Diverticulosis vs. Diverticulitis – What’s the difference?

Diverticulosis is a condition where small pockets or sacs form along the colon wall. According to the American Gastroenterological Association, about half of people have diverticulosis by age 50. The exact cause of diverticulosis is unclear. Studies are mixed on the effects of fiber in the diet, and genetics are thought to play a factor.

Most patients with diverticulosis do not have symptoms, and it’s often discovered during a colonoscopy or a CT scan done for another reason. These pockets are usually located in the left colon. When there are large number of pockets in this colon segment, some patients may have symptoms such as cramping (especially in the lower part of the belly) and/or a change in bowel habits that can result in either diarrhea or constipation.

When these pockets become infected or swollen, the diagnosis then becomes diverticulitis.

Diverticulitis typically affects people later in life – ages 60 and older – and is seen a bit more in men than in women. While having these pockets is common, only 2-5% of patients with diverticulosis will develop diverticulitis. Antibiotics may be prescribed to treat diverticulitis and most people recover quickly. If the infection is left untreated, these pockets in the colon wall can form abscesses and would need to be drained or addressed with surgery.

Contrary to popular belief, eating seeds, nuts or popcorn does not cause diverticulitis. In fact, patients who eat a high-fiber diet that can contain these foods have a lower risk of having more severe cases of infection.

After a first episode of a diverticulitis infection, a colonoscopy is often recommended to make sure there is no other reason for the infection occurring, such as cancer. This is a rare cause.

To summarize: Diverticulosis (colon pockets) is common; diverticulitis (pocket infection) is less common. Getting evaluated for your symptoms is important to diagnose an infection early before it has the potential to become more serious. Be as specific as possible when discussing symptoms with your doctor. Going to an emergency department is recommended if pain is severe, if you have a fever or if there are any other new or concerning symptoms.

For additional information, check out the the Diseases & Disorders section of our webpage at Diseases.aspx.