Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 15-36: Diverticular Disease of the Colon + Key Features Download Section PDF Listen +++ ++ Incidence increases with age in Western societies 5% at age < 40 30% at age 60 50% at age > 80 Uncommon in developing countries Most are asymptomatic, discovered incidentally at endoscopy or on barium enema Causes Diet deficient in fiber Ehlers-Danlos syndrome Marfan syndrome Scleroderma The extent to which abnormal motility and hereditary factors contribute to diverticular disease is unknown + Clinical Findings Download Section PDF Listen +++ ++ Nonspecific complaints Chronic constipation Abdominal pain Fluctuating bowel habits Whether these symptoms are due to alterations in the colonic motility, visceral hypersensitivity, gut microbiota, or low-grade inflammation is unclear Physical examination usually normal May reveal mild left lower quadrant tenderness Complications occur in 33%, including lower GI bleeding and diverticulitis + Diagnosis Download Section PDF Listen +++ ++ Routine laboratory studies normal Diverticula best seen on barium enema and CT imaging Colonoscopy less sensitive than barium enema + Treatment Download Section PDF Listen +++ ++ High-fiber diet or fiber supplements (bran powder, 1–2 tbsp twice daily orally; psyllium or methylcellulose) When diverticulosis-associated lower GI bleeding occurs, more than 95% of cases require < 4 units of blood transfusion