What Is Diverticulitis?
Diverticulitis is the infection or inflammation of pouches that can form in your intestines. These pouches are called diverticula.
Diverticula usually aren’t harmful. They can show up anywhere in your intestines. If you have them, it's called diverticulosis. But it they become infected or inflamed, you have diverticulitis.
Sometimes, diverticulitis is minor. But it can also be severe, with a massive infection or perforation (your doctor will call it a rupture) of your bowel.
Diverticulitis vs. diverticulosis
Diverticulosis is a medical condition when small, bulging pouches form on the wall of your bowel. On the other hand, diverticulitis is the medical condition when those pouches get inflamed or infected. Together, these two conditions are known as diverticular disease.
Types of Diverticulitis
There are four types:
Acute. In this type, diverticulitis develops suddenly but goes away quickly with treatment. You can have multiple episodes like these with chronic inflammation. This may happen because an episode you had didn’t heal all the way. Or, it might happen because of another chronic condition in your colon.
Chronic. You can have multiple episodes of diverticulitis with chronic inflammation. This may happen because an episode you had didn’t heal all the way. Or, it might happen because you have another chronic condition in your colon.
Uncomplicated. This is the most common type of diverticulitis. It easily gets better with the right treatment.
Complicated. Your diverticulitis can become complicated when your inflammation causes other problems. For example, you might have severe inflammation that causes a diverticulum to rupture. This can cause scarring.
What Are the Symptoms of Diverticulitis?
Some signs you might have diverticulitis are:
- Pain that may be constant and last several days. This is most likely to be on the lower left side of your abdomen. But your pain may be located on the right side of your abdomen, especially if you're of Asian descent.
- Nausea and vomiting.
- Abdominal tenderness.
- Constipation or diarrhea.
What does a diverticulitis attack feel like?
Diverticulitis symptoms include severe abdominal pain and fever. Your pain might be sharp and penetrating, or you might have a burning sensation. The pain is usually moderate to severe.
Your pain may be constant and persist for several days. The lower left side of your abdomen is the usual site of pain. Sometimes, however, the right side of your abdomen may be more painful, especially if you're of Asian descent.
Diverticulitis can be acute or chronic. With the acute form, you may have one or more severe attacks of infection and inflammation. In chronic diverticulitis, inflammation and infection may go down but never clear up completely. Over time, the inflammation can lead to a bowel obstruction, which may cause constipation, thin stools, diarrhea, bloating, and belly pain. If the obstruction continues, abdominal pain and tenderness will increase, and you may feel sick to your stomach or throw up.
What Causes Diverticulitis?
Diverticula can develop when weak places in your colon give way, causing small pouches to protrude through your colon wall. Diverticulitis happens when the diverticula tear, causing swelling and sometimes infection.
Doctors aren't sure why some people get diverticulitis while some don't. Studies suggest that your genes might play a role. Most people with diverticulitis are unaware they have it.
Your chances of getting diverticulitis increase as you age. It’s more common when you're over 40.
Some risk factors include:
- Being overweight
- Smoking cigarettes
- Not getting enough exercise
- Eating lots of fat and red meat but not much fiber
- Taking certain kinds of drugs, including steroids, opioids, and nonsteroidal anti-inflammatories, such as ibuprofen or naproxen
Diverticulitis, stress, and depression
There's no evidence that stress causes diverticulitis, but some experts believe it may play a role in aggravating flare-ups. However, studies do show that when you have diverticulitis, you have a higher risk for depression and anxiety.
What Are the Complications of Diverticulitis?
If you don’t treat it, diverticulitis can lead to serious complications that require surgery:
- Abscesses, collections of pus from the infection, may form around the infected diverticula. If these go through the intestinal wall, you could get peritonitis. This infection can be fatal. You’ll need treatment right away.
- Perforation or tearing in the intestinal wall can lead to abscesses and infection because of waste leaking into the abdominal cavity.
- Scarring can lead to a stricture or blockage of the intestine.
- Fistulas can develop if an infected diverticulum reaches a nearby organ and forms a connection. This most often happens between the large intestine and the bladder. It can lead to a kidney infection. Fistulas can also form between the large intestine and either the skin or the vagina.
- Stricture, which happens when the colon narrows in the affected area.
