Diverticulosis Seen on Colonoscopy: What Does It Mean?

Diverticulosis seen on colonoscopy means the doctor noticed small pouches, called diverticula, bulging outward through weak spots in the wall of the large bowel. On its own it is a description of the bowel wall, not a diagnosis of infection or inflammation, and most people who have it never get symptoms from it.

It is often found by chance. MedlinePlus notes that diverticulosis may be found when tests are done for another reason, such as a colonoscopy arranged for something else. Reports may say 'diverticulosis', 'diverticular disease' or 'sigmoid diverticula'. The sigmoid colon is the lower part of the large bowel, where NIDDK says the pouches mostly form.

This guide is for adults reading a colonoscopy report that mentions diverticulosis. It explains common terms and helps prepare questions. It cannot judge your own report, explain your symptoms or replace the advice of the team that did the test.

A report that says diverticulosis does not rule out later problems. The NHS advises seeing a GP urgently or contacting NHS 111 (or your local equivalent) if any of the following happen:

• Blood or slime (mucus) in your poo.
• Tummy pain that is getting worse or does not go away.
• A high temperature, or feeling hot, cold or shivery.
• Repeated vomiting and being unable to keep fluids down.
• Diarrhoea for more than 7 days, or being sick for more than 2 days.

Call emergency services or go to an emergency department if someone is bleeding heavily from the bottom, or has severe tummy pain together with vomiting, a swollen tummy, or being unable to poo or pass wind. The NHS also lists confusion, pale or blotchy skin, a very high or low temperature, or fast breathing or breathlessness as possible signs of sepsis that need emergency help.

NIDDK says that if you have bleeding from your rectum, even a small amount, you should see a doctor right away. Diverticular bleeding can be severe. Do not wait for a routine follow-up letter if any of these symptoms appear.

The words sound alike but describe different situations. Diverticulosis means the pouches are there. The NHS uses the term for pouches that are not causing symptoms. Diverticular disease is the term the NHS uses when the pouches cause symptoms such as lower tummy pain, bloating, constipation or diarrhoea.

Diverticulitis means one or more pouches have become inflamed. NIDDK describes its pain as typically severe and sudden, most often in the lower left side of the abdomen, and says it may come with fever and chills, nausea or vomiting. A colonoscopy that shows diverticulosis does not mean you have, or had, diverticulitis.

Diverticular bleeding is a separate complication. NIDDK explains that it happens when a small blood vessel in the wall of a pouch bursts, and it is a common cause of bleeding from the lower digestive tract. Some episodes stop on their own, but others need treatment, and that decision belongs to a clinician.

Yes. The NHS says most people will get some diverticula as they get older, and most will not get any symptoms. NIDDK reports that more than 30% of US adults aged 50 to 59, and more than 70% of those older than 80, have diverticulosis.

Because it is so common, the finding is frequently listed alongside other results on a colonoscopy report. Being common does not make new symptoms unimportant, and it does not explain symptoms that led to the test unless your clinician says so.

The NHS advises a balanced diet with whole grains, fruit and vegetables. If you currently eat little fibre, it suggests increasing it slowly and drinking plenty of water. NIDDK notes that a diet low in fibre and high in red meat may increase the risk of diverticulitis, and that doctors may recommend more high-fibre foods for people with ongoing symptoms or past diverticulitis.

In the past, people were often told to avoid nuts, seeds and popcorn. NIDDK says more recent research suggests these foods are not harmful for people with diverticulosis, and most people do not need to avoid specific foods. The NHS says no specific foods need to be avoided.

Ask before making big changes if you have another bowel condition, a restricted diet or swallowing problems. MedlinePlus also notes that NSAID painkillers may increase the chance of diverticulitis complications, so mention any regular painkillers to your clinician or pharmacist rather than stopping or starting medicines yourself.

Diverticulosis is usually only one line of a report. Check whether the same test also found polyps, took biopsies or recorded anything else, and whether any results are still pending. A note of diverticulosis does not answer those other questions.

If the colonoscopy followed a positive stool test for blood, the guide on a positive FIT result explains that pathway. If symptoms such as diarrhoea continue after an otherwise normal-looking colonoscopy, see the separate guide on that situation rather than assuming diverticulosis is the cause.

Bring the full colonoscopy report, not just a summary line. These questions can help you leave with a clear plan.

• Where in my bowel were the diverticula seen, and how widespread were they?
• Do you think my diverticulosis is linked to the symptoms that led to this colonoscopy, or is it a separate finding?
• Were any polyps removed or biopsies taken, and when will those results be ready?
• Is there anything about my diet, fibre intake or regular medicines that I should review?
• Which symptoms should make me seek urgent care, and who should I contact out of hours?
• Do I need any further follow-up for this finding, or is the next step decided by other results?

On SameCase, patients and verified doctors share de-identified cases. Reading how other people described a report that mentioned diverticulosis, which questions they asked and what their clinicians explained can help you notice what to ask about your own results.

Other people's cases cannot tell you what your report means or whether your symptoms are serious. We encourage you to use them only to prepare questions, and to bring any new or worrying symptoms to a clinician who can examine you.