Normal anatomyThe colon, or large intestine, is a muscular tube that begins at the end of the small intestine and runs to the rectum. The colon absorbs water from liquid stool that is delivered to it from the small intestine.Indications, part 1Diverticula are out-pouchings of the wall of the colon. They are thought to be the result of a diet low in fiber. By the age of 60, over half of all Americans have colonic diverticula.Indications, part 2In most cases, diverticula go unnoticed. However, in a small percentage of patients, diverticula can cause problems. The most common problem is diverticulitis, which occurs when a small, hard piece of stool is trapped in the opening of the diverticula. This leads to inflammation and death of the segment of colon containing the diverticula.Indications, part 3Diverticula can also bleed and cause significant blood loss from the gastrointestinal tract. Vessels overlying a diverticula are stretched until they break, causing bleeding into the colon. Blood is usually passed in the stool.IncisionTreament of diverticulitis and diverticular bleeding involves surgical removal of the segment of colon containing the diverticula. While the patient is deep alseep and pain free (general anesthesia), an incision is made in the midline of the abdomen.ProcedureAfter the diseased area is removed, the healthy ends of the colon are sewn back together. Occasionally, especially in cases of diverticulitis, where there is significant inflammation, a colostomy is performed. After the inflammation has resided, the colostomy is removed and the healthy ends of the colon are sewn back together.Reviewed ByReview Date: 01/31/2011David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.