Diverticular

Diverticular, in medical usage, relates to diverticula, small pouchlike herniations in the lining of the digestive tract. The term is most often used in connection with diverticular disease, which encompasses diverticulosis (the presence of diverticula) and diverticulitis (inflammation or infection of diverticula). Diverticula most commonly form in the colon, especially the sigmoid segment, and are more prevalent with aging. Most individuals with diverticulosis are asymptomatic; symptoms, if present, may include intermittent lower abdominal discomfort or changes in bowel habit. Diverticular bleeding can occur when a diverticulum erodes a blood vessel, causing painless rectal bleeding that may stop spontaneously.

Diverticulitis occurs when a diverticulum becomes inflamed or infected. It typically presents with localized lower abdominal pain (often left lower quadrant in Western populations), fever, and leukocytosis; nausea and altered bowel habits may occur. Complications include abscess, perforation, fistula (for example, to the bladder), obstruction, and sepsis.

Diagnosis usually involves CT imaging for suspected diverticulitis; colonoscopy is generally avoided during acute episodes but may be performed later to evaluate other pathology. For diverticular bleeding, endoscopic, radiologic, or surgical interventions may be used to control bleeding.

Management ranges from lifestyle changes to medical therapy. Diverticulosis is managed with high-fiber diet and hydration to reduce constipation; diverticulitis is commonly treated with antibiotics, with severity guiding outpatient versus inpatient care. Severe, recurrent, or complicated cases may require hospital admission and surgery (often resection of the affected colon). Prevention centers on a high-fiber diet, regular physical activity, weight management, and cautious use of NSAIDs.

Diverticular disease generally has a good prognosis, though complications can occur and recurrent episodes are possible.