Diverticulitis and Your Colon

Food is digested and nutrition absorbed in the twenty feet of small intestine. This is the long, thin segment of bowel that begins at the stomach and ends in the right lower abdomen. After the digestive process is complete, the liquid waste enters the five feet of large intestine, or colon, which ends in the rectum. Just above the rectum is the sigmoid (s-shaped) part of the colon where diverticulitis usually occurs. About two gallons of liquid stool enters the right colon each day where excess water is purified and recycled back into the blood stream. The remaining solid waste, or stool, eventually enters the rectum where the waste is stored until it is convenient to have a bowel movement.

What is Diverticulitis?

Diverticulitis is a condition that affects the large intestine, or colon. A normal colon is strong and relatively smooth. A colon affected by Diverticulitis has weak spots in the walls. These defects allow the development of balloon-like sacs or outpouches – much like a bubble forming on a worn inner tube. These hollow pouches, – about the size of a large pea – called diverticular, occur when the inner intestinal lining has pushed through weakened areas of the colon wall. A single pouch is called a diverticula. Although Diverticulitis can occur anywhere in the colon, 80% are found in the lower left side – called the sigmoid colon – because that is where the colon is the narrowest and the inner pressure the highest. The presence of these pouches on the colon is called Diverticulitis. When the pouches are inflamed or infected, it is called diverticulitis.

What are the complications of Diverticulitis?

Diverticula usually don’t cause any symptoms unless they become inflamed or infected. In fact, most people with Diverticulitis experience no symptoms at all. However, complications do occur and can be serious. These may include abdominal pain, rectal bleeding, and diverticulitis.

Abdominal Pain

Most diverticular pouches are painless. But, if you have enough of them, they can cause thickening and narrowing of the sigmoid colon. This results in painful spasms in the lower left part of the abdomen. When Diverticulitis is far advanced, the lower colon may become narrowed and distorted. When this occurs, there may be thin or pellet-shaped stools, persistent bouts of constipation, and an occasional rush of diarrhea.

Rectal Bleeding

Bleeding occurs from a ruptured blood vessel in one of the pouches. This may produce a gush of red blood from the rectum or maroon-colored stools. The bleeding is usually self-limited and stops on its own, but requires careful evaluation and usually a brief hospitalization. Occasionally, emergency surgery is necessary to stop the loss of blood.


Diverticulitis is a complication of diverticulosis. The colon is home to many beneficial bacteria – helpful as long as they stay within the colon. Sometimes, one of the diverticular pouches becomes thin and ruptures allowing bacteria normally contained inside the colon to seep out through the wall and cause infection on the outside of the colon. When this occurs, it is called diverticulitis. Diverticulitis can be mild with only slight discomfort in the left lower abdomen – or it can be extreme with abscess formation, severe tenderness and fever.

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