Skip to main contentLast updated: 12-Nov-2026
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Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gastro & Cancer Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
Diverticular bleeding is a sudden gush of red or maroon blood from the bowel, usually with no belly pain. A small blood vessel in the wall of a pouch (diverticulum) has burst.
Most bleeds stop on their own. The first job is to keep you stable. Scans and a colonoscopy then find the source, and a clip, a band or a vessel block can seal it.
Surgery is the last step, kept for bleeding that cannot be stopped or keeps returning from a known spot.
This post explains the bleeding side of diverticular disease. For the whole picture, including pouches that get inflamed, see our diverticular disease treatment page.
A diverticulum is a small pouch that pushes out through the bowel wall. A blood vessel runs over the dome of the pouch. Over the years its wall weakens and breaks into the bowel.
This is a problem of the blood vessel. It is not an infection. That is why the bleed usually comes without pain, and without fever. The pouch does not need to be inflamed for this to happen.
Pouches are most often on the left side of the colon. Yet the right side gives a larger share of the heavy bleeds. Right-sided pouches have wider necks, so more of the vessel is exposed. This pattern is common in Indian patients, who often have right-sided pouches.
| Feature | Diverticular bleeding | Diverticulitis |
|---|---|---|
| What goes wrong | A blood vessel bursts | The pouch is inflamed or infected |
| Pain | Usually none | Pain, mostly low on the left |
| Blood | Sudden red or maroon blood in large amount | Rare, and needs another cause looked for |
| Usual side | Often the right colon | Mostly the left colon |
| Antibiotics | No use | Used in some patients |
| First step | Stabilise, then find the source | Scan, then decide on drainage or surgery |
Older age, high blood pressure and hardened arteries raise the risk. So do pain-killer tablets such as diclofenac, aspirin, other blood thinners and anticoagulants.
If you have pouches and take a pain-killer tablet every day, tell your doctor. Many people with knee or back pain take these for years. A safer pain plan can lower the risk of a second bleed. Do not stop a heart tablet or a blood thinner on your own. That decision is made with your heart doctor.
Go to a hospital at once if you pass a large amount of blood, feel faint, or have a racing heart. Do not wait to see if it settles.
A heavy bleed from the stomach or the first part of the gut can also look like red blood from below. So the team checks the upper gut too, when you are unwell. Other causes, such as piles, a bowel infection or a polyp, are also kept in mind.
Treatment of the body comes first: drips, blood if needed, and correction of any blood thinner. Then a scan or colonoscopy finds the vessel that is bleeding.
| Test | When it is used | Good and bad points |
|---|---|---|
| CT angiography | Heavy bleeding, or an unstable patient | Fast, needs no bowel clean-out, and maps the vessels. It shows the bleed only while blood is flowing. |
| Colonoscopy | A stable patient, after a bowel clean-out | It finds the source and can treat it at once. It is hard to do during a heavy bleed. |
| Catheter angiography | Ongoing bleeding seen on CT | It finds and blocks the vessel in one sitting. It is a small procedure with its own risks. |
| Red-cell scan | Slow, on-and-off bleeding with a clear CT | It picks up slow bleeding but shows the site poorly. It is never used alone to plan an operation. |
Most surgeons now do not insist on a colonoscopy within a day for every patient. Studies found no gain from rushing a scope into an unprepared bowel. Urgency is kept for a patient who is still bleeding or unstable. For that person a CT angiogram is usually the faster and safer first test.
Most diverticular bleeds stop without any procedure. When one does not, a clip, a band or a vessel block seals the spot. Surgery comes last.
In the right-sided bowel the wall is thin. A band or heat can then injure it, so the choice of tool is made with care. A vessel block needs the catheter to reach as far out as possible. This protects the bowel from losing its blood supply.
Surgery is for bleeding that cannot be stopped, or that returns again and again from a spot we have proven. We remove only the segment that bleeds.
| Situation | Operation | Point to note |
|---|---|---|
| The bleeding segment is known | Removal of that segment of the colon | This gives the lowest chance of a repeat bleed |
| Repeated bleeds from one proven segment | Planned removal of that segment, when you are fit | Done by laparoscopy or an open cut, whichever is safer |
| Heavy bleeding, source not found | Removal of most of the colon | Rare, and kept for an emergency |
A segment should never be removed on a guess. A wrong guess leaves the real source behind, and the bleeding returns. That is why we first prove the spot by CT, angiography or colonoscopy. Dr Harsh Shah performs colon operations by the laparoscopic or the open method, whichever is safer for you.
It can. A bleed from a pouch may return, even years later. Knowing the risk and the medicines to avoid lowers the chance.
If bleeding returns again and again from a proven spot, a planned operation becomes a fair choice. We talk this through in clinic, with your scans in front of us.
Bring your hospital papers from the bleed, every scan and colonoscopy report, and the list of medicines you take.
It is bleeding from a small blood vessel in the wall of a diverticulum, a pouch in the colon. It causes a sudden gush of red or maroon blood, usually with no belly pain.
It can be, because the blood loss may be heavy and sudden. Many bleeds stop on their own. Still, go to a hospital, so that your blood pressure and blood count can be watched.
Usually yes. When it does not, a clip, a band or a vessel block seals the spot. Surgery is kept for bleeding that cannot be stopped.
Pain-killer tablets such as diclofenac, aspirin, other blood thinners and anticoagulants. Do not stop a heart tablet on your own. Review the list with your doctors.
Bleeding comes from a burst blood vessel and usually has no pain. Diverticulitis is inflammation or infection of a pouch, and it hurts. Antibiotics help diverticulitis, not a bleed.
Yes, once the bleeding settles and the bowel can be cleaned. It confirms the source and looks for polyps or other growths that could also bleed.
Yes, a bleed from a pouch can return, even years later. Avoiding pain-killer tablets where possible and reviewing blood thinners lowers the chance.
When bleeding cannot be stopped by other means, or keeps returning from one proven segment of the colon. The operation removes only that segment, once the spot is proven.
For the whole condition, start at the diverticular disease treatment page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Did you pass a large amount of fresh blood from the bowel, with no belly pain? Were you told it may be diverticular? Dr Harsh Shah, a surgeon, studies your reports and scans with you. He explains what stopped the bleeding, what could start it again, and which medicines need care. Bring your colonoscopy, scan and blood reports. You can also call, or message us on WhatsApp. Call For Appointment Book on WhatsApp Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
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