Which Is Worse: Diverticulitis or Diverticulosis?

Diverticulitis is a condition where the diverticula in the colon are inflamed and infected. Diverticulitis is the condition that develops if your diverticulosis gets worse and you develop additional symptoms.

Diverticulosis is a condition in your gastrointestinal GI tract, usually located in your colon.

Diverticulosis is relatively harmless, but it can develop into a more serious condition called diverticulitis. 

Understanding how one leads to the other is important to preventing either condition from taking hold.

What are diverticulitis and diverticulosis?

Diverticulitis and Diverticulosis can usually be found in your colon. Together, they make up a condition called diverticular disease. 

Both conditions share the common presence of something called a diverticulum. These diverticula are pockets inside your colon walls that can weaken areas in your colon’s lining over time. 

What happens to your diverticula determines whether you have diverticulitis or diverticulosis.

What is diverticulosis?

Diverticulosis simply means that you have the pockets in your colon walls called diverticula. You shouldn’t have any additional complications. 

However, symptoms such as an infection can lead to more serious diverticular diseases. 

What is diverticulitis?

Diverticulitis occurs if your diverticulosis worsens and you develop additional symptoms. 

When the diverticula in your colon are inflamed or infected, then you have diverticulitis. This condition can range from mild to severe. 

Serious cases of diverticulitis require much more intensive surgical procedures. 

Diverticulosis doesn’t have any noticeable symptoms. In fact, most people with diverticulosis don’t even know they have it. 

If you have diverticulosis, you may occasionally experience digestive symptoms like bloating, cramps, or constipation. 

Symptoms of diverticulitis

The symptoms of diverticulitis are more severe than diverticulosis. You may feel them suddenly. These include:

• Lack of appetite
• Nausea and vomiting
• Fever
• Chills
• Bloating
• Gas
• Tenderness in your lower abdomen

What causes diverticulosis?

Doctors don’t really know exactly what causes diverticula to develop and cause your diverticulosis. 

The diverticular spots in your colon are caused by pressure in your colon wall. This is usually the result of straining or muscle spasms. 

Diets without enough fiber produce stool that is difficult to pass. This causes your colon to work harder, which is more likely to weaken its walls. 

What causes diverticulitis?

When your diverticula are inflamed and/or infected, this causes diverticulitis. 

The causes for infections like this are not well known. Doctors think that stool and bacteria get caught in the diverticula, leading to infection.

Certain people are more at risk of developing diverticulitis. Those people can be any of the following:

• Male
• Obese
• Inactive
• Over the age of 50
• Smokers
• Regular users of nonsteroidal anti-inflammatory drugs (NSAIDS)

Only a licensed healthcare professional can diagnose diverticulosis or diverticulitis.

Diagnosing diverticulosis

Since diverticulosis has no obvious symptoms, it’s difficult to diagnose. You may only find out during routine examinations, such as a colonoscopy or x-rays. 

If you start experiencing the symptoms of diverticulosis, your doctor may perform magnetic resonance imaging (MRI) or computerized tomography (CT) scan to check your colon for diverticula.

Diagnosis diverticulitis

Diverticulitis has a genetic component. Your doctor will review your medical history and conduct a physical exam. 

In addition to a colonoscopy, x-rays, MRI, or CT scan, your doctor may request the following tests: 

• Digital rectal exam (DRE)
• Stool sample
• Barium enema
• Sigmoidoscopy

Treating diverticulosis

No treatment is required if you have diverticulosis without any symptoms. 

When symptoms such as bloating or abdominal pain begin to form, your doctor may recommend a high-fiber diet to release pressure in the colon. Otherwise, no treatment is needed. 

Treating diverticulitis

Diverticulitis treatment will be different for everyone. Diverticulitis is usually either acute or chronic. Each requires a different type of treatment. 

Acute diverticulitis treatment is for new and current attacks. Your doctor may prescribe antibiotics to reduce infection in your colon, as well as a change in diet. 

Attacks that are more severe may require hospitalization. These include diverticulitis symptoms such as:

• Drastic changes in blood pressure
• Fever
• High white blood cell count
• No response to antibiotics 

Severe attacks of diverticulitis can cause lasting damage to your colon. 

Abscesses can form when the inflamed diverticula rupture. Mild abscesses can be treated using antibiotics. Severe abscesses require draining through a process called percutaneous drainage.

The types of surgical procedures vary between people and cases. But if acute diverticulitis requires surgery, it’s typically for the following reasons:

• Your colon becomes perforated, which brings on other severe symptoms.
• Abscesses that cannot be drained safely may require surgery. 
• If other therapies and hospitalization do not work, surgery may be suggested.
• Surgery may be required for a person who has a damaged immune system.

Chronic diverticulitis generally requires surgery that involves taking out portions of your colon and reconnecting it. This is typically reserved for when complications occur during an acute attack or if attacks continue. 

Changes in your diet and lifestyle can help prevent future attacks of diverticulitis. These include:  

• Regular exercise promotes regular bowel function and reduces the stress on your colon.
• A fiber-rich diet helps soften stool, allowing it to pass more easily through your colon.
• Drinking an adequate amount of fluid replaces the fluid absorbed by your colon. This prevents constipation and stress on your colon.
• Not smoking, because it increases your risk of contracting diverticulitis.