Reported in this paper are the results of a two-step study. Stage 1 included the retrospective analysis of 3,681 X-ray examinations of the colon carried out between 2002 and 2004 with the purpose of elucidating the structure of colonic diseases and detection of gender-specific differences between them. Stage 2 was the retrospective evaluation of the results of the follow-up observations of 486 patients presenting with colonic diverticular disease. The parameters estimated included dynamics of the patients' subjective complaints, the quality of life, individual clinical features, multiple X-ray and/or endoscopic studies with the quantitative assessment of the number and characteristics of the diverticles, and changes in the intestinal mucosa. In addition, the results of X-ray and endoscopic examination of the colon were compared and complication detected. The data obtained made it possible to distinguish between two main clinico-morphological variants of the development of uncomplicated symptomatic colonic diverticular disease (DD), namely the condition reminiscent of irritated bowl syndrome and colonic diverticular disease with an ischemic component. These variants are different in the severity of pain syndrome, the presence or absence of concomitant diseases, the quality of life, and the results of morphological investigations of mucosal biopsies from the colon. The authors hypothesize that the development of each variant of colonic diverticular disease is governed by different etiological factors that should be taken into consideration for making a prognosis and the choice of pathogenetic therapy.