This definition is restricted to diverticula of the colon. The colon is made up of the large intestine. It extends from the end of the ileum to the anal canal that surrounds the anus. Diverticulitis is an inflammation of a diverticulum or diverticula in the intestinal tract. The condition is best described as an out pouching of the intestinal mucosa through the muscle wall of the sigmoid colon causing little distended sacs with stagnant feces and associated pain.

The cause is unknown; however, lack of fiber in the diet may be a contributing factor. This lack of fecal residue reduces the lumen of the bowel and leads to higher than normal intra-abdominal pressure with bowel movements.

Manifestations of diverticulitis include: fever, nausea, pain; left lower quadrant abdominal tenderness; and alternating constipation with diarrhea. Perforation may occur, and signs and symptoms of peritonitis may develop. These manifestations include intense, severe pain; weakness; clammy cold skin; abdominal distention; decreased bowel motility; hypotension; tachycardia; high fever; and signs of dehydration.

A barium enema or sigmoidoscopy may be dangerous during the active inflammatory period. An elevated sedimentation rate may indicate infection, and a computed tomography (CT) scan may be helpful.

The treatment for mild diverticulitis is to prevent constipation and fight infection. Stool softeners, antibiotics, pain medication, and antispasmodics may be used. In acute diverticulitis, oral food and liquid are contraindicated, and intravenous fluids and broad-spectrum antibiotics are administered. After repeated attacks, a bowel resection may be required. If a severe attack begins, a diverting colostomy is performed first, then a second operation with a reanastomosis is done after all infection is cleared up.

Postoperatively, the patient is cautioned against using laxatives without consulting with a physician. Straining and heavy lifting are to be avoided until healing is complete. Diet should avoid gas-producing foods.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. [38 CR 4.114]

• There are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia and disturbances in nutrition. Consequently, certain coexisting diseases in this area, as indicated in the instruction under the title “Diseases of the Digestive System,” do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding as outlined in 38 CFR 4.14.  [38 CFR 4.113]