Diverticulosis is a condition where small pouches form and protrude through weak spots in the intestinal wall. Diverticular bleeding happens when a blood vessel in a pouch bursts.

Diverticular bleeding is a complication of diverticulosis. Bleeding may stop on its own or require treatment. Treatment for bleeding may involve a doctor inserting an elastic band into intestinal wall pouches or injecting medication into a blood vessel.

When these treatments do not work, surgery may be necessary.

In some cases, diverticular bleeding can be severe and life threatening.

This article discusses diverticular bleeding, including triggers, treatment, and when to talk with a doctor. It also outlines other conditions that can cause bleeding from the colon.

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Diverticulosis involves the formation of small pouches that push outward through weak places in the colon or large intestine. They usually occur in the lower part of the colon, known as the sigmoid colon. A single pouch is known as a diverticulum.

Diverticular bleeding happens when small blood vessels in the wall of the diverticulum burst. It is a common cause of bleeding in the lower intestinal tract.

Diverticular bleeding is typically painless and comes and goes. It also involves a large volume of blood.

Severe bleeding can cause symptoms such as:

Diverticular bleeding is a complication of diverticulosis.

The following may play a role in diverticular disease:

  • genetics
  • a diet low in fiber
  • inactivity
  • certain medications, such as steroids
  • smoking

According to a small 2019 study, certain factors are closely associated with diverticular bleeding in particular, such as:

Yes, diverticular bleeding can be severe and life threatening.

A poor outlook is more likely in people who:

  • are older than age 60 years
  • have cardiovascular disease
  • have raised creatinine levels, which indicates a decline in kidney function

In some cases, diverticular bleeding may stop on its own.

When treatment is necessary, a doctor must find the source of the bleeding to stop it.

Once the bleeding episode is over, dietary changes may help prevent the worsening of diverticulosis and repeated bleeding.

Methods of finding and stopping the bleeding

Doctors may use the following methods to find and stop diverticular bleeding:

  • Colonoscopy: A colonoscopy involves viewing the interior of the colon. After identifying the source of the bleeding, a doctor may insert special tools, such as an elastic band, to stop the bleeding.
  • Angiogram: An angiogram is an X-ray that uses dye to show blood vessels. After locating the bleeding vessel, a doctor can inject medication or other materials into it to stop the flow.
  • Surgery: If other interventions do not work to stop the bleeding, surgery to remove portions of the affected colon is likely necessary.

Blood transfusions

If a person has lost a lot of blood, they may need a blood transfusion and other treatments for diverticular bleeding.

Diet

Eating a diet high in fiber may help lower a person’s risk of developing diverticular disease. A doctor may recommend slowly increasing fiber intake over time.

Good sources of fiber include:

  • fruits
  • vegetables
  • whole grains, such as oats and brown rice

Diverticular bleeding can involve bleeding that comes and goes and stops on its own. Bleeding that is continuous requires medical intervention.

A 2019 study suggests that bleeding goes away without medical intervention in approximately 70–80% of people with diverticular bleeding. Bleeding recurs in about 38% of people.

Any rectal bleeding or blood in the stool that continues for more than 1 day or occurs frequently should be checked by a healthcare professional.

Most people with diverticular bleeding do not have other symptoms.

However, other conditions can cause similar bleeding from the intestinal tract. Doctors may need to rule out other conditions before diagnosing diverticular bleeding.

Common conditions that can cause bleeding from the colon include:

Hemorrhoids

Symptoms of internal hemorrhoids include:

  • bleeding from the rectum after a bowel movement
  • a visible hemorrhoid prolapse

Symptoms of external hemorrhoids include:

  • hard, tender lumps around the anus
  • anal itching
  • pain when sitting

Colon cancer

Aside from causing blood in the stool, colon cancer can also change bowel habits.

People with colon cancer may also experience gas pains and weight loss for no apparent reason.

Post-polypectomy

A polypectomy involves the removal of polyps, which are small growths on a mucous membrane, such as the colon. Polyps are usually noncancerous.

Post-polypectomy bleeding may happen immediately, after a few hours, or days later.

Angiodysplasia

This condition involves enlarged or abnormal blood vessels in the intestinal tract. In some cases, these blood vessels may bleed.

People with angiodysplasia typically do not experience pain. However, they may have iron deficiency anemia. In cases of heavy bleeding, people may experience low blood pressure.

Any amount of bleeding from the rectum should prompt a doctor’s visit. Bleeding may not stop on its own, leading to significant blood loss.

Diverticular bleeding occurs when diverticulum blood vessels burst. The bleeding is usually painless and comes and goes.

If the bleeding is severe, it can cause low blood pressure and a rapid heart rate. Severe bleeding can be life threatening.

The bleeding may stop without any medical intervention. However, heavy continuous bleeding needs treatment.

Because other conditions can also cause bleeding from the rectum, doctors will take a person’s medical history and perform an exam to rule them out.