A clear guide for Valley Gastroenterology patients.
What is diverticular disease?
Diverticula are small pouches that can form in the colon wall as we age. This is called diverticulosis and often has no symptoms. When a pouch becomes inflamed or infected, it’s called diverticulitis.
Common symptoms
Diverticulosis (no active infection): often none; sometimes mild cramps, bloating, or irregular bowel habits.
Diverticulitis (flare):
Left‑lower abdominal pain/tenderness
Fever or chills, nausea, loss of appetite
Constipation or diarrhea
Red‑flags — seek care promptly
Severe or worsening abdominal pain
High fever, persistent vomiting, or inability to keep liquids down
Rectal bleeding (bright red or maroon stools)
Signs of complications: fainting, fast heart rate, confusion
If severe pain, heavy bleeding, fainting, or signs of shock occur, call 911 or go to the nearest ER.
How it’s diagnosed
History & exam, CBC and inflammatory markers
CT scan of the abdomen/pelvis when diverticulitis is suspected to confirm and look for complications (abscess, perforation, obstruction)
Colonoscopy is not done during an acute flare but is usually recommended about 6–8 weeks after recovery(especially after a first episode or if you’re due for screening) to exclude other causes and update screening.
Treatment
Uncomplicated diverticulitis (no abscess/perforation):
Many patients can be treated at home
Diet: start with clear liquids, advance to low‑fiber/soft as pain improves, then gradually return to normal
Antibiotics: used selectively based on symptoms and risk factors—your clinician will advise
Close follow‑up; return if worsening or not improving in 48–72 hours
Complicated diverticulitis (abscess, perforation, severe infection):
Hospital care with IV fluids/antibiotics; drainage of abscess if needed
Surgery for ongoing sepsis, free perforation, fistula, obstruction, or recurrent severe attacks impacting quality of life
Diverticular bleeding:
Often painless bright‑red or maroon bleeding; go to the ER if heavy
Managed with resuscitation, colon prep, and colonoscopy; most cases stop on their own
Prevention & long‑term care
High‑fiber diet (goal 25–30 g/day) after recovery; consider psyllium or other fiber supplements
Stay hydrated and physically active
Maintain a healthy weight; avoid tobacco
Seeds and nuts are generally safe for most people
Discuss regular colorectal cancer screening—diverticulosis does not replace the need for screening
FAQs
Do I always need antibiotics for diverticulitis? Not always. For mild, uncomplicated cases, antibiotics may be selective; we decide based on your symptoms and risk factors.
Will I need surgery? Most people do not. Surgery is considered for complications or frequent/severe recurrences.
Can diverticulitis come back? Yes, but many patients have no or few recurrences with time and lifestyle measures.
Alaska‑specific note
We offer telehealth for triage and follow‑ups. If winter roads are unsafe, we’ll reschedule without penalty and coordinate local labs or imaging when possible.
Next steps
If you have persistent left‑lower abdominal pain, fever, or new GI bleeding, contact us. After recovery from a first episode, schedule a colonoscopy in ~6–8 weeks (or sooner if we advise) to complete evaluation and update screening.