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NICE guideline: Diverticular disease: diagnosis and management

For Diverticular disease and diverticulitis and Thrombophilia

The National Institute for Health and Care Excellence (NICE) have published a guideline on the diagnosis and management of diverticular disease.

Diverticular disease: the care you should expect
Diverticular disease affects the large intestine (bowel). As people get older, small bulges called ‘diverticula’ can develop in the lining of their intestine. These are very common and don’t usually cause any symptoms. But in a few people they can cause symptoms like abdominal pain, bloating and bleeding from the rectum (bottom). Rarely they can lead to complications like infections, abscesses or blockages in the intestine.

We want this guideline to make a difference to people with diverticular disease by making sure:
  • people get the right diagnosis straightaway and their symptoms are not mistaken for other bowel conditions
  • people get better advice on controlling their symptoms by making lifestyle changes
  • antibiotics are only offered when they’re really needed
  • people are referred quickly if they have complications that need urgent treatment.
The guideline covers:
  • Diverticulosis
  • Diverticular disease
  • Acute diverticulitis

About diverticular disease and diverticulitis
Diverticular disease and diverticulitis are related digestive conditions that affect the large intestine (bowel).

Diverticula are small bulges or pockets that can develop in the lining of the intestine as you get older.

Most people with diverticula don't get any symptoms and only know they have them after having a scan for another reason.

When diverticula cause symptoms, such as pain in the lower tummy, it's called diverticular disease.

If the diverticula become inflamed or infected, causing more severe symptoms, it's called diverticulitis.

You're more likely to get diverticular disease and diverticulitis if you don't get enough fibre in your diet.

Symptoms of diverticular disease include:
  • tummy pain, usually in your lower left side, that tends to come and go and gets worse during or shortly after eating (emptying your bowels or passing wind eases it)
  • feeling bloated
  • constipation, diarrhoea, or both
  • occasionally, mucus in your poo
If your diverticula become infected and inflamed (diverticulitis), you may suddenly:
  • get constant, more severe tummy pain
  • have a high temperature of 38C or above
  • feel sick or vomit
  • feel generally tired and unwell
  • get blood in your poo or bleeding from your bottom (rectal bleeding)

NHS website for diverticular disease
Contains public sector information licensed under the Open Government Licence v3.0.
Accessed 28/11/19
Links available in External Resources

© NICE [2019]

Diverticular disease: diagnosis and management. NICE guideline [NG147]. Published date: November 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.

NICE guideline: Diverticular disease: diagnosis and management

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