History: Individuals with diverticulosis often are asymptomatic, but some may complain of colicky pain in the lower left side of the abdomen that is relieved by a bowel movement. Other symptoms may include constipation, gas pains, bloating, and upset stomach; less frequently, diarrhea may occur (Cunha). Painless rectal bleeding (hemorrhage) occurs in up to 25% of individuals (Joffe). Individuals with diverticulitis may complain of persistent fever and acute pain (mild or severe) localized to the lower left side of the abdomen. They also may report changes in bowel habits, abdominal tenderness, extended periods of constipation or increased frequency of defecation. Other symptoms of diverticulitis include nausea, vomiting, painful urination, and/or increased urinary frequency.
Physical exam: Exploration of the abdomen with hands and fingers (palpation) may reveal a firm, tender section of colon that lies immediately before the rectum (sigmoid colon). Examination also may reveal a distended abdomen that is resonant or drum-like in tone (tympanic). With diverticulitis, palpation over the left lower quadrant of the abdomen produces pain and sometimes may reveal a tender mass in the abdomen. The individual also may respond to abdominal palpation by contracting (guarding) the abdominal muscles. Decreased bowel sounds may be noted in individuals with diverticulitis. The individual may report tenderness when the examiner inserts a gloved finger into the rectum (digital rectal examination) to assess possible causes of bleeding and pain (Cunha).
Tests: Tests for diverticulosis or diverticulitis include a complete blood count (CBC) with differential, urinalysis and urine culture, occult blood testing of the stool. Barium enema x-rays may be done after recovery from an episode of presumed acute diverticulitis to verify that colon cancer was not the actual cause of the illness. Barium enema x-rays are not generally done during an episode of presumed diverticulitis. Abdominal x-rays may reveal perforation of the diverticulum (free air in the abdomen). Computed tomography (CT) of the abdomen and pelvis may be useful in diagnosis. A flexible, fiberoptic viewing scope (endoscope) can be inserted through the anus and into the colon (sigmoidoscopy or colonoscopy) to assess for bleeding or strictures. X-rays may be taken following injection of a radiopaque dye into a vein (intravenous pyelogram) to rule out other conditions that produce symptoms similar to diverticulosis and/or diverticulitis (e.g., left ureter stone or colovesical fistula).
Source: Medical Disability Advisor