Diverticular Disease

6 November 2025

Diverticular disease occurs when small pouches (diverticula) form in the wall of the large bowel. Many people have diverticulosis without symptoms; diverticular disease causes abdominal discomfort or bowel changes, and diverticulitis is when a pouch becomes inflamed or infected.

At The New Foscote Hospital, you’ll receive consultant-led assessment, appropriate tests, and—when indicated—onsite colonoscopy to confirm the diagnosis and rule out other conditions.

Symptoms

Left-sided lower abdominal pain (often crampy)
Bloating, wind, or changes in bowel habit (constipation, diarrhoea, or both)
Mucus in the stool
Rectal bleeding (usually small amounts, bright red or maroon)
Fever and more constant, localised pain during diverticulitis

Urgent red flags – seek immediate medical help (999/A&E):

Severe or worsening abdominal pain with fever
Persistent vomiting, inability to pass wind or stool
Heavy rectal bleeding, black or tarry stools
Signs of shock (pale, clammy, dizzy, fainting)

Diverticulosis, Diverticular Disease & Diverticulitis: What’s The Difference?

Diverticulosis: pouches in the bowel wall with no symptoms.
Diverticular disease: symptoms such as pain or bowel change are present.
Diverticulitis: an inflamed/infected pouch causing more intense pain, fever and tenderness; sometimes complications (abscess, perforation, fistula or stricture).

Causes And Risk Factors

Ageing bowel wall elasticity
Low-fibre diet and constipation
Obesity and inactivity
Smoking
Certain medicines (e.g., NSAIDs, steroids)
Family history (less commonly)

Diagnosis At New Foscote Hospital

Your consultant will take a focused history and examination and may recommend:

Onsite colonoscopy to confirm diverticular disease, assess extent, and exclude other causes (polyps, cancer, colitis). Biopsies taken when appropriate.
Blood tests (infection, anaemia, inflammation).
CT scan during suspected acute diverticulitis or to evaluate complications (arranged where clinically appropriate).
Stool tests in selected cases.

Endoscopy – Colonoscopy
Imaging & Diagnostics
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Treatment

Diverticulosis / Diverticular Disease (no acute infection)

Dietary fibre: gradually increase wholegrains, fruit and vegetables; consider supplemental fibre if advised.
Hydration and regular physical activity.
Targeted medications: antispasmodics for cramps; simple analgesia (avoid unnecessary NSAIDs—seek prescriber advice).
Address constipation with clinician-recommended laxatives and lifestyle measures.

Diverticulitis (inflamed/infected)

Managed according to severity:
- Mild: oral antibiotics (when indicated), rest, fluids and a short period of a modified diet before returning to normal fibre.
- Moderate–severe or complicated: hospital care for IV antibiotics, imaging, and possible drainage of abscesses.
After recovery, a follow-up colonoscopy may be advised if you haven’t had recent bowel assessment.

When Is Surgery Considered?

Recurrent complicated diverticulitis
Stricture, fistula, persistent symptoms not responding to treatment
Perforation or uncontrolled bleeding (urgent surgery in an acute setting)

Your consultant will discuss individual risks, benefits and recovery expectations.

Recovery And Prevention

Re-introduce and maintain adequate fibre and fluids after an acute flare settles.
Keep active and maintain a healthy weight.
Review regular painkillers with your prescriber; limit NSAIDs where possible.
Attend recommended surveillance or follow-up appointments.

When To Seek Specialist Help

Book an assessment if you have:

Ongoing left-sided abdominal pain or bowel habit change
Rectal bleeding or unexplained anaemia
Recurrent episodes of suspected diverticulitis
Concerns about long-term symptoms or complications

Early investigation provides clarity and a tailored plan.

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