Probability of Developing Diverticulitis

Diverticulosis (the presence of small pouches in the colon wall) is extremely common, affecting about 35% of adults under 50 and more than 50% of those over 60 in Western countries. Of those with diverticulosis, approximately 10-25% will develop diverticulitis at some point, an inflammation or infection of the pouches. This makes the overall lifetime risk of diverticulitis about 5-10%.

Diverticulitis typically presents with left lower abdominal pain, fever, nausea, and changes in bowel habits. Complicated diverticulitis (involving abscess, perforation, fistula, or obstruction) occurs in about 15-20% of diverticulitis episodes and may require hospitalization or surgery. About 200,000 hospital admissions per year in the US are for diverticulitis.

Risk factors include age, low-fiber diet, obesity, smoking, physical inactivity, and NSAID use. The traditional advice to avoid nuts, seeds, and popcorn has been debunked by research showing no association with diverticulitis risk. Treatment for uncomplicated diverticulitis has evolved: recent studies suggest that antibiotics may not be necessary for mild cases, and a "watch and wait" approach may be appropriate. About 15-30% of patients have recurrent episodes, and elective surgery is considered for those with frequent recurrences or complications.