Colitis, diverticulitis and diverticulosis

Terms like colitis, diverticulitis, diverticulosis and irritable bowel syndrome, spastic colon can be confusing. Colitis, diverticulitis, IBS, irritable bowel syndrome, spastic colon although different are often used interchangeably by some people. Colitis means inflammation of the colon or large intestines. Colitis may be acute or chronic and may occur due to infections, drugs, toxins, ischemia, radiation therapy etc. Colitis may also be a manifestation of chronic IBD or idiopathic inflammatory bowel disease (ulcerative colitis and Crohn’s disease).

Diverticulosis is the presence of divertculi (plural for diverticulum), usually in the colon. The colonic divertculosis is very common in the western society presumably because of lack of fiber in diet. As many as 50% or more may have colonic diverticulosis by the age of 50 years and this number may exceed 80% by the time one reaches the age of 80 years. Usually these diverticuli are asymptomatic and an incidental finding on barium enema or colonoscopy. In a minority of cases, they may cause complications such as diverticulitis and bleeding etc which may even become life-threatening.

Diverticulitis occurs as a result of micro-perforation in the colon at the site of diverticulum. It is usually on the left side of colon and usually contained giving rise to localized infection and inflammation. This usually responds to medical measures including antibiotics. At times, such a perforation may form an abscess, cause bacteremia and become even become life-threatening. Surgery may be needed in severe cases.

Diverticular bleed occurs more commonly from right sided diverticulosis. It is usually painless and massive and usually requires hospitalization and blood transfusions. Majority of such bleeds stop spontaneously. Recurrent cases may need suregry.

Do you or someone you know has colitis or diverticulosis? What has been your experience with these terms? Please share your thoughts.