How Doctors Diagnose Diverticulosis

Medically Reviewed By William C. Lloyd III, MD, FACS
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doctor talking to patient before ct scan

Diverticulosis is a condition that occurs when small sacs, called diverticula, form along your colon wall. Usually, they are found towards the end of your colon close to your rectum. This is the sigmoid colon. Diverticulosis is common and experts estimate that at least half of adults in the western world older than 60 years have at least one diverticulum. Many people who have diverticulosis don’t know it because the condition doesn’t always cause symptoms, and only about 20% of people with diverticulosis go on to develop complications.

Accidental Diverticulosis Diagnosis

It isn’t unusual for people to learn they have diverticulosis by accident. Many times, doctors performing examinations for other issues, such as a routine colon cancer screening, find diverticula. An undiagnosed medical condition discovered by accident is called an incidental finding.

Your risk of developing diverticulosis may increase if you are overweight or you regularly consume a low-fiber diet, so exercise and weight maintenance or weight loss are often recommended when diverticula are found.

Diverticulosis symptoms, such as cramping and diarrhea, are oftentimes mistaken for other bowel problems. Symptoms are more likely to affect people who have diverticulitis, which is when a diverticulum becomes inflamed and possibly infected. This condition can be very painful.

Diverticulitis symptoms may include:

  • Abdominal cramping
  • Tenderness in the lower part of the abdomen, particularly on the left
  • Fever
  • Chills
  • Diarrhea
  • Constipation

Diagnosing Diverticulosis

Doctors diagnose diverticulosis if they find diverticula by one or more tests. You might undergo one of these tests:

  • Colonoscopy: A long, flexible tube with a camera on one end is inserted through your rectum and advanced through the colon. Images sent to a screen allow the gastroenterologist to see the colon wall.
  • Barium enema: A liquid, barium, is injected into your colon by enema. X-rays of your colon show the barium and any irregularities along the colon wall.
  • Video capsule endoscopy: To perform this test, you must swallow a vitamin-sized capsule that contains a camera. This camera takes photos as it travels through your gastrointestinal tract, also providing images of the colon wall where there may be diverticula.
  • CT (Computed tomography) scan: A CT scan uses X-rays (ionizing radiation) and a computer software program to provide more detailed images than X-rays alone. CT scans show if there are inflamed diverticula. You may have to swallow a contrast an hour before the examination. A contrast is a liquid that can be seen by X-ray. This allows the gastroenterologist to have a better view of the colon wall. By swallowing the contrast in advance of the test, it will be in your colon during the CT scan.

Diverticulosis is a common condition that is most often benign and not causing any symptoms. If you believe you may have diverticulosis, speak with your doctor to see what tests may be necessary. Your doctor can recommend ways to prevent diverticulitis and treatment options if you develop it.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 2
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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