Diverticulosis: What It Is, Causes, Symptoms, and How to Manage It

Diverticulosis is a common digestive condition in which small, bulging pouches (called diverticula) form in the lining of the large intestine (colon). It becomes more common with age, especially after 50, and many people have it without ever knowing.

For most people, diverticulosis does not cause symptoms or serious problems. However, in some cases, it can lead to complications such as inflammation or infection. Understanding the condition can help you reduce your risk and know when to seek medical care.

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What Is Diverticulosis?

Diverticulosis occurs when weak spots in the colon wall give way under pressure, forming small pouches. These pouches most often develop in the lower part of the colon (the sigmoid colon).

It's important to know:

• Diverticulosis is very common, especially in adults over 60.
• Most people with diverticulosis never develop symptoms.
• It is often found during routine colonoscopy or imaging for another issue.

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Diverticulosis vs. Diverticulitis: What's the Difference?

These two terms are often confused but mean different things.

Diverticulosis

• The presence of diverticula (pouches).
• Usually causes no symptoms.
• Typically does not require medication or surgery.

Diverticulitis

• Occurs when one or more diverticula become inflamed or infected.
• Causes abdominal pain and other symptoms.
• May require antibiotics, hospitalization, or in rare cases, surgery.

Not everyone with diverticulosis develops diverticulitis. In fact, most people do not.

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Symptoms of Diverticulosis

Most individuals with diverticulosis feel completely normal.

When symptoms do occur, they are usually mild and may include:

• Mild abdominal cramping (often on the lower left side)
• Bloating
• Constipation
• Diarrhea
• Changes in bowel habits

These symptoms can overlap with other digestive conditions, such as irritable bowel syndrome (IBS). If you're experiencing ongoing stomach issues and want to explore what might be causing them, you can check your symptoms with a free AI-powered tool to help identify potential causes and get personalized health insights before your doctor's appointment.

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What Causes Diverticulosis?

The exact cause of diverticulosis isn't fully understood, but several well-established risk factors are involved.

1. Low-Fiber Diet

A diet low in fiber is strongly associated with diverticulosis.

Fiber helps soften stool and makes it easier to pass. Without enough fiber:

• Stools become harder.
• The colon must work harder to push waste through.
• Increased pressure may cause weak spots in the colon wall to bulge outward.

2. Aging

Age is the biggest risk factor.

• Rare before age 40.
• Common after age 60.
• Extremely common by age 80.

As we age, the colon wall naturally weakens.

3. Genetics

Diverticulosis can run in families. If close relatives have it, your risk may be higher.

4. Lifestyle Factors

Research shows higher risk with:

• Obesity
• Smoking
• Physical inactivity
• Diet high in red meat and processed foods

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How Is Diverticulosis Diagnosed?

Because diverticulosis usually has no symptoms, it is often found during testing for other reasons.

Common diagnostic tools include:

Colonoscopy

• A flexible camera inserted into the colon.
• Often performed for routine colon cancer screening.
• Allows direct visualization of diverticula.

CT Scan

• Often used if diverticulitis is suspected.
• Helps detect inflammation, infection, or complications.

Stool Tests

• Used to check for bleeding or infection.

If you have no symptoms, diverticulosis alone does not usually require extensive testing.

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Treatment and Management of Diverticulosis

If you have diverticulosis without complications, the goal is simple: prevent progression to diverticulitis and maintain healthy digestion.

1. Increase Fiber Intake

This is the most important step.

Aim for 25–30 grams of fiber per day from foods such as:

• Fruits (apples, pears, berries)
• Vegetables (broccoli, carrots, leafy greens)
• Beans and lentils
• Whole grains (oats, brown rice, whole wheat bread)

Increase fiber gradually to avoid gas and bloating.

2. Drink Plenty of Water

Fiber absorbs water. Without enough fluids, constipation can worsen.

Most adults should aim for:

• About 6–8 glasses of water daily (unless otherwise advised by a doctor).

3. Exercise Regularly

Physical activity helps stimulate normal bowel movements.

• Walking, swimming, or cycling are excellent choices.
• Even 30 minutes most days can make a difference.

4. Maintain a Healthy Weight

Excess weight increases abdominal pressure and may raise the risk of complications.

5. The Nuts and Seeds Myth

For years, people with diverticulosis were told to avoid:

• Nuts
• Seeds
• Popcorn

The belief was that these foods might get stuck in diverticula and cause infection.

Modern research does not support this. These foods are generally safe and are often good sources of fiber.

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Possible Complications of Diverticulosis

While most people do well, diverticulosis can sometimes lead to complications.

1. Diverticulitis

Symptoms include:

• Persistent abdominal pain (often lower left side)
• Fever
• Chills
• Nausea or vomiting
• Tenderness in the abdomen

This condition requires medical evaluation and often antibiotics.

2. Diverticular Bleeding

Diverticula can sometimes bleed.

Signs include:

• Bright red blood in the stool
• Maroon-colored stool
• Blood on toilet paper

Bleeding may be painless but can be heavy. This requires immediate medical care.

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When to See a Doctor

Seek medical attention right away if you experience:

• Severe or constant abdominal pain
• Fever with abdominal discomfort
• Nausea and vomiting that won't stop
• Significant change in bowel habits
• Bright red blood in your stool
• Lightheadedness or weakness with bleeding

These symptoms may indicate diverticulitis or another serious condition.

Even if symptoms seem mild, persistent digestive issues should be discussed with a healthcare professional. Early evaluation can prevent complications.

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Living Well with Diverticulosis

The good news is that most people with diverticulosis live normal, healthy lives without complications.

Simple lifestyle adjustments can significantly reduce risk:

• Eat a balanced, fiber-rich diet.
• Stay hydrated.
• Stay physically active.
• Avoid smoking.
• Keep up with recommended colon cancer screenings.

Diverticulosis is common and manageable. Awareness—not fear—is the key.

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Final Thoughts

Diverticulosis is a widespread condition characterized by small pouches in the colon. Most people never experience symptoms, and many discover it only during routine screening.

While complications like diverticulitis or bleeding can occur, they are not the norm. A high-fiber diet, good hydration, and regular exercise are the cornerstone of prevention and long-term digestive health.

If you're concerned about your digestive health or experiencing any unusual symptoms, you can take a free AI symptom checker assessment to receive personalized insights about what might be causing your discomfort. However, online tools are not a substitute for professional medical care.

If you have severe pain, fever, or rectal bleeding, speak to a doctor immediately. Prompt medical evaluation is essential for anything that could be serious or life-threatening.

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Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice. Always speak to a qualified healthcare provider about symptoms, diagnosis, or treatment decisions.