inflammatory drugs like ibuprofen)

If you think you have either UC or diverticulitis, talk to your doctor about it. You might be referred to a gastroenterologist, a doctor who specializes in digestive issues, for a correct diagnosis.

Your doctor will first do a detailed medical exam. They’ll ask you about your medical history including things like your diet, your bowel movements, and medications you might be taking.

Common tests to diagnose UC and diverticulitis include:

• Blood tests. This is done to check for infections
• Stool sample test. This checks for bacteria or parasites that might cause your stomach pain, cramps, or diarrhea
• Colonoscopy. The doctor will use a thin, flexible tube with a camera on the tip to explore your entire colon. They may take small tissue samples to test.
• Flexible sigmoidoscopy. This is similar to a colonoscopy, except your doctor will only explore your rectum and s-shaped sigmoid colon – both of which are located at the lower end of your colon. This is usually done if you have severe inflammation.
• Barium enema. This test is also called lower gastrointestinal tract radiography. In this test, your doctor injects a liquid containing barium into your butt. The barium coats your entire colon and makes it easier to see clearly under an X-ray scan.
• CT scan. This test allows your doctor to scan your abdomen and pelvic area and spot inflamed areas in your colon. The scan can detect the irritated or inflamed pouches for diverticulitis and confirm the condition.

In both conditions, treatments usually involve medications or, sometimes, surgery. In severe cases, your doctor may recommend a combination of the two to bring your symptoms under control. Certain over-the-counter medications may ease some of your pain-related symptoms. These include:

• Anti-diarrheal medications
• Pain relievers
• Antispasmodics to ease cramps and bloating
• Iron supplements, especially if you’re bleeding

UC treatments may include:

Anti-inflammatory drugs. This is usually the first line of treatment. This can include drugs like 5-aminosalicylates and corticosteroids. Some newer drugs like sulfasalazine and 5-ASAs (like mesalamine), which are called “steroid-sparing,” can be safely taken long-term. Your doctor may not want you to take steroids long-term because of their side effects.

Immunosuppressant drugs. This helps to reduce inflammation in your colon and cut down the immune response that might attack your digestive cells.

Biologics. This targets the proteins made by your immune system.

Surgery. About 30% of people who have UC need surgery. It’s sometimes the only cure, especially if medications don’t ease your symptoms or they become too difficult to manage. Your doctor may consider a surgery called proctocolectomy.

In this procedure, your entire colon and rectum are removed. Most surgeries also involve a procedure in which your doctor will attach a pouch at the end of the small intestine or outside your body to pass poop directly into it.

Diverticulitis treatments may include:

Antibiotics. If your case is mild, your doctor may prescribe oral antibiotics to bring the symptoms under control. If you have multiple bouts of diverticulitis episodes, you’ll need to go to the hospital for intravenous (IV) antibiotics and fluids. At this point, your doctor may consider surgery as an option, too.

Surgery. Your doctor may recommend you have surgery for diverticulitis because of issues in your colon such as:

• Abscess (a type of walled-off infection)
• Obstruction
• Tears that cause pus or poop to leak into your stomach cavity
• Tunnel-like opening in the colon that connects with other organs (fistula)
• Continuous bleeding (if your diverticulitis is recurring)

In some cases, you may need a colostomy bag after surgery. It’s a pouch that’s attached outside of your body to pass poop into if your colon needs time to heal. Once your colon is healthy, your doctor might remove the colostomy bag.

UC is a lifelong condition, and your symptoms may come and go. About 30% of people with UC have severe symptoms, and flare-ups might happen more frequently. While medications often help, surgery may also be needed.

In contrast, most cases of diverticulitis, even though it’s also considered a lifelong condition, clear up with a 7- to 10-day course of antibiotics and plenty of rest. If you have severe symptoms, talk to your doctor about other treatment options.

Managing your diet and stress and making time for regular physical exercise are key to lowering your risks for both conditions. However, because some of the symptoms are specific, there are steps you can take to avoid your condition flaring up or getting worse.

To prevent diverticulitis, you should:

• Eat more fiber. This helps your poop move better in your digestive tract and reduces any pressure on the colon walls
• Drink lots of water, this prevents constipation.

If you’re not sure what to eat, talk to your doctor.

To lower your odds for UC or manage flare-ups, you should:

• Get plenty of sleep. This can ease emotional stress and keep your immune system in check.
• Avoid using too many nonsteroidal anti-inflammatory drugs (NSAIDs). For pain relief and fever, switch to alternatives like acetaminophen (Tylenol).
• Be careful when you take antibiotics. These drugs can trigger UC flare-ups. Let your doctor know if it does.

