Diverticula are protrusions of the intestinal mucosa. They can occur on the weak areas of the intestinal wall; for example, in areas where a blood vessel enters the intestinal wall. If there are numerous bowel diverticula, this is known as diverticulosis. Diverticula can become inflamed, which causes diverticulitis.
Intestinal diverticula can principally occur in the entire intestinal tract. However, they appear predominantly in the colon, i.e. in the area of the left lower abdomen. Intestinal diverticula occur in older people in particular. Chronic constipation can contribute to the development of bowel diverticula. Bowel diverticula do not usually cause any symptoms and are frequently discovered by chance during a colonoscopy. Sometimes, bowel diverticula cause intestinal bleeding. In around 20% of cases, however, an infection known as diverticulitis develops from a diverticulum.
Diverticulitis often causes stomach pain, typically in the left lower abdomen. The pain frequently improves when the patient breaks wind or has a bowel movement. Constipation, diarrhoea or flatulence are further symptoms which can occur as part of diverticulitis. In severe forms of the disease, they are accompanied by fever and a general feeling of malaise.
Diverticulitis is not harmless. If it is untreated, it can cause an intestinal rupture and peritonitis.
Diverticulitis is diagnosed on the basis of the patient’s medical history and with different examinations, such as an ultrasound examination of the abdomen or computer tomography. A blood test is used to detect signs of inflammation. If the diverticulitis is acute, a colonoscopy will not be carried out due to the danger of an intestinal rupture.
The treatment depends on the symptoms and whether there is any inflammation. Diverticula which do not cause any symptoms do not require treatment.
Mild diverticulitis can be treated with a bland diet or by temporarily abstaining from food (fasting). More severe forms of diverticulitis must be treated with antibiotics and artificial food. A stay in hospital is also usually necessary. Surgery is necessary in the event of a suspected intestinal rupture or abscess formation. Surgery is also used as a form of treatment for chronic courses or if conservative treatment does not bring the desired results. Find out more about the surgical procedures in the colon surgery section.