Unlike diverticulitis, SCAD involves inflammation of the colon between diverticula (interdiverticular mucosa), while sparing the diverticular orifices.

SCAD may lead to abdominal pain, especially in the left lower quadrant, intermittent rectal bleeding and chronic diarrhea.

[1] The cause of SCAD is unknown, but may be related to local colonic ischemia, fecal stasis, or mucosal prolapse.

Evaluation should include assessment for additional causes of colitis, such as medication induced (checkpoint inhibitors, NSAIDs, etc.).

Laboratory results are usually normal in SCAD, although the white blood cell count may be mildly elevated.

[2] People with SCAD may develop left lower quadrant abdominal cramping, intermittent rectal bleeding, and chronic diarrhea.

[1] Rectal bleeding (hematochezia) is the most common symptom,[3] and is the presenting complaint in more than 70% of individuals with SCAD.

Several factors may influence the development of the disease, such as local colonic ischemia, fecal stasis, or mucosal prolapse.

[1] However, ulcerative colitis usually affects the rectum and inflammation in IBD extends to areas of the colon without diverticulosis.

[8] Imaging tests, including CT abdomen, may show inflammation or thickening of the distal colon, with associated diverticulosis.

In severe cases of SCAD, where corticosteroids are unable to be discontinued, then surgery may be considered (segmental resection).

The natural history of SCAD lacks rigorous study, with little data regarding long term outcomes.

[14] As evidence suggested increasing overlap with inflammatory bowel disease, SCAD became recognized as a distinct condition.