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Diverticular Disease

Diverticula are small, protruding pouches that occur in the gastrointestinal tract. They are most common in the large intestine, often forming in the last part of the colon (termed the sigmoid colon because of its ‘S’ shape). Over many years, high pressure inside the colon can cause a weakness in the intestinal wall, resulting in a diverticulum.

Diverticula are common in adults. Most patients never have any symptoms and do not develop diverticulitis. However, in some instances, one or more diverticulum becomes inflamed, leading to diverticulitis. Colorectal surgeons at the University of Chicago Medicine are skilled in evaluating the presence of diverticular disease, as well as providing medical and surgical treatment options.


Depending on the severity of the inflammation, symptoms may be very mild or more severe. General symptoms of diverticulitis include fever, abdominal pain, cramping and change in stool. Abscess, perforation, and sepsis, or a severe abdominal infection called peritonitis, may be more serious signs of diverticulitis.

We do not know exactly what causes some patients to develop diverticulitis. A diet very high in fiber can reduce the risk. Foods such as popcorn, nuts, and seeds were traditionally thought to contribute to diverticulitis, but this has been shown not to be true.

Uncomplicated Diverticulitis: Patients with uncomplicated diverticulitis often have mild symptoms that can be managed with a course of oral antibiotics at home. In some instances, hospitalization and intravenous antibiotics may be required. These episodes can recur, however, patients who have a mild form very rarely develop more serious disease later on, and surgery usually is not required.

Complicated Diverticulitis: Complicated diverticulitis means the inflammation and infection has progressed to form an abscess or free perforation. Patients with complicated diverticulitis usually require hospital admission and intravenous antibiotics. If a larger abscess is present, it may require drainage with a small drain placed by interventional radiology. In rare circumstances when a patient is very ill or is not responding to antibiotics, urgent surgery is required and a portion of the colon may be removed.

Other complications related to diverticulitis include intestinal obstruction and fistula formation. A fistula is a connection from one organ to another, or to the skin. Patients with fistula formation from diverticulitis eventually require surgery to treat the problem. Due to these potential complications, it's important to see a colorectal surgeon who has experience in diagnosing and treating diverticulitis, as well as other disorders of the gastrointestinal tract. Our team of fellowship-trained experts will work with you to create a comprehensive care plan and answer any questions you may have.