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Diverticulitis Causes, Symptoms, and Treatments

Diverticulosis is a health problem where small pouches bulge through weak parts of the colon.

Diverticulitis occurs when these pouches become inflamed. It can cause bleeding, cramping, and pain.

Doctors treat diverticulitis with medicine, changes to your diet, and sometimes surgery.

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What Is Diverticulitis?

Diverticulitis happens when small sacs (diverticula) push through weak spots in the colon and become inflamed. These pouches tend to form in the lower part of your colon (the sigmoid colon).

Diverticulitis often comes on fast. It can cause pain, bleeding, and other serious issues if not treated.

Diverticulosis, the illness that precedes diverticulitis, is common as people get older.

In the U.S., diverticulosis affects more than:

  • 30% of people between 50 and 59.
  • 70% of people over 80.

Still, fewer than 5% of people with diverticulosis get diverticulitis.

About 200,000 people are in the hospital for diverticulitis each year.

Is diverticulitis very serious?

Diverticulitis can be mild or severe.

If not treated, it can lead to severe issues that could threaten your life.

What causes diverticulitis?

Increased pressure from constipation may cause pouches in the colon to form. But for the most part, diverticulitis causes are unknown.

Your family history and lifestyle may make you more prone to getting diverticulitis.

What can trigger diverticulitis?

Doctors don't always know what triggers diverticulitis.

A diet low in fiber and high in red meat may be one trigger.

What are diverticulitis risk factors and complications?

It's crucial to be aware of diverticulitis risk factors and complications, especially as you get older.

Diverticulitis risk factors

Certain risk factors may play a role in getting diverticulitis, such as:

  • A lifestyle where you mostly sit and don't move around much.
  • Being over 50 years old.
  • Genetics.
  • Not eating enough fiber and eating too much read meat.
  • Obesity.
  • Smoking.
  • Taking certain medicines, like nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids.

Research looks at other factors that may lead to diverticular disease.

They include:

  • Bacteria or stool getting stuck in a pouch in the colon.
  • Changes in the microbiome, the collection of organisms like fungi, bacteria, and viruses that exist in your intestines.
  • Immune system problems.
  • Problems with the muscles, nerves, or connective tissue in the colon.

Complications of diverticulitis

If not treated, diverticulitis can lead to severe health issues like:

  • Abscess. A swollen, painful area filled with pus. An abscess can happen when there's an infection in the diverticula.
  • Bleeding. When a blood vessel in a pouch bursts, the internal bleeding can be severe or even threaten your life.
  • Bowel obstruction. A blockage that keeps fluids, gas, and stool from moving through your colon. It may be a partial or complete blockage.
  • Colonic stricture. A narrowing of the colon that leads to bowel obstruction.
  • Fistula. An abnormal opening between the colon and some other organ, such as the vagina or bladder.
  • Perforation. A hole in your colon.
  • Peritonitis. An infection of the lining of the abdominal cavity.

How can I reduce my risks of diverticulitis?

You may not be able to stop diverticulitis from occurring, but you can reduce your risk by:

  • Eating a diet rich in fiber, fruits, and vegetables.
  • Drinking lots of water.
  • Getting exercise on a routine basis.
  • Not eating a lot of red meat.
  • Not smoking.
  • Staying at a healthy weight.

Doctors used to suggest avoiding certain foods, such as popcorn, nuts, and seeds. But recent research shows that these foods are safe for people with diverticulosis.

Why choose UPMC for diverticulitis care?

We're experts at treating diverticular disease. Our colon and rectal care specialists offer custom treatments.

Our goal isn't just to treat your diverticulitis. We aim to prevent complications and improve your quality of life.

Your health care team may include:

  • Family doctors.
  • Digestive health and disorders doctors.
  • Registered dieticians.

Diverticulitis Symptoms and Diagnosis

You may not notice signs of diverticulitis right away. Many people don't notice symptoms until they have issues like pain and bleeding.

What are the signs and symptoms of diverticulitis?

The symptoms of diverticulitis include:

  • Bleeding from the rectum.
  • Bloating.
  • Chills.
  • Constipation that alternates with diarrhea.
  • Cramping in the abdomen.
  • Fever.
  • Nausea or vomiting.
  • Pain in the lower abdomen, most often on the left side.

Diverticulitis pain tends to be severe and come on fast. But it can also start out mild and get worse as the days go on.

Diverticulitis symptoms can be like those of other health issues, such as inflammatory bowel disease (IBD). It's vital to see a doctor if you have any of the above symptoms.

What does a diverticulitis attack feel like?

A diverticulitis attack often feels like a sharp pain or cramp on the left side of your belly. This pain may last for days.

You may also have fever, chills, vomiting, constipation, or diarrhea.

How do you diagnose diverticulitis?

To find out if you have diverticulitis, your doctor will start by asking about your health history.

They'll ask about your:

  • Symptoms.
  • Medicines.
  • Bowel movement habits.
  • Diet and lifestyle.

Then your doctor will do a physical exam.

They'll check your vital signs and press on your belly to feel for lumps or see if it's tender. They'll use a stethoscope to listen for belly sounds and may also do a digital rectal exam.

Your doctor may also order tests, including:

  • Blood test. To check for signs of diverticulitis or related issues.
  • Colonoscopy. To help confirm diverticulitis and rule out other health problems, like colon cancer.
  • Imaging tests. Ultrasound, CT, or MRI scans to get images of your colon.
  • Stool test. To learn if you have diverticulitis or a problem like IBD.

What Are the Treatment Options for Diverticulitis?

Diverticulitis treatment will depend on how severe your disease is.

Your doctor may prescribe medicine and changes to your diet. But if your symptoms are severe, you may need treatment in the hospital.

Treatment may include one or more of the following:

  • A clear liquid diet. Taking a break from normal food for a short while gives your colon time to rest. Your doctor will have you slowly add solid foods as your symptoms improve.
  • Antibiotics.
  • Colonoscopy to treat diverticular bleeding.
  • Eating high fiber foods or taking fiber supplements.
  • Medicine to reduce inflammation and manage pain. Your doctor may prescribe acetaminophen instead of NSAIDs, which may increase the chance of diverticulitis complications.
  • Probiotics to help your gut bacteria work.
  • Surgery. If diverticulitis doesn't improve with medicine or changes to your diet, doctors may need to remove part of your colon. You may also need surgery if you have a severe issue like a bowel obstruction, fistula, perforation, or peritonitis.