Diverticular disease and diverticulitis - Diagnosis 

Diagnosing diverticular disease and diverticulitis 

Diverticular disease can be difficult to diagnose from the symptoms alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome (IBS).

As a first step, your GP may recommend blood tests to rule out other conditions such as coeliac disease (a condition caused by an abnormal immune response to gluten).

Colonoscopy

To confirm you have diverticula (small bulges in the side of the colon) the inside of your large intestine (colon) will be looked at. This can be done with a colonoscopy.

During a colonoscopy, a thin tube with a camera at the end (a colonoscope) is inserted into your rectum and guided into your colon. Before the procedure begins, you will be given a laxative to clear out your bowels.

A colonoscopy is not usually painful, but it can feel uncomfortable. You may be offered painkilling medication and a sedative beforehand to make you feel more relaxed and help reduce any discomfort.

Barium enema X-ray

Another technique for confirming the presence of diverticula is a barium enema X-ray. Barium is a liquid that shows up on X-rays. It is used to coat the inside surface of organs that do not show up on X-ray, such as the colon.

As with a colonoscopy, you will be given a laxative to clear out your bowels before you have a barium enema X-ray.

During the procedure, a tube is inserted into your rectum. The barium liquid is squirted into the tube and up into your rectum. A series of X-rays are then taken.

For a few days after having a barium enema X-ray, your stools will appear white and discoloured due to the barium passing out of your body. It is nothing to worry about.

Diverticulitis

If you have had a previous history of diverticular disease, your GP will usually be able to diagnose diverticulitis from your symptoms and a physical examination. A blood test may be taken because a high number of white blood cells indicates infection.

Further tests will be needed if you have no previous history of diverticular disease. This is to rule out other possible conditions, such as gallstones or a hernia.

A barium enema X-ray may be used, as well as a computerised tomography (CT) scan. A CT scan takes a series of X-ray scans, which are then reassembled by a computer to build up a more detailed 3-D image of the inside of your body.

A CT scan may also be used if your symptoms are particularly severe. This is to check whether the infection has spread to other parts of your body or a complication, such as an abscess, has occurred.

Page last reviewed: 11/05/2012

Next review due: 11/05/2014

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The 8 comments posted are personal views. Any information they give has not been checked and may not be accurate.

mwill said on 11 January 2013

I have been suffering symptoms of IBS for a number of years and more recently moderate to severe abdominal pain and cramps in my left side. My doctor refered me to a specialist who in turn refered me to the hospital for a colonoscopy.

I was not given any anesthetic though was offered gas and air which I refused. The procedure was a little uncomfortable and embarassing but the staff were excellent and put me at ease. Although they were able to view most of the colon which appeared fine, I was referred again for a Barium Enema & Xray a couple of weeks later. The most unpleasant part of the procedure for this was the preperation the day before with Picolax. This seems to turn your tummy inside out in order to clear out your digestive system! The procedure was quite uncomfortable as they also fill your colon with air but things returned to normal after about 24 hours, the leaflet said there may be discomfort for up to 36 hours.

I have recently received a letter to say that they have diagnosed Diverticular disease and some "wear and tear" on the left side of my colon. Having read the advice given on this site I will be looking at my diet in the future and increasing my fibre intake.

The main reason I have posted this is to urge anyone who is experiencing symptoms to go to their GP. I have put it off for too long just because I was too embarrased to speak to my doctor. It really is not that bad and at least I know that it is not something more sinister and can be treated to some extent by change of diet.

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Winniegrif said on 25 April 2012

I had the usual symptoms and was offered a colonoscopy. I turned this down in favour of a barium CT scan which as it turned out was a doddle and would recommend as an alternative. It was totally painless and no sedative was needed. I think the only reason this is not offered genrally is probably cost. You can insist on having this procedure. Diverticular was successfully diagnosed and was also given the all clear on anything else.

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huey45 said on 02 December 2011

hi i had what i thought was ibs, but after a recent colonoscopy examination, my consultant confirmed it was diverticular disease, i had had a colonoscopy examination 10 yrs previous to this but it was not disclosed to me at the time, that i had diverticular disease, but no matter...my main symptoms are large amounts of wind, both ends of body, severe bloating of adomen, looking like im 8 months pregnant,
frequent visits to toilet to empty my bowels, then revisits feeling im not empty.. and terrible itching around and inside my rectum...

i am taking 1 tablet of fybergel nightly+ 1 senokot tablet nightly and have increased my fibre intake this seems to help a little, and cutting down on spicey foods, curries, chillies etc...i hope this helps with other sufferers

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Terry H said on 24 October 2011

I have had what I thought was IBS for a number of years, however I went for a colonoscopy 3 weeks ago and had to take the Piolax and Clean Prep mixtures the day before.. I was told that I had a small ulcer and diverticulitis.... However ever since then, I have had more stomach craps and loose stools ever since. I use to go to the loo once a day, now I am wanting to go more often... I am worried what is going on??
The colonoscopy was no trouble at all, but the day after the procedure I have been like this ever since.
I am now starting to worry!!

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User556069 said on 17 May 2011

Colonoscopy is very rarely done under local anaesthetic and is rather done with the use of a sedative such as midazolam. Although this does somewhat relax the patient during the procedure, they remain conscious. In most cases it is quite uncomfortable and in some it can be painful enough to stop the procedure. I think this should be made clearer on this page. The benefit of the midazolam is that you are likely to forget the procedure afterwards but this is not always the case and some do remember the pain.

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bowelman said on 02 December 2010

I AM A 66 YEAR OLD MALE, RECENTLY RESIDENT IN FRANCE. FOR SEVERAL YEARS I HAVE GONE TO UK DOCTORS WITH LEFT SIDE ABDOMINAL PAIN, AND NO REASON FOUND. IN FRANCE, MY OPINON OF DOCTORS IS NOT SO HIGH, BUT AN ULTRASOUND REVEALED IMMEDIATELY PLENTY OF DIVERTICULA AND A POSSIBLE PROBLEM.ALSO, TREATMENT INITIALLY WITH NIFUROXAZIDE OR EQUIVALENT. CAN I SUGGEST THIS IS A BETTER STARTING POINT THAT COLONOSCOPY, WHICH IS OFTEN UNPLEASANT?

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Anan said on 14 November 2010

This page and others on colonoscopies say that the procedure is not painful because it is done under sedation or local anaesthetic. I had a colonoscopy recently under sedation and the examination had to be stopped because it was causing me, in the consultant's words, "severe pain". Why not acknowledge the possibility and explain what will happen in such a case?

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grd 88 said on 01 November 2010

In paragraph 1 you say, 'irritable bowel syndrome (IBS), a common but poorly understood condition that causes inflammation of the bowel' - this is incorrect: IBS does not cause inflammation of the bowel, as you acknowledge in the IBS pages. I think your writer is confusing IBS with IBD - Inflammatory Bowel Disease, which is a different condition.

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CT scan

A CT scan uses a series of X-rays to produce very detailed pictures of the inside of your body