diverticulosisdiverticulitis

Diverticulosis and diverticulitis are related conditions affecting the large intestine. Diverticulosis refers to the presence of diverticula, pouch-like herniations of mucosa and submucosa through the muscular wall, most commonly in the sigmoid colon. It usually causes no symptoms, though some people experience minor changes in bowel habits or intermittent pain. The condition is more common with advancing age and a diet low in fiber; risk factors include obesity, smoking, and certain medications.

Diverticulitis is inflammation or infection of one or more diverticula and represents progression of diverticular disease. It typically presents with left lower quadrant abdominal pain, fever, and leukocytosis; nausea, constipation or diarrhea, and malaise may occur. Complications include abscess, perforation with peritonitis, fistula to bladder or vagina, and bowel obstruction.

Diagnosis: diverticulosis is often found incidentally on imaging or endoscopy. In suspected diverticulitis, computed tomography with contrast is the preferred imaging test and helps distinguish uncomplicated from complicated disease. Colonoscopy is usually deferred during an acute attack to avoid perforation and to rule out cancer; a follow-up colonoscopy is often planned after recovery if colorectal cancer screening has not been recently performed.

Management: diverticulosis usually requires no specific treatment beyond dietary considerations and routine screening. For diverticulitis, management depends on severity: uncomplicated cases may be treated with oral antibiotics and outpatient care in many guidelines, while complicated cases or those with high fever, immunosuppression, or signs of sepsis require hospitalization and IV antibiotics, with possible drainage or surgery. Prevention focuses on a high-fiber diet, weight management, and avoiding unnecessary NSAIDs.