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The most common symptoms are painful cramps in the lower part of your abdomen, probably on the left side. Your pain may come and go, or it may be constant. It often starts after you've had a meal and gets better when you pass gas or a stool.

You may also feel bloated. Or you may notice a change in your bowel habits, with your stools getting looser or, more often, harder.¹

Doctors usually used a test called barium enema to find out whether you have diverticular disease. A barium enema is an X-ray of your colon. A thick white liquid that contains the chemical barium is passed through your rectum into your colon (your large bowel) to make the X-ray pictures show up more clearly.²

But the results of this test can be wrong in about one-third of people with diverticula.³

Most doctors now recommend a test called colonoscopy for people with diverticular disease.⁴ During this test, your doctor will use a thin flexible tube with a light and camera at the end (called a colonoscope) to look at the inside of your colon. The tube is put in through your rectum and slowly pushed into your colon.

You can have a colonoscopy at your doctor's office, in a clinic or at a hospital. The test takes up to an hour.⁵

You'll probably be given painkillers and medication to make you drowsy (a sedative) just before you have the test. You should be able to go home a couple of hours after having the test. But you shouldn't drive for a few hours after taking a sedative, so you may need someone to take you home.⁵

Sometimes diverticula can bleed. When this happens, you may see a lot of blood in your stools. But the bleeding usually stops by itself and doesn't need treatment. If you get blood in your stools, you should see your doctor. If the bleeding doesn't stop, you may need an operation.⁶

If one or more of your diverticula become inflamed or infected, your doctor will say you have diverticulitis. Usually this happens when pieces of stool getting stuck in a pouch on their way out of your body.¹

If you get diverticulitis, you may:¹

• Get more severe and constant pain in your lower abdomen, usually on the left side
• Get a fever
• Feel sick to your stomach or you may vomit
• Get constipation or diarrhea.

You can get these symptoms with many other conditions.⁴ Your doctor will examine you and may test your blood for infection. That may be enough to confirm the diagnosis and start treatment.⁷ But if your doctor isn't sure whether you have inflamed diverticula, they may be refer you to a hospital or to a radiology center for more tests.⁷

If the pain in your abdomen is very bad, you may have an X-ray of your chest and abdomen.⁷ But the best test for diverticulitis is a computed tomography scan (a CT scan).⁷ In this test, doctors use X-ray equipment linked to a computer (a CT scanner) to produce clear pictures of your colon.⁸ The CT scanner is a large, square machine with a hole in the middle. You lie inside the machine, and an X-ray tube moves around your body to take pictures.⁸

Having a CT scan isn’t painful. You’ll probably have to have some dye put into your body before the test to make the lining of your colon show up more clearly on the scan. Usually you’re given the dye as a drink or as an injection.⁷ The scan takes between five minutes and 30 minutes.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.