Diverticulosis and diverticulitis: symptoms, causes and treatment
The difference between diverticulosis and diverticulitis, the symptoms, how they are diagnosed and treated, and when to see a gastroenterologist.
Also known as: Diverticular disease; Diverticulitis
What diverticulosis and diverticulitis are
Diverticula are small pouches that bulge outwards through weak spots in the wall of the large bowel (colon). Having these pouches is called diverticulosis. It becomes more common with age, and most people who have it never know, because the pouches cause no trouble. It is often found by chance during a scan or a colonoscopy done for another reason.
Diverticulitis is what happens when one or more of these pouches becomes inflamed, and sometimes infected. It usually comes on over hours to a few days and can range from a mild illness treated at home to a serious problem needing hospital care. Doctors use the broader term diverticular disease when the pouches cause ongoing symptoms, bleeding or inflammation.
Symptoms
Diverticulosis on its own usually causes no symptoms. Some people get ongoing bloating, cramps or pain in the lower abdomen, and constipation or diarrhoea, which can be hard to tell apart from irritable bowel syndrome. Diverticulitis typically causes:
- Lower abdominal pain, most often on the lower left side, that is constant and may be severe
- Tenderness when the area is pressed
- Fever and chills
- Nausea or vomiting
- A change in bowel habit: constipation, or sometimes diarrhoea
A separate problem is diverticular bleeding: a small blood vessel in a pouch bursts, causing a sudden passage of red or maroon blood from the back passage, often without pain. It can be heavy and needs urgent assessment.
Pain on the lower right side is more often appendicitis, but diverticulitis can occur on the right too, and doctors sometimes need a scan to tell them apart.
Causes and risk factors
The exact cause is not fully understood. The pouches seem to form where pressure inside the bowel pushes the lining through weaker points in the muscle wall. Factors linked to a higher risk include:
- Increasing age
- A diet low in fibre and high in red meat
- Long-standing constipation and straining
- Lack of regular physical activity, and obesity
- Smoking
- Regular use of painkillers of the NSAID group and of steroids
- Family history, suggesting genes play a part
Traditional Indian diets built around whole grains, dal, vegetables and fruit are naturally high in fibre. As diets in cities shift towards refined flour, polished rice, processed snacks and more meat, and as people sit for longer, these protective habits are worth holding on to.
Complications
- Abscess — a pocket of pus next to the bowel
- Perforation — a hole in the bowel wall, which can lead to peritonitis, a serious infection of the lining of the abdomen
- Fistula — an abnormal passage between the bowel and another organ, such as the bladder, which can cause air or stool in the urine
- Narrowing or blockage of the bowel after repeated inflammation
- Bleeding from a pouch
How it is diagnosed
The doctor will ask about your pain, bowel habits, fever and medicines, and will examine your abdomen. Tests may include:
- Blood tests — to look for signs of infection and inflammation, and to check for anaemia after bleeding
- Urine and stool tests to rule out other causes
- CT scan of the abdomen — the main test during a suspected attack of diverticulitis, as it shows inflammation and complications such as an abscess
- Ultrasound or MRI in some situations, for example in pregnancy
- Colonoscopy — a camera test of the large bowel. It is not done during an acute attack, but is often advised some weeks after recovery to check the bowel and rule out colorectal cancer, which can cause similar symptoms
Treatment
Diverticulosis
If the pouches cause no symptoms, no treatment is needed beyond healthy bowel habits. For ongoing mild symptoms, a doctor may advise a high-fibre diet, sometimes with a fibre supplement such as isabgol (psyllium husk), plenty of water, and medicines to relieve cramps.
Mild diverticulitis
Mild, uncomplicated diverticulitis can often be managed at home. Your doctor may suggest a short period on a clear liquid diet to rest the bowel, followed by a gradual return to soft and then normal food. Antibiotics are often prescribed, although in very mild cases some doctors may not use them. Pain relief is usually with paracetamol rather than NSAID painkillers, which can raise the risk of complications. Return quickly if pain worsens, fever rises or you cannot keep fluids down.
Severe or complicated diverticulitis
People who are very unwell, older or frail, have weakened immunity, or have complications are treated in hospital with intravenous fluids and antibiotics. An abscess may be drained with a needle guided by a scan. Surgery to remove the affected part of the colon is needed for perforation, peritonitis, a fistula, a blockage, bleeding that does not stop, or in some people with repeated attacks. Sometimes a temporary stoma (an opening of the bowel onto the tummy) is needed.
Living with it and preventing attacks
- Eat plenty of fibre every day: whole grains, millets, dal, beans, vegetables and fruit
- Increase fibre gradually and drink enough water, so it does not cause bloating
- Stay physically active and aim for a healthy weight
- Stop smoking
- Avoid regular NSAID painkillers unless a doctor advises them
- You do not usually need to avoid nuts, seeds or popcorn; older advice to cut these out is no longer generally followed
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, if you have:
- Severe abdominal pain, especially if the whole abdomen becomes hard and very tender
- High fever with chills and feeling very unwell
- Persistent vomiting, or being unable to keep fluids down
- Heavy bleeding from the back passage, or passing blood with dizziness or fainting
- Not passing stool or wind, with a swollen abdomen
Which doctor to see
A general physician can assess new abdominal pain and arrange tests. A gastroenterologist diagnoses and manages diverticular disease, performs colonoscopy and treats bleeding. A general surgeon or GI surgeon is involved when an abscess, perforation or repeated attacks need a procedure or surgery.
You can find gastroenterologists in Bengaluru or GI surgeons in Bengaluru on The Doctor Index, each with a registration you can check. If you have passed blood, read about gastrointestinal bleeding.
Common questions
Questions people ask
- Is diverticulosis serious?
- Usually not. Most people with diverticulosis never have symptoms or complications. A small number develop diverticulitis or bleeding. A high-fibre diet, regular exercise and not smoking may lower that risk, and a doctor can advise if you have symptoms.
- What should I eat during a diverticulitis attack?
- Your doctor may advise clear fluids such as water, clear soups and coconut water for a short time, then soft, low-fibre foods, building back to a normal high-fibre diet once you recover. Follow the plan your own doctor gives you.
- Can diverticulitis come back?
- It can. Some people have only one attack, while others have repeated episodes. Keeping a high-fibre diet, staying active and not smoking may reduce the risk. If attacks keep recurring or are complicated, surgery may be discussed.
- Is diverticulitis the same as colon cancer?
- No. They are different conditions, but they can cause similar symptoms such as pain, change in bowel habit and bleeding. That is why a colonoscopy is often recommended after recovery from a first attack, to check the bowel properly.
This condition is usually assessed by a gastroenterologist. Every profile shows the doctor’s registration and what has been checked.
Gastroenterologists in Bangalore
A few gastroenterologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Diverticulosis and Diverticulitis; ask the clinic whether the doctor sees it.
Related conditions
- Celiac Disease
- Constipation
- Crohn's Disease
- Diarrhea
- Foodborne Illness
- Gallstones
- Gastroenteritis
- Gastrointestinal Bleeding
All gastroenterology conditions →
Practical reading
All postsSources
- MedlinePlus, National Library of Medicine — Diverticulosis and Diverticulitis
- Government of India — Emergency Response Support System (112)
- MedlinePlus, National Library of Medicine — Diverticulosis and Diverticulitis — Public-domain health-topic summary
Diverticulosis and diverticulitis: symptoms, causes and treatment is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0761.