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What are the Risks and Complications of Diverticulitis?

Though there is thought to be a genetic component linked to diverticulitis, research points to diet and lifestyle as the primary cause. Diverticulitis was first reported in the U.S. in the early 1900s, when processed foods with little to no fiber were becoming the norm in the American diet. Diverticulitis is still relatively unknown in areas where low fiber processed foods are unavailable. Known contributing factors are:

  • A diet lacking fiber
  • Genetic factors
  • Lack of exercise
  • All three considering the diet and lifestyle inherent in our modern world.

Leading Factors for those with Diverticulitis:

  • A low-fiber diet is the highest risk factor. Worse in industrialized nations, the low-fiber diet causes slow progress and excess colon pressure.
  • High fat and high beef diets also contribute to diverticular disease.
  • Aging leads to a change in the breakdown of collagen and a decrease in peristaltic action.
  • Weakening of the walls of the colon can be a contributing factor. It is speculated that the overuse of antibiotics contributes to the weakening in the bowel wall, increasing the need for pre- and probiotics (see Healthy Bowel Support).
  • Previous corticosteroid anti-inflammatory therapies have shown to increase risk.
  • Smoking increases the risk of Diverticulitis and complications associated with it.


About 3000 people die each year in the U.S. from Diverticulitis or related complications and there are a number of complications associated with it. It is 3 times more common in males and more common after age 50. Those most at risk include those who eat a low fiber diet, those who eat a high fat diet (especially from red meat), and those who do not exercise regularly or are obese.

Complications can include:

Abscesses: An abscess occurs when infection/pus collects in a confined area. With diverticulitis, it is generally inside the little sacks or pouches called diverticuli. The abscess needs to be treated either orally or drained through the abdominal wall, which can become serious. If leaking occurs and infection spreads into the abdominal cavity it is called peritonitis, which needs immediate surgery to clean the abdominal cavity and remove the infected part of the colon as it can be fatal.

Bleeding: Bleeding from diverticulitis is rare but is sometimes severe. If it stops by itself, no treatment is needed. It happens when a blood vessel in a diverticulum weakens and ruptures. In the rare case that the bleeding does not stop, surgery may be necessary.

Fistulas: A fistula is an abnormal opening or passageway that happens when damaged tissue comes into contact with each other and connects when healing. In diverticulitis, it is a rare condition that usually occurs when the swelling in the intestine presses against other organs and connects to them. When this happens, it is usually between the bladder and the colon and affects men more than women. This may cause chronic infection of the urinary tract and usually necessitates surgery to remove the fistula and the affected part of the colon.

Obstructions: Scarring may occur due to infection and can be mild to severe. In some cases, it may lead to an obstruction in the bowel, necessitating emergency surgery.