How is diverticulitis diagnosed?


The development of ‘diverticulitis’ implies inflammation of the segment of the colon (usually sigmoid colon) affected with diverticulosis (or diverticular disease). The acute episode is usually diagnosed based on the clinical findings of abdominal pain and tenderness combined with a CT scan of the abdomen that reveals the findings of inflammation of the colon. Once the inflammation has resolved, a colonoscopy is usually performed to evaluate the colon primarily to rule out the presence of other conditions particularly cancer that may mimic diverticulitis.

Patients presenting with history of left lower quadrant abdominal pain (maybe generalized or right sided pain), change in bowel habit (diarrhea or constipation), nausea, vomiting, fever, tenderness on abdominal exam (guarding/rebound tenderness indicative of peritoneal signs/complicated diverticular disease) should be suspected to have acute diverticulitis. They may have leukocytosis and elevated inflammatory markers such as C reactive protein.

The best modality to diagnose and stage acute diverticulitis is a CT scan of the abdomen and pelvis with (oral, rectal or intravenous) contrast. It has the best specificity and sensitivity and provides additional information regarding complicated diverticular disease-presence of colon perforation or an abscess or involvement of other organs. Colonoscopy is contraindicated if acute diverticulitis is suspected which can lead to perforation from air insufflations during the procedure.

Muslim Atiq, MD
Diverticulitis, inflammation of diverticula (pouches in the intestine), is diagnosed by examining the abdomen for tenderness, drawing a blood test to check for infection, and ordering an imaging test, like a CT scan, to visualize the diverticula for inflammation or infection.

Because the most common symptom of diverticulitis is severe abdominal pain, most doctors will have to rule out other causes of abdominal pain before deciding on a diagnosis of diverticulitis. The doctor may order a CT scan, which is similar to an X-ray, of your internal organs. A CT scan can show the presence of infected sacs on the intestine wall, which is a cause of diverticulitis. Your doctor may also order blood tests and may also touch the area that hurts. Some people become aware that they are at risk for diverticulitis during routine colonoscopies.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.