Gastroenterology Book



Aka: Diverticulosis, Diverticular Disease, Diverticuli, Diverticulum, Diverticula, Colonic Diverticuli
  1. See Also
    1. Diverticulitis
    2. Diverticular Hemorrhage
  2. Definitions
    1. Diverticulum (Diverticula, Diverticuli)
      1. Small pouch or sac that bulges from the wall of a hollow organ (e.g. Colonic Diverticuli)
    2. Diverticulosis
      1. Colonic Diverticula present on Colonoscopy or imaging
    3. Acute Diverticulitis
      1. Inflammation of a Diverticulum
  3. Epidemiology
    1. Rare in non-developed countries
    2. Diverticulosis Prevalence
      1. Age over 40 years: 10%
      2. Age over 60 years: 50%
      3. Age over 80 years: 70%
  4. Pathophysiology
    1. Characteristics
      1. Colonic Muscle wall is weak where vessels penetrate
      2. Usually multiple Diverticuli present
      3. Size: Usually <10 mm
    2. Distribution
      1. Sigmoid colon
        1. Most common site for Diverticuli in western societies (accounts for 85% of Diverticuli)
      2. Ascending colon (right Diverticuli)
        1. Age <60 years
        2. Asian patients
    3. Protective factors
      1. Vegetarian Diet
      2. High fiber diet
  5. Symptoms
    1. Asymptomatic in 85% of patients
    2. Colicky Abdominal Pain without inflammation in 15%
      1. Relieved with Bowel Movement or Flatus
      2. Worse with eating
      3. Associated with bloating and Constipation
      4. Left lower abdominal tenderness to palpation
    3. Diverticulitis develops in 5% of patients
  6. Differential Diagnosis
    1. Irritable Bowel Syndrome
    2. Colon Cancer
    3. Inflammatory Bowel Disease
    4. Incarcerated Hernia
    5. Mesenteric Ischemia
  7. Diagnosis: Symptomatic Diverticular Disease
    1. Colonoscopy is test of choice
      1. Rules out Colon Cancer
      2. Contraindicated in active Diverticulitis
  8. Management
    1. High fiber diet
    2. Avoid high residue foods (seeds, nuts, corn)
      1. Recommended theoretically to prevent lodging in tics, but has been dispelled as a risk factor
      2. No evidence to support this
    3. Antispasmodic agents have no evidence to support use
  9. Complications
    1. Diverticulitis
      1. Incidence 1.5 to 6 per 1000 person years for those with Diverticula
      2. Affects 1 to 4% of patients with Diverticular Disease (lifetime risk)
    2. Diverticular Hemorrhage
      1. Incidence 0.46 per 1000 person years for those with Diverticula
      2. Most common cause of Lower Gastrointestinal Bleeding
  10. References
    1. Bailey (2022) Am Fam Physician 106(2): 150-6 [PubMed]
    2. Rustom (2018) Inflamm Intest Dis 3(2): 69-74 [PubMed]
    3. Salzman (2005) Am Fam Physician 72:1229-42 [PubMed]
    4. Stollman (1999) Am J Gastroenterol 94:3110-21 [PubMed]

Colon diverticulum anatomic structure (C0012811)

Definition (MSH) A pouch or sac opening from the COLON.
Concepts Anatomical Abnormality (T190)
MSH D004241
ICD9 562.1
English Diverticula of colon, Colonic diverticula, Diverticulum, Colon [Disease/Finding], diverticula colon, diverticula of colon, colon diverticulum, colonic diverticula, diverticulum colon, colon diverticula, Colonic Diverticulum, Diverticulum, Colon, Diverticulum, Colonic, Colon Diverticula, Diverticula, Colon, Colonic Diverticula, Diverticula, Colonic, Colon diverticulum anatomic structure, colon; diverticulum, Colon Diverticulum
Dutch colondivertikels, colon; divertikel, Colondiverticulosis, Colondivertikel, Divertikel, colon-
German Divertikel des Kolons, Divertikel, Kolon-, Kolondivertikel
Portuguese Divertículos do cólon, Divertículo Colônico, Divertículo Cólico, Divertículo do Colo
Spanish Divertículos de colon, Divertículo Colónico, Divertículo Cólico, Divertículo del Colon
Swedish Kolondivertikel
Japanese ケッチョウケイシツ, 大腸憩室, 結腸憩室, 憩室-結腸
Czech kolon - divertikl, Divertikly tračníku
Finnish Koolonin divertikkeli
Italian Diverticoli del colon, Diverticolo del colon
Polish Uchyłkowatość jelita grubego, Uchyłek okrężnicy, Uchyłki jelita grubego
Hungarian Vastagbél diverticulumai
Norwegian Tykktarmsdivertikkel, Divertikkel, tykktarm, Colondivertikkel, Divertikkel, kolon, Kolondivertikkel, Divertikkel, colon
French Diverticules intestinaux, Diverticule colique, Diverticule du côlon, Diverticules du côlon
Derived from the NIH UMLS (Unified Medical Language System)

Diverticulum (C0012817)

