Diverticular Bleeding

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Topic Overview

What is diverticular bleeding?

Diverticular bleeding occurs when pouches (diverticula ) that have developed in the wall of the large intestine (colon) bleed. If you have these pouches, you have a condition called diverticulosis.

Diverticular bleeding causes a large amount of blood to appear in your stool. Bleeding starts suddenly and usually stops on its own. Abdominal pain usually does not occur with the bleeding.

If you have a large amount of blood in your stool, see a doctor right away. It is possible, but not common, to quickly lose so much blood that you become lightheaded or weak.

What causes diverticular bleeding?

Pouches (diverticula) form along the wall of the large intestine (colon) when high pressure inside the colon pushes against weak spots in the colon wall. Bleeding occurs when a hole (perforation) develops between a pouch (diverticulum) and a blood vessel.

What are the symptoms?

Diverticular bleeding usually causes sudden, severe bleeding from the rectum. The blood may be dark red or bright red clots. In most cases there is no pain, and the bleeding stops on its own.

How is diverticular bleeding diagnosed?

Diverticular bleeding is diagnosed by ruling out other causes of the bleeding. Your doctor will do a medical history and physical examination, along with some tests. Imaging tests such as angiography (also known as arteriography) may be done to find the location of persistent bleeding. Colonoscopy, the inspection of the entire large intestine (colon) using a long, flexible, lighted viewing scope (colonoscope), is considered one of the most useful tests for determining the source of bleeding in the lower intestines.

Your doctor might do a test called technetium-labeled red blood cell bleeding scan to look for the source of bleeding. In this test, some blood is taken from you, and a small amount of radioactive material called technetium is added to the blood. The blood containing the technetium is then injected back into your bloodstream and traced to the source of bleeding.

How is it treated?

Bleeding from diverticula often will stop on its own. If it does not, treatment may be needed to stop it and to replace lost blood, and you may need to be hospitalized. Treatment may include intravenous fluids, blood transfusions, injection of medicines, and in some cases surgery to remove the diseased part of the colon.

Can diverticular bleeding be prevented?

Eating a high-fiber diet, getting plenty of fluid, and exercising regularly may help prevent the formation of diverticula. But if you already have diverticulosis, diet may not help prevent bleeding.

Last updated:	July 30, 2008
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC