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Diverticulosis and diverticulitis sound similar, but they describe two very different conditions involving your colon. You may hear the terms after you’ve had a colonoscopy or imaging reports, or your doctor may have mentioned them if you’re experiencing symptoms such as abdominal pain and changes in bowel habits.
Understanding what these terms mean can help you make sense of your results, know what to watch for and understand the steps that can support your digestive health.
Let’s take a closer look.
Your colon is one of the last stops in your digestive system. Its primary function is to absorb water, electrolytes, minerals and essential vitamins from digested food waste in the process of creating solid stool for elimination as a bowel movement.
Small pouches can form in the wall of your colon that push outward through weak spots in its wall. These pouches are called diverticula. If you have them, it’s a condition called diverticulosis.
In some cases, one or more of the pouches can become inflamed, which is called diverticulitis. In medical language, the suffix “-itis” means inflammation. So, diverticulitis is inflammation involving a diverticulum. Let’s take a closer look at these two conditions.
Diverticulosis means you have one or more diverticula, or small pouches, in the wall of your colon. They most often develop in the lower part of the colon and become more common with age, especially in adults over 50.
For most people, diverticulosis causes no symptoms and is discovered during a colonoscopy or imaging of the abdomen or pelvis done for another reason. Seeing diverticulosis on your report does not mean you have an infection, active inflammation or a disease.
Some people living with diverticulosis may experience digestive symptoms such as:
But these symptoms can have many possible causes, so your doctor may need to evaluate them rather than assuming diverticulosis is the reason. Other conditions, including kidney stones, urinary problems and certain gynecologic conditions, can also cause similar abdominal symptoms. In fact, diverticulosis is generally considered to be asymptomatic. But this can change if you develop diverticulitis.
Related: How to prevent kidney stones: 4 simple steps to lower your risk
Diverticulitis occurs when one or more of these small pouches (diverticula) become inflamed. It is most common among adults in their 50s and 60s, but its incidence is increasing among younger people.
A diverticulitis flare-up can cause abdominal pain that is typically felt in the lower-left side of your abdomen. The pain may come on suddenly or start out mild and become worse over several days.
While diverticulitis develops most often on the left side, some people can experience right-sided diverticulitis. This can be confused with other conditions that present on the right side, such as gallbladder disease or appendicitis (inflammation of the appendix).
Other symptoms of diverticulitis include:
Diverticulitis can range from mild to more serious. Your symptoms and a physical exam are important components of diagnosing diverticulitis. Depending on your symptoms and medical history, your doctor may order blood tests or imaging, such as a computed tomography (CT) scan, to look for signs of inflammation and other complications like an abscess, a blockage, a fistula (abnormal connection of the bowel to another part of the body), or a perforation in the colon.
The simplest way to remember the difference is:
In even simpler terms, think of diverticulosis as a finding that usually never causes a problem, while diverticulitis is an active complication of diverticulosis that can cause noticeable symptoms and may require medical treatment.
That distinction between diverticulosis vs. diverticulitis can make the results from your colonoscopy easier to understand. If your report says you have diverticulosis but you feel well, you generally do not need to assume that you are having a diverticulosis flare or that an infection is present.
If you have diverticulosis and no symptoms, you may not need any specific treatment. Your doctor may instead recommend habits that support your overall colon and digestive health such as:
If you have diverticulitis, treatment depends on how severe your symptoms are and whether complications are present. Some people with uncomplicated diverticulitis can manage the condition and recover at home.
Treatment may include temporary changes to what you eat and drink, pain relief and, in some cases, antibiotics.
More serious cases may require treatment in a hospital setting. Complications such as an abscess, intestinal blockage or perforation may require additional procedures or surgery. Colonoscopy is not recommended during a diverticulitis flare-up.
Your diet can be part of a long-term approach to colon health, but you do not need to follow a highly restrictive diet simply because you have diverticulosis or diverticulitis.
Research suggests that eating more fiber and less red meat may lower the risk of diverticulitis. Fiber is found in foods such as:
If you need to increase your fiber intake, do it gradually and be sure you are drinking enough fluids to help your digestive system adjust. Taking a heaping tablespoon (about 10 grams) of a soluble fiber supplement, such as psyllium, can also be beneficial.
You also do not generally need to avoid nuts, popcorn or seeds because you have diverticulosis. Older recommendations often advised avoiding these foods, but research has not shown that they increase the risk of diverticulitis.
Related: The diverticulitis diet: Best foods to eat during a flare-up
A new bout of lower abdominal pain does not automatically mean you have diverticulitis, but certain symptoms deserve prompt medical attention.
Contact your doctor if you have persistent or worsening abdominal pain, especially pain in the lower-left abdomen, or if abdominal pain occurs along with fever, chills, nausea, vomiting or a significant change in your bowel habits.
You should also seek urgent medical care for repeated vomiting, significant weakness or other symptoms that make it difficult to keep fluids down. Heavy rectal bleeding should be addressed immediately since some people can develop bleeding from diverticulosis as well.
If you have already had diverticulitis, your doctor can help you recognize your typical symptoms and make a plan with you on what to do if they return.
The difference between diverticulosis vs. diverticulitis comes down to whether you have pouches in your colon or active inflammation involving those pouches. Diverticulosis is common and causes no symptoms. Diverticulitis can cause abdominal pain and other symptoms and may require treatment.
If diverticulosis shows up on your next colonoscopy report, talk with your doctor about what it means for you and whether any changes to your diet or lifestyle make sense.
If you develop new or worsening abdominal symptoms, get medical advice rather than trying to self-diagnose a potential diverticulitis flare.
Still have questions about your digestive health? Make an appointment with a gastroenterologist to discuss your symptoms.
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