Definition (MSH) A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.
Definition (CHV) a pouch in a hollow organ such as intestine
Definition (CHV) a pouch in a hollow organ such as intestine
Definition (CHV) a pouch in a hollow organ such as intestine
Definition (NCI_NCI-GLOSS) A small pouch or sac that bulges out from the wall of a hollow organ, such as the colon.
Concepts Pathologic Function (T046)
MSH D004240
SnomedCT 31113003
English Diverticula, Diverticulum NOS, Diverticulum [Disease/Finding], Diverticulum, diverticulum, diverticulums, diverticula, Diverticulum (morphologic abnormality), Diverticulum, NOS
Italian Diverticoli, Diverticolo NAS, Diverticolo
Dutch divertikel NAO, divertikels, divertikel, Divertikel
French Diverticule SAI, Diverticule, Diverticules
German Divertikel NNB, Divertikelbildung, Divertikel
Portuguese Divertículo NE, Divertículos, Divertículo
Spanish Divertículo NEOM, divertículo (anomalía morfológica), divertículos, divertículo, Divertículos, Divertículo
Japanese 憩室NOS, ケイシツ, ケイシツNOS, ケイシツショウ, 憩室症, 憩室
Swedish Divertikel
Czech divertikl, Divertikl NOS, Divertikly, Divertikl
Finnish Divertikkeli
Croatian Not Translated[Diverticulum]
Latvian Not Translated[Diverticulum]
Polish Uchyłkowatość, Uchyłek
Hungarian Diverticulum k.m.n., Diverticulum, Diverticulumok
Norwegian Divertikkel
Derived from the NIH UMLS (Unified Medical Language System)

Diverticulosis (C1510475)

Definition (MSH) A condition characterized by the presence of multiple diverticuli in the walls of an organ.
Definition (NCI_NCI-GLOSS) A condition marked by small sacs or pouches in the walls of a hollow organ, such as the colon. These sacs can become inflamed and cause a condition called diverticulitis.
Definition (NCI) A finding indicating the presence of multiple pouches, usually in the colonic or gastric wall.
Concepts Anatomical Abnormality (T190) , Disease or Syndrome (T047)
MSH D004240
ICD9 562
ICD10 K57, K57.90
SnomedCT 68047000, 155778008, 197094004, 235772003, 197081001, 197093005, 197116004, 155781003, 197082008, 155780002, 271365001, 31113003, 397881000, 63532004
English Diverticula of intestine NOS, Diverticula of the intestine NOS, Diverticular disease intestine, Diverticular disorder of intestine, Diverticulosis NOS, Diverticulosis unspecified, diverticula of intestine (diagnosis), diverticulosis (diagnosis), diverticulosis, diverticula of intestine, Diverticular disorders, Diverticulum intestinal, Diverticular disease of intestine, Diverticular disease of intestine NOS, intestinal diverticulum, Disease;diverticular;intestine, diverticulum intestinal, Diverticulosis NOS (disorder), Diverticular disease(& [of intestine]), Diverticulosis unspecified (disorder), Diverticular disorder of intestine (disorder), Diverticular disease(& [of intestine]) (disorder), Diverticula of the intestine NOS (disorder), Diverticula of intestine, Diverticular disease, DD - Diverticular disease, Diverticula of intestine (disorder), Diverticular disease (disorder), Diverticulum of intestine, Diverticula of intestine, NOS, Diverticular Disorder, Diverticulosis, diverticular disease
Italian Disturbi diverticolari, Diverticolo dell'intestino, Malattia diverticolare, Diverticoli dell'intestino, Diverticolosi
Dutch diverticulose, divertikelziekte, darmdivertikels, Diverticulose/diverticulitis, darmdivertikel, divertikelaandoeningen, Divertikelziekte, Diverticulosis
French Diverticulite de l'intestin, Maladie diverticulaire, Diverticulose, Affections diverticulaires, Diverticule intestinal
German Divertikelerkrankung, Divertikel des Darms, Divertikulose, Divertikulose des Darmes, Darmdivertikel, Divertikelerkrankungen
Portuguese Divertículos do intestino, Doença diverticular, Diverticulose, Afecções diverticulares, Divertículo intestinal
Spanish Enfermedad diverticular, Divertículos de intestino, Diverticulosis, trastorno diverticular de intestino (trastorno), Diverticulosis NOS, trastorno diverticular de intestino, diverticulosis no especificada, diverticulosis, SAI (trastorno), divertículos intestinales, SAI (trastorno), diverticulosis, SAI, divertículos intestinales, SAI, diverticulosis no especificada (trastorno), diverticulosis, divertículo del intestino (trastorno), divertículo del intestino, divertículo intestinal, enfermedad diverticular (trastorno), enfermedad diverticular, Trastornos diverticulares, Divertículo intestinal
Japanese 憩室疾患, 腸憩室, 憩室症, 憩室性疾患, チョウケイシツ, ケイシツセイシッカン, ケイシツショウ, ケイシツシッカン
Czech Divertikulóza, Divertikl střeva, Divertikly střeva, Divertikulární poruchy, Divertikulární nemoc, divertikulóza
Korean 창자의 곁주머니(게실)병
Hungarian Diverticulosis, Intestinalis diverticulum, Bél diverticulumai, Diverticulum betegségek, Diverticulosisos betegség
Norwegian Divertikulose
Derived from the NIH UMLS (Unified Medical Language System)

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