What Is Diverticulitis?
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Medically reviewed by Jay N. Yepuri, MD
Diverticulitis is a condition that affects your digestive system and occurs when small pockets on the lining of your intestines become inflamed or infected. While diverticulitis can happen due to an infection, sometimes you can develop symptoms without an exact underlying cause. Most people with this condition experience severe stomach pain near their colon, among other infection-related symptoms such as fever and nausea.
The number of people diagnosed with this condition is increasing, and it appears to be more common in older adults. That’s why knowing the symptoms, learning when to seek care, and understanding the options for treatment are so important.
Types of Diverticulitis
There are two main types of diverticulitis: uncomplicated and complicated. Your healthcare provider can distinguish which type you have based on your results from imaging scans. It’s important to note that 80% of people have the uncomplicated type, while 20% of people have complicated diverticulitis.
Uncomplicated Diverticulitis
With uncomplicated diverticulitis, the pouches in the intestinal lining become inflamed. The inflammation does not appear to be spreading to other areas and there are no signs of pus, abscesses, or other complications.
Complicated Diverticulitis
Complicated diverticulitis occurs when there is a build-up of pus, known as an abscess. Inflammation has spread along the lining of the intestine and perforations (or, small holes in the walls of the intestines) may be present.
It’s also possible for obstructions or blockages to form in the intestines, which can make it difficult for stool to travel through your intestinal tract. Some people with complicated diverticulitis are also at risk for experiencing inflammation in their stomach lining—a condition known as peritonitis.
Symptoms
You might first see symptoms of diverticulosis before you see symptoms of diverticulitis. Diverticulosis occurs when the small pockets on your intestinal lining start to develop. Although most people don't experience symptoms of diverticulosis, it’s possible to experience bloating, cramping, or constipation.
Diverticulitis occurs when the small pockets on your intestinal lining become inflamed. These symptoms usually appear suddenly and worsen over the next few days. The most common symptom is pain in the left side of the abdomen.
Other symptoms of diverticulitis may include:
Swelling
Lower abdominal tenderness
Changes in bowel movements and urinary patterns
Keep in mind: if you experience repeated episodes of diverticulitis, your symptoms will generally feel the same as the symptoms you had the first time you had diverticulitis.
Causes
Diverticulitis happens when small pockets (called diverticula) in the intestines develop and become inflamed. When your body becomes inflamed, your immune system sends fighter cells to protect your body when it comes in contact with harmful cells or foreign agents. As a result of the inflammation, you can experience a wide variety of symptoms including pain, fever, and swelling.
Researchers don’t currently understand the exact cause of diverticulitis and why symptoms can vary from person to person. One theory is that diverticulitis happens when small or large (micro or macro) holes develop in the diverticula. These holes are also known as perforations. Perforations can cause a leakage of intestinal bacteria into the surrounding areas of the intestine, which can cause inflammation to occur.
Risk Factors
While anyone can develop diverticulitis, certain factors can raise your risk of experiencing symptoms. These risk factors include:
Obesity
Sedentary lifestyle
Changes in the microbiome of the intestines
Certain medications like steroids and nonsteroidal anti-inflammatory drugs (NSAIDs)
Diagnosis
Diagnosing diverticulitis can be challenging because symptoms often mimic the symptoms of other conditions, such as appendicitis. If you notice changes to your digestive health, it’s best to see your healthcare provider for proper testing.
During your appointment, your healthcare provider will likely take a full medical history, learning about your symptoms, conditions, lifestyle habits, and medications. They will also perform a physical exam to understand where your symptoms are occurring.
After the physical exam and medical history intake, your healthcare provider may choose to order one or more of the following tests to further examine your condition:
Computed tomography (CT) scan: An imaging test that can detect the cause of your stomach pain
Ultrasound: An alternative imaging test that uses sound waves to create pictures of the abdomen
Colonoscopy: Uses a small camera that is attached to a thin tube and inserted into your intestines to check for inflamed or infected diverticula
X-ray: Another imaging test that can help your provider visualize the presence of inflammation and other complications
Pregnancy test: To rule out pregnancy as the cause of your abdominal pain, your healthcare provider might order a pregnancy test
Blood tests: Can check your white blood cell count or C-reactive protein (CRP) levels, which can indicate the presence of inflammation in your body
It’s important to note that imaging tests are the most useful and reliable exam to diagnose diverticulitis, as these tests can help determine the location of the inflammation and the severity of your condition.
Treatment
The goal of treatment for diverticulitis is to treat the infection, improve symptoms, and prevent episodes from recurring in the future. Your exact treatment plan will depend on the severity of your symptoms. If your symptoms are mild or you have uncomplicated diverticulitis, your treatment may involve getting lots of rest at home. However, with complicated diverticulitis, you may need a more robust treatment plan, including medication or surgery.
The most common treatment options for diverticulitis include:
Antibiotics: A treatment option for people who have complicated diverticulitis, are immunosuppressed, or have underlying health conditions. Generally, antibiotic treatment will last seven to ten days.
Percutaneous drainage: Involves draining any abscesses that have formed in your intestines with a needle
Surgery: If your condition progresses or becomes severe, surgery may be needed to remove a part of the intestine or colon to help ease symptoms
How to Prevent Diverticulitis and Recurring Episodes
After an initial episode, it is important to prevent the recurrence of diverticulitis in the future—as this can decrease your risk of experiencing complications. If you have diverticulosis, you are at an increased risk of developing diverticulitis down the line.
Researchers are still learning about what you can do to prevent the onset of diverticulitis symptoms. However, some evidence suggests that the following strategies may reduce your risk of developing the condition and prevent future episodes from recurring:
Avoid vigorous or intense physical activity, and opt for moderately challenging exercise instead
Limit smoking tobacco
Reduce consumption of red meat
Increase your fiber intake
Take medications such as non-steroidal anti-inflammatory drugs (NSAIDs) as prescribed
Complications
Those diagnosed with diverticulitis have a 20% likelihood of developing complications related to this condition. Potential complications include:
Developing abscesses
Obstruction of the intestinal tract, which can make it difficult for stool to pass
A fistula, or an abnormal connection between the intestines and nearby organs
Perforation or holes in the intestines or colon
Living With Diverticulitis
Research on treating and managing diverticulitis remains ongoing. It’s estimated that 33% of people who experience diverticulitis have recurring episodes in the future. Recurrent episodes tend to be more common in older adults, but anyone can have them.
Symptoms of diverticulitis can significantly affect your quality of life. If you notice that your symptoms are making it difficult for you to carry out daily tasks, it’s essential to get tested to learn the underlying cause of your pain and seek treatment from your healthcare provider.
A Quick Review
Diverticulitis is a digestive system condition that causes inflammation in small pockets of your intestinal lining. As a result of the inflammation, it’s common to experience sudden and severe pain in your abdomen, along with other symptoms like fever, changes in bowel movements, and nausea.
While uncomplicated diverticulitis can be treated with rest, complicated diverticulitis may require other treatment approaches such as antibiotics or surgery. If you’re experiencing new or worsening pain in your stomach, it’s best to see your healthcare provider to get tested and understand the treatment options that are right for you.
Frequently Asked Questions
What is the difference between IBS and diverticulitis?
Both IBS and diverticulitis can cause similar symptoms, such as stomach pain and discomfort. However, diverticulitis is inflammation of small pockets located in your intestinal lining, while IBS is a group of symptoms that affects your digestive system and ability to pass bowel movements.
Can diverticulitis go away on its own?
Uncomplicated diverticulitis generally goes away on its own with rest in most people. However, complicated diverticulitis may require a treatment plan that includes medication or surgery.
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