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Diverticular disease (diverticulitis, diverticulosis) Medical On Group Orenburg

Studies show an increase and increase in the number of patients with diverticular disease. According to a number of authors, it occurs from 25% to 30% and increases with age to 60-70% in people over 60 years of age and accounts for more than 30% of all diseases of the colon.

The increase in the incidence of the disease is explained by the increase in the number of elderly people leading a sedentary lifestyle, a decrease in the consumption of vegetable fiber, slag-free nutrition), disorders of the gastrointestinal tract (gastritis, peptic ulcer, cholelithiasis, chronic pancreatitis, etc.) and improved capabilities of modern diagnostics of this disease.

It should be noted here that it is difficult to determine the frequency of this disease due to the fact that people with this disease rarely go to doctors and undergo examinations. Colon diverticula are usually an acquired disease and more often 90-92% occur in the left colon.
According to the course of the disease, it is possible to distinguish: asymptomatic course (as an accidental finding during examination) about 30-35%. and disease with severe clinical manifestations.

The most common opinion about the possible cause of this disease is a violation of the work (motility) of the colon, which is accompanied by an increase in pressure in it. Contribute to this obesity, narrowing of the colon, increased flatulence, constipation, frequent diarrhea, beriberi, hernia of the anterior abdominal wall, inflammation. As well as acquired (age), congenital weakness of the connective tissue. This is evidenced by the frequent combination of this disease with varicose veins, hernias, flat feet, hemorrhoids.

Diverticulosis is more often manifested by pain in the abdomen, more often on the left, and disorders of the bowel. The pain often has a cramping character and, as a rule, does not increase with palpation of the abdomen. Violation of the intestines is more often the alternation of constipation with diarrhea, but constipation is more characteristic. The progression of the disease can lead to complications: Diverticulitis is the most common complication when inflammation, inflammatory bowel disease, diarrhea, and injury from coarse feces join.

Which can lead to the formation of infiltrates (stimulating tumors of the abdominal cavity), their abscessing (the appearance of pustules) and, as a result, perforation of the intestinal wall with the formation of peritonitis and intestinal fistulas. Intestinal bleeding up to 30% of cases. They can be hidden and massive. Massive bleeding is less common. But even minor bleeding can lead to anemia. Intestinal obstruction is more often observed with infiltration of surrounding tissues and narrowing of the intestinal lumen. And also with a long course of the disease with massive adhesive processes.

In the diagnosis of the disease without complications, the most valuable are radiological (irrigoscopy with irrigography) and endoscopic (sigmoidoscopy, colonoscopy). Thus, the possibility of manifestation of severe complications requires timely diagnosis and treatment of diverticular disease.

Author of the article:

• Gorbunov A. Yu.

Other articles by this author (similar articles):

• Constipation – what is it

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Diverticulosis – a disease of civilization

“I have intestinal diverticulosis. Recently I had an operation – they removed the rectum. Let your doctors tell you about this disease – what is diverticulosis, what causes it and why is it dangerous? All the time I think: was it possible to do without surgical intervention in my case?

Address: Ilina Maria Evdokimovna, 664006 Irkutsk region, Zapadny township, s. Khomutovo, st. Deputatskaya, 11.

Hernial sacs

Let’s try to imagine the large intestine. It looks like a tube, or rather, a hose for irrigation – long, flexible and has a fairly thick wall, consisting of several layers. The inner layer is the mucous and submucosal membranes; the middle and strongest layer is the muscular membrane; outer – serous membrane. It’s like the layered structure of a soccer ball – tough and hard leather on the outside and a soft but supple rubber bladder on the inside.

Now imagine that a hole, a hole, is formed in the outer hard shell of this ball. What will happen then? The high pressure inside the ball will push part of the soft and elastic inner rubber chamber outward: a pocket protruding outward is formed. This can be compared with a hernia on the abdomen – the contents stick out through a defect in the muscles. Approximately the same thing happens with the colon with diverticulosis. If the pressure inside the intestinal lumen is large, and there are holes in the muscle layer, then the inner lining of the intestine tends outward through these holes, forming protrusions in the form of sacs. They are called diverticula. A condition where there are many diverticula in the colon is called diverticulosis. If diverticula begin to become inflamed or other complications appear, then diverticulosis turns into a more serious form of the disease – diverticulitis.

Diverticulosis is often discovered incidentally. For example, when a person has a diagnostic colonoscopy, a bowel x-ray, or a CT scan of the abdomen for some other reason.

Our ancestors did not know such a disease

Everyone has holes in the muscular layer of the intestine – both children and adults. These are numerous places through which small branches of vessels pass. They carry blood to the inner layer of the intestinal wall. However, diverticula sacs do not form in all people. What causes them to appear?

