Understanding the Stages of Diverticulitis

Diverticulitis is a gastrointestinal condition that is characterized by inflamed or infected pouches, or diverticula, in the digestive system. These pouches are most often found in the large intestine (colon). These diverticula are relatively common in people over the age of 40, however, when they become inflamed or infected they can cause severe abdominal pain and other unpleasant symptoms.

The treatment for diverticulitis depends on what stage the condition is in. Mild diverticulitis can be treated with a simple diet change or antibiotics, but the more severe stages often require surgery done by a diverticulitis specialist.

Stages of Diverticulitis

There are four stages of diverticulitis according to the Hinchey classification:

  • Stage I: Diverticulitis with phlegmon or localized pericolic or mesenteric abscess. This means there are inflammatory masses or abscesses in the fat surrounding the colon or the folds of the small intestine.

  • Stage II: Diverticulitis with walled-off pelvic, intra-abdominal, or retroperitoneal abscess. This means that the abscesses of pus or infected fluid are walled off in the area outside of the peritoneum or in the intra-abdominal space.

  • Stage III: Perforated diverticulitis causing generalized purulent peritonitis. This means that the abscesses have burst and the inflammation is discharging pus into the abdomen.

  • Stage IV: Rupture of diverticula into the peritoneal cavity with fecal contamination causing generalized fecal peritonitis. This means the abscesses have ruptured into the peritoneal cavity and the rupture has led to the presence of feces in the peritoneal cavity causing an infection.

According to Dr. Francisco Itriago MD

If the diverticula are ruptured, then the patient may require surgical removal of part of the sigmoid colon, but mild cases are usually treated with a clear liquid diet and antibiotics.

For instance, Stage III and IV diverticulitis have ruptured abscesses that would most likely require surgery, but Stage I and II do not.


Diverticulitis Statistics

By the age of 60 around 50% of Americans have or have had diverticulosis. What causes diverticulitis? Well, diverticulosis is simply the presence of abscesses or pouches (diverticula) in the wall of the colon; diverticulosis is different from diverticulitis in that the abscesses in diverticulosis do not cause symptoms. However, 10% to 25% of people with diverticulosis develop diverticulitis.

Diverticulitis is more likely to develop in people with low fiber diets and consume a lot of red meats. These types of diets are most often found in developed countries such as the U.S. In fact, people in countries where vegetable-rich, high fiber diets are the norm rarely develop diverticulitis.

Among people ages 50 and older, women are more likely than men to develop diverticulitis, however, men are more likely to develop it before age 50. Almost everyone over the age of 80 has diverticulosis, but not all of these people have diverticulitis.

Diverticulitis is the cause of around 3,000 deaths per year in the United States, and an estimated 2 million people in America have diverticulitis.

Other Information on Diverticulitis:

If you have diverticulitis, then you should see a diverticulitis doctor at once, as the condition is serious and most likely requires medical attention and possibly even surgery. Symptoms include abdominal pain, fever, nausea, vomiting, chills, tender abdomen, cramps, constipation, blood in the stool, and rectal bleeding.