If you have severe bleeding, you may need a blood transfusion.
How Is Diverticulitis Diagnosed?
The symptoms of diverticulitis can also look like other problems. Your doctor will narrow things down by ruling out other issues. They’ll start with a physical exam. Women may get a pelvic exam, too. Your doctor may then order one or more tests, including:
- Blood, urine, and stool tests to look for infection
- CT scans to look for inflamed or infected diverticula
- A liver enzyme test to rule out liver problems
- A pregnancy test for women of childbearing age to rule out pregnancy as a cause of abdominal pain
- A poop test to rule out infection when you have diarrhea
How Is Diverticulitis Treated?
Diverticulitis home remedies
If your diverticulitis is mild, your doctor will suggest rest and a liquid diet while your intestines heal.
This liquid diet is also called a “diverticulitis diet.” You start by drinking only clear liquids, such as water, broth, non-pulpy juices, ice pops, and plain tea or coffee. As you feel better, you can add low-fiber foods such as eggs, yogurt, cheese, white rice, and pasta. These foods are gentle on your digestive system. This treatment works well for most people who have clear-cut cases of diverticulitis.
If you have an infection, your doctor might also give you antibiotics. They may also suggest a mild pain reliever such as acetaminophen.
More severe cases
In more severe cases, you might need to stay in the hospital and take antibiotics that are intravenous (injected into your veins). If you have an abdominal abscess, your doctor will drain it. If your intestine is ruptured or you have peritonitis, you’ll need surgery.
There are two main types:
- Primary bowel resection. In this procedure, your surgeon will remove diseased parts of the intestine and reconnect the healthy sections. You can have normal bowel movements afterward.
- Bowel resection with colostomy. This needs to be done if there’s so much swelling that the surgeon can’t reconnect your colon to your rectum right away. Your doctor will create an opening in your abdominal wall so waste can flow into a bag. Surgeons can often reconnect the bowel after the inflammation has passed.
The kind of operation you need depends on the type of complication you have and how serious it is.
When you’re healed, your doctor might give you a colonoscopy to rule out colon cancer.
You can prevent diverticulosis and diverticulitis and their complications by eating plenty of fiber, drinking lots of water, and exercising regularly.
These habits can help prevent diverticulitis:
Get regular exercise. This helps your bowels function correctly and reduces pressure inside your colon. Try to exercise at least 30 minutes most days.
Eat more fiber. Foods high in fiber include fresh fruits, vegetables, and whole grains. They soften your poop and help it pass through your colon. Contrary to popular belief, eating seeds and nuts doesn't increase your risk for diverticulitis.
Drink lots of fluids. Fiber works by absorbing water and increasing waste in your colon. But if you don't drink enough water, fiber can cause you to be constipated.
Avoid smoking. This increases your risk of diverticulitis and many other health issues.
When to Talk to Your Doctor
Get in touch with your doctor if you have symptoms of diverticulitis. Get immediate care if you have:
- Blood in your poop
- Fever above 100.4 F (38 C)
- Nausea, vomiting, or chills
- Sudden belly or back pain that's severe or getting worse
- Diverticulitis is the medical condition when small pouches on the wall of your bowel get inflamed or infected.
- It's not common, affecting 4% of people with diverticulosis.
- It's unknown what causes diverticulitis. Your genes may play a role. Other causes may include eating lots of red meat, not getting enough exercise, being overweight, and smoking.
- You can help prevent diverticulitis by drinking plenty of water, getting regular exercise, and eating lots of fiber.
- Most cases are mild, but it can be severe and lead to serious medical conditions and surgery.
Does diverticulitis go away on its own?
Sometimes. If you have mild, uncomplicated diverticulitis, it often goes away on its own. That usually takes about a week, but you should still see your doctor. They might prescribe antibiotics or pain meds. They can tell you what to do while you're recovering. If your case isn't mild, or you have an infection, and you don't see your doctor, you can develop more severe medical problems.
Is diverticulitis serious?
Diverticulitis is usually mild, but it can be severe and cause serious medical problems.
How common is diverticulitis?
Diverticulosis is common, but diverticulitis is an uncommon complication. It affects about 4% of those who have diverticulosis. If you have diverticulitis, you have a 20% chance of getting it again.