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Diverticular Bleeding

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 (belly) 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?

The reason pouches (diverticula) form in the colon wall is not completely understood. Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall.

Normally, a diet with enough fiber (also called roughage) produces stool that is bulky and can move easily through the colon. If a diet is low in fiber, the colon must exert more pressure than usual to move small, hard stool. A low-fiber diet also can increase the time stool remains in the bowel, adding to the high pressure.

Pouches may form when the high pressure pushes against weak spots in the colon. Weak spots are where blood vessels pass through the muscle layer of the bowel wall to supply blood to the inner wall.

Bleeding occurs when the blood vessel going to the pouch breaks open.

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 exam, 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 thought to be one of the most useful tests for finding the source of bleeding in the lower intestines.

Your doctor might do a test called a 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.

You may have a higher risk of diverticular bleeding if you take aspirin regularly (more than 4 days a week).1

Other Places To Get Help

Organizations

American College of Gastroenterology
6400 Goldsboro Road
Suite 200
Bethesda, MD 20817
Phone: (301) 263-9000
Web Address: http://patients.gi.org
 

The American College of Gastroenterology is an organization of digestive disease specialists. The website contains information about common gastrointestinal problems.


American Society of Colon and Rectal Surgeons
85 West Algonquin Road
Suite 550
Arlington Heights, IL  60005
Phone: (847) 290-9184
Fax: (847) 290-9203
Email: ascrs@fascrs.org
Web Address: www.fascrs.org
 

The American Society of Colon and Rectal Surgeons is the leading professional society representing more than 1,000 board-certified colon and rectal surgeons and other surgeons dedicated to treating people with diseases and disorders affecting the colon, rectum, and anus.


National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD  20892-3570
Phone: 1-800-891-5389
Fax: (703) 738-4929
TDD: 1-866-569-1162 toll-free
Email: nddic@info.niddk.nih.gov
Web Address: www.digestive.niddk.nih.gov
 

This clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health. The clearinghouse answers questions; develops, reviews, and sends out publications; and coordinates information resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.


References

Citations

  1. Strate LL, et al. (2011). Use of aspirin or nonsteroidal anti-inflammatory drugs increases risk for diverticulitis and diverticular bleeding. Gastroenterology, 140(5): 1427–1433.

Other Works Consulted

  • Travis AC, Blumberg RS (2012). Diverticular disease of the colon. In NJ Greenberger et al., eds., Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy, 2nd ed., pp. 259–272. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Last Revised July 19, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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