What Is Diverticular Bleeding and What to Do About It

"Diverticulitis" is the term for the existence of diverticula, which are bulges in the lining of the large intestine. Most people with diverticulitis don't experience symptoms, but diverticular bleeding may occur when blood vessels in these bulges break. Diverticular bleeding is usually painless, but it may cause heavy bleeding from the rectum. Complications may develop depending on how severe the bleeding is.

This article covers the symptoms and complications of diverticular bleeding, diagnosing and treating diverticular bleeding, and when to get help.

What Are Diverticulitis Signs and Symptoms?

Many people who have diverticulitis don't experience symptoms. For those who do, symptoms can include:

• Intense stomach pain that can happen over time or suddenly
• Constipation and/or diarrhea
• Cramps and bloating
• Stomach pain with vomiting, fever, constipation, or diarrhea
• Large amounts of blood in the stool
• Blood in the rectum

Complications

When diverticulitis exhibits symptoms, getting treatment can be important, as complications could worsen the condition. Untreated diverticulitis could result in:

• Diverticular bleeding
• Pain while urinating or urinating more frequently
• Abscess (pus-filled bump) in the colon
• Fistula: Damaged tissue that connects to tubes
• Peritonitis: A stomach lining infection
• Perforation: Hole in the colon
• Intestinal obstruction: Scarring of the intestines, which can make digestion and bowel movements difficult

How Is Diverticular Bleeding Diagnosed?

Diagnosing diverticular bleeding can require ruling out other causes of rectal bleeding. Diagnosis can require visiting a healthcare professional for the following:

• Discussing medical history
• Undergoing a physical examination
• Angiography (or arteriography): An X-ray of blood flow that can detect clots and tears in blood vessels
• Colonoscopy: A long tube with a camera attached that's inserted into the colon, through which a healthcare provider views inside of the colon to look for bleeding
• Technetium-labeled red blood cell bleeding scan: Blood that's drawn and then mixed with a radioactive chemical called technetium that's inserted back into the patient to detect concentrations of technetium to indicate active bleeding

Treatment

If you experience rectal bleeding, it's advised to see a healthcare professional as soon as possible in the event you need a blood transfusion.

Diverticular bleeding treatment can include:

• Waiting for the bleeding to stop on its own (after speaking with a healthcare professional)
• If bleeding is excessive, getting medical attention to replace the blood
• Intravenous (IV) fluids
• Blood transfusion
• Medications via injections
• Surgery to remove the infected part of the colon (colectomy)

Diverticulitis could be treated with:

• Increased fiber intake
• Tylenol (acetaminophen) for pain management, avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, as they can irritate the stomach
• Bulk-forming laxatives
• Antibiotics via IV injection
• Surgical removal of diverticula
• Colectomy: Surgical removal of part of the large intestine
• Stoma surgery: Attaching a bag to the stomach to collect waste
  

When to Seek Care

It's important to seek medical care for rectal bleeding as soon as it occurs since there is a risk of losing too much blood. Finding the source and stopping the bleeding should be done as soon as possible.

Summary

Most people do not experience symptoms of diverticular disease. Symptoms of diverticulitis might include extreme stomach pain, blood in stools, cramps, bloating, diarrhea, or constipation. Diverticular bleeding includes rectal bleeding without pain, heavy but intermittent bleeding, dark or light red blood clots, or sudden rectal bleeding.

If left untreated, diverticulitis could create complications like an abscess or fistula in the colon, a perforation (hole in the colon), peritonitis (infection of stomach lining), or an intestinal obstruction (scarring of the intestines).

Treatments for diverticular bleeding include blood transfusion, medication, administering IV fluids, or, in extreme cases, surgery to remove a part of the colon.