First of all, this is facilitated by high pressure inside the intestinal lumen. The colon works best when soft, loose contents pass through. If the stool is hard, then the intestine is desperately trying to push it to the exit. At the same time, it is strongly compressed, and the pressure inside it increases significantly: favorable conditions are created for the formation of diverticula.

The second reason is the weak muscular wall of the intestine. When the holes in the muscle layer expand, even a slight increase in pressure inside the intestine is enough to form diverticula.

Initially, diverticulosis and diverticulitis were detected mainly in elderly people over 60-70 years old, in whom, due to the general aging of the body, the wall of the large intestine also weakens. Now, these conditions are often found in fairly young men and women who eat refined foods and have very little physical activity. Deficiency of vegetables and fruits, lack of liquid and excess of starchy foods and sweets – the so-called “Western” type of diet – often leads to constipation, which, in turn, can provoke the early development of diverticulosis.

The disease rapidly became younger, because our ancestors did not know what diverticulosis was at all. The indigenous peoples of Africa, Australia and Oceania, who eat mainly plant foods, do not know about this disease. Diverticulosis and diverticulitis became a common disease in Western countries in the middle of the 20th century precisely because of the increased availability of refined foods, foods high in sugar, a decrease in the amount of dietary fiber (bran, fruits, vegetables) in the diet of people.

Be on the alert

A person may not even guess about the formation of diverticula for a long time. The very name of the condition “diverticulosis” suggests that diverticula do not manifest themselves in any way. Until small particles of intestinal contents get into these sacs and can not come out back. In such a situation, an inflammatory process can begin inside the diverticulum or several diverticula, and this condition is already called “diverticulitis”. A person with inflamed diverticula feels pain in the abdomen, which may be aching or even shooting. Most often it hurts in the left side of the abdomen. The pain may subside after taking antispasmodics, which relax the intestinal wall and help empty the diverticula. If the inflammation is serious, then a person’s body temperature may rise, general malaise may occur, and abdominal pain intensifies.

If a person knows that he has diverticula of the large intestine, then if you experience pain in the abdomen, an increase in body temperature, you should consult a doctor, preferably immediately a surgeon or a coloproctologist. The doctor will diagnose, prescribe special research methods with which it will be possible to determine if there is inflammation of the diverticula (diverticulitis), if there is, how serious it is and how best to treat it. Inflammation of diverticula is a very dangerous condition. The wall of the diverticulum is very thin, and if pus accumulates inside it, then, breaking through the intestinal wall, it will go straight into the abdominal cavity. And this is already peritonitis – a life-threatening condition, and if a person is not urgently helped, everything can end in death.

Often, inflammation of diverticula leads to the formation of inflammatory thickening of the intestinal wall (infiltrates) or the formation of purulent cavities that can turn into fistulas (channels), connecting the intestinal lumen with other internal organs, such as the bladder. And although diverticula themselves do not have the ability to malignant degeneration, but a chronic inflammatory process in the intestinal wall can contribute to the appearance of cancer cells in the area of ​​inflammation and, as a result, the formation of a colon tumor.

Is surgery necessary?

In most cases, diverticulitis is treated on an outpatient basis. A special diet is prescribed that normalizes the stool, as well as antispasmodics (duspatalin), dietary fiber (mucofalk or phytomucil), probiotics – drugs that combine different types of beneficial bacteria (bifidumbacterin, bifiform, linex). Sometimes antibiotics are prescribed.

But if the patient’s condition is severe – the temperature rises, there is a large diverticular infiltrate (compaction) or there is a suspicion of diverticulum rupture, the patient is hospitalized and treated in the clinic under the supervision of a doctor. Treatment begins with intravenous administration of antibacterial and anti-inflammatory drugs. If the inflammation does not subside or complications arise, then they resort to surgical treatment – the removal of the diseased part of the colon. These operations can be performed openly, i.e. through a large incision in the abdomen, or laparoscopically through small punctures using long instruments under the control of a video camera.

If the diverticulitis is advanced – a large infiltrate or abscess has formed in the abdominal cavity, an emergency operation may be required to save the person’s life. Often, during such operations, after removing part of the intestine, its ends are not sutured, since it is likely that holes will form in these sutures due to inflammation and the intestinal contents will again enter the abdominal cavity. Then the end of the intestine is removed in the left half of the abdominal wall in the form of a colostomy – an opening for the removal of feces. In this case, the feces are collected in a special bag, which is glued at the place where the intestine comes out. With a favorable postoperative course, a second operation can be performed after a few months in order to stitch the colon, restoring the normal course of the intestine and emptying through the anal canal.

For some people who have diverticula without inflammation, a coloproctologist may suggest prophylactic surgery. If a person has suffered several attacks of diverticulitis, but they have passed against the background of conservative treatment, then in order not to wait for the development of more serious complications, it is possible to remove the diseased part of the intestine as a preventive measure.