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Difference Between Ulcerative Colitis and Diverticulitis

Ulcerative colitis is when the large intestine is inflamed. Diverticulitis is when diverticula in the colon are inflamed.

What is Ulcerative colitis?


Ulcerative colitis is a type of inflammatory bowel disease (IBD) in which the mucosa layer of the large intestine becomes inflamed and ulcerated.

Causes and prevalence:

The main cause of ulcerative colitis is believed to be a malfunctioning immune system, triggering inflammation. The inflammatory response specifically targets the mucosa, which is a layer within the colon and rectum. The condition often starts in the rectum but may spread upwards into the colon. There may be genetic factors involved in causing the illness and it may also involve issues with bacteria living in the gut. The condition is common with about 500,000 people in North America having ulcerative colitis.

Symptoms and complications:

The symptoms of ulcerative colitis include diarrhea, pain in the abdomen, an urgent need to defecate, stools with blood in, and nausea. People with ulcerative colitis may also have anemia and lose weight. Complications include toxic megacolon and a perforated colon.


Diagnosis is based on examining stool samples and also by sigmoidoscopy and taking a biopsy. A biopsy will show the abnormal mucosal layer typical of the disease.


Antidiarrheal medication and a change in diet can help treat the condition. Corticosteroids and some types of biologic agents can also be very helpful in treating ulcerative colitis. Surgery may be needed in some cases.

What is Diverticulitis?


Diverticulitis is an inflammatory condition of the pouches (diverticula) of the colon.

Causes and prevalence:

The cause of diverticulitis is often poor diet where people eat a high-fat but low-fiber diet.  A poor diet leads to the diverticula developing and, in time, inflammation and infection can develop in these. It is thought that pieces of stool or food trapped in the diverticula can lead to infection and the inflammatory reaction of the condition. Diverticulitis is most common in people who are over 40 years of age and it is found in about half of all people over age 60. 

Symptoms and complications:

The symptoms of diverticulitis include fever, nausea, and pain in the lower left region of the abdomen. Most often the patient experiences constipation. Diarrhea can sometimes happen as well. A complication of diverticulitis is cancer, in fact, there is a 33% higher chance of colorectal cancer in people who have had diverticulitis. Other complications include abscess formation and bowel wall perforation. Perforation can lead to peritonitis and death.


A physical exam and ultrasound can lead to suspicion that the person has diverticulitis. Diagnosis of diverticulitis can be confirmed by having a CT scan and colonoscopy. 


An antibiotic such as Metronidazole is often used to treat diverticulitis. In some cases, surgery may be needed. 

Difference between Ulcerative colitis and Diverticulitis?


Ulcerative colitis is an inflammatory bowel condition where the colon becomes inflamed. Diverticulitis is when pouches that have formed in the colon become inflamed.


Symptoms of ulcerative colitis include bloody stools, pain, nausea, and weight loss. Symptoms of diverticulitis include pain in the left side of the abdomen, nausea, constipation and diarrhea.


Ulcerative colitis is thought to result from a problem in the immune system. Diverticulitis results from eating food too high in fat and not eating high fiber foods.


Perforation of the colon, toxic megacolon, and death are complications of ulcerative colitis. Perforation of the bowel, peritonitis, cancer, and death are complications of diverticulitis.


Treating ulcerative colitis includes using antidiarrheals, corticosteroids, a change in diet, and sometimes surgery. Treating diverticulitis includes using antibiotics but sometimes surgery is needed.

Table comparing Ulcerative colitis and Diverticulitis

Summary of Ulcerative colitis Vs. Diverticulitis

  • Ulcerative colitis and diverticulitis are both problems of the digestive system.
  • Blood in the stools is a common symptom of ulcerative colitis.
  • Diverticulitis typically presents as pain in the lower left abdomen.
  • Both ulcerative colitis and diverticulitis need to be carefully managed and treated to avoid dangerous complications.


What is more serious colitis or diverticulitis?

Diverticulitis is considered to be the more serious of the two conditions.

Is ulcerative colitis and diverticulitis connected?

These conditions can be connected. For instance, ulcerative colitis can occur in the mucosa of the pouches (diverticula) of the colon.

What can be mistaken for diverticulitis?

Several conditions can be mistaken for diverticulitis because the symptoms can indicate other problems. Conditions that are sometimes mistaken for diverticulitis include inflammation of the ileum, ovarian cysts, kidney stones, bowel obstruction, and colitis.

What are the symptoms of colitis and diverticulitis?

Both conditions cause abdominal pain and nausea, but bloody stools are typical of colitis. 

What triggers diverticulitis flare-ups?

Diverticulitis flare-ups are triggered by bacterial infections in the diverticula.

Where is the pain felt with colitis?

When a person has colitis, they most often feel sore on the left side of the abdomen.

What do diverticulitis attacks feel like?

An attack of diverticulitis causes a crampy and sharp pain in the abdomen. People often feel nauseated as well.

Will a colonoscopy show diverticulitis?

A colonoscopy can show that a person has diverticula that are inflamed.

Can diverticulitis turn cancerous?

Diverticulitis can turn cancerous. A person’s risk of cancer is much higher after having diverticular disease.

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References :

[0]Onur, Mehmet Ruhi, et al. "Diverticulitis: a comprehensive review with usual and unusual complications." Insights into imaging 8.1 (2017): 19-27.

[1]Roberts‐Thomson, Ian C., Robert V. Bryant, and Samuel P. Costello. "Uncovering the cause of ulcerative colitis." JGH Open 3.4 (2019): 274-276.

[2]Walfish Aaron E. and R.A.C. Companioni. “Ulcerative colitis”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/gastrointestinal-disorders/inflammatory-bowel-disease-ibd/ulcerative-colitis

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