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
Signs of diverticular bleeding include:
Rectal bleeding that is heavy but painless
Sudden rectal bleeding
Bleeding that is irregular or unpredictable
Dark or bright red clots
When diverticulitis exhibits symptoms, getting treatment can be important, as complications could worsen the condition. Untreated diverticulitis could result in:
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
If lower gastrointestinal bleeding is not diverticular bleeding, causes might include:
Anorectal abscess: When pus collects gathers around the rectum
Colitis: Inflammation (swelling) of the colon
Colon cancer: An overgrowth of abnormal cells in the colon or rectum
Colonic polyps: Extra tissue that grows in the colon
Crohn's disease: A condition that includes inflammation of the digestive tract
Endometriosis: When extra tissue of the uterus grows in other areas
Intussusception: When one part of the intestine slides into another
Meckel diverticulitis: An outpouching of the small intestine that occurs at birth
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
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
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.
If you're experience bleeding from the rectum, seek medical attention as soon as possible before you lose a significant amount of blood, which can then require a blood infusion.
Symptoms of excess blood loss include:
Anxiety or agitation
Cool, clammy skin or pale skin
Confusion or feeling faint
Lack of urine or less urine than usual
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.