Little pockets or pouches, known as diverticula, can sometimes form along the lining of your large intestine, also known as your colon. Having this condition is known as diverticulosis.
Some people may have this condition but never know it.
Sometimes, though, the little pockets in your colon can become inflamed or infected. When these pockets become infected, it can cause a flare-up or attack known as diverticulitis.
Until it’s treated or the inflammation eases, diverticulitis can cause sharp pain, along with other symptoms.
Read on to learn the most common symptoms of diverticulitis, as well as the risk factors, how it’s diagnosed and treated, and steps you can take to prevent a flare-up.
Did you know?
In Western populations:
- diverticulosis occurs in about 10 percent of people over age 40
- diverticulosis occurs in approximately 50 percent of people over age 60
- the risk of developing diverticulosis increases with age and affects almost everyone over the age of 80
In many cases, diverticulosis doesn’t cause any troublesome symptoms. You may never know you have the condition until you have a colonoscopy or some type of imaging that reveals the bulging pouches in your colon.
However, if the pockets in your colon wall become inflamed and infected, it becomes diverticulitis. Some people refer to it as a diverticulitis attack or flare-up.
The most common symptom is sharp, cramp-like pain in your lower abdomen. The pain may come on suddenly and persist for days without letting up.
Usually the pain is on the left side of the lower abdomen. However, people of Asian descent may be more likely to feel diverticulitis pain on the lower right side of their abdomen.
Other symptoms of diverticulitis can include:
- constipation or diarrhea
- tenderness over the affected area of your abdomen
The small pockets or pouches usually develop in weakened areas of the colon wall. Several factors can cause these pockets to form, such as increased pressure from gas, liquid, or waste.
When these pockets get blocked with waste, bacteria can build up causing swelling and infection. This is what’s known as diverticulitis.
Genetics may play a role, which means if you have family members who have this condition, you may be more likely to get it, too. But there are other factors that may increase your risk of developing diverticulitis.
Some of the most common risk factors include:
- Age: As you get older, your risk of developing diverticulitis increases.
- Smoking: The nicotine and chemicals in cigarettes and other tobacco products can weaken the lining of your colon.
- Not drinking enough water: If you’re dehydrated, your body will have a harder time with digestion, and waste may not pass through your colon as easily.
- Medications: Some drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and steroids may weaken or irritate the colon wall.
- Lack of exercise: Working out regularly seems to decrease the odds of developing diverticulitis.
- Overweight: Carrying extra weight can put more pressure on your colon.
- Straining during a bowel movement: This can put extra pressure on the wall of the colon.
Any time you have sudden, intense pain in your abdomen, it’s important to follow up with your doctor.
Along with sudden pain, other warning signs that should prompt you to see a doctor include:
- fever and chills
- constipation or diarrhea
Diverticulitis symptoms can be similar to several other digestive conditions. Your doctor will be able to do the necessary tests and procedures to rule out other causes, and to give you an accurate diagnosis.
It’s important to tell your doctor about all of your symptoms. This will help them eliminate other conditions and pinpoint the cause of your symptoms.
To start, you doctor will review your symptoms and your medical history. They’ll likely perform a physical exam, specifically checking the area of your abdomen that hurts.
If diverticulitis is suspected, your doctor may order a computed tomography (CT) scan. This type of imaging test can help your doctor see inside your colon and identify the diverticula and their severity.
Other tests that may be ordered include:
- blood and urine tests to look for infection
- liver enzyme test to check for liver disease
- stool test to check for infection in people with diarrhea
- pregnancy test for women to eliminate pregnancy as a cause
Your treatment will depend on whether your symptoms are mild or severe.
If your symptoms are mild, your doctor will likely treat your diverticulitis with:
- antibiotics to treat the infection
- an over-the-counter pain reliever like acetaminophen (Tylenol)
- a liquid-only diet for a few days to help your colon heal
If your symptoms are more severe, or you have other health problems, you may need to be hospitalized until the infection starts to improve. In a hospital setting, your diverticulitis will likely be treated with:
- antibiotics that are given intravenously
- a needle inserted into the affected area if an abscess has formed and needs to be drained
In severe cases, surgery may be needed. This is typically the case when:
- antibiotics don’t help to clear up the infection
- an abscess is too large to be drained with a needle
- diverticulitis has caused an obstruction in your colon
- the colon wall has been perforated by an abscess or obstruction
If your diverticulitis is mild, your doctor may recommend a clear liquid diet for a few days to give your colon time to heal. Don’t stay on a liquid diet longer than recommended by your doctor.
A clear liquid diet can include items such as:
- tea or coffee without milk or cream
- water, seltzer water, or flavored carbonated water
- ice popsicles without chunks of fruit
- fruit juice without pulp
Once your symptoms start to improve, your doctor may recommend that you start adding low-fiber foods to your daily food plan, such as:
- yogurt, milk, and cheese
- cooked or canned fruits without the skin
- white rice and pasta
- refined white bread
Other home remedies that may help include:
- Probiotics: Available in capsule, tablet, and powder form, these “good” bacteria may help improve the health of your digestive tract.
- Digestive enzymes: These proteins help break down food during digestion and they also kill toxins. Although there’s no research to support the benefits of digestive enzymes specifically for diverticulitis,
one studyhas found that they may help ease abdominal pain and other common digestive issues.
Always check with your doctor before trying dietary changes and other home remedies.
Although the exact root cause of diverticulitis isn’t yet known, there are some steps you can take to lower your risk of developing this condition, such as:
- Eat a high-fiber diet: Try to limit red meat, full-fat dairy, fried foods, and refined grains. Instead, eat more whole grains, fresh fruits and vegetables, legumes, nuts, and seeds.
- Drink plenty of water: Try to drink at least 8 glasses of fluids a day. Being well hydrated can help prevent constipation and keep your digestive tract working properly.
- Exercise regularly: Being active can help promote healthy bowel function.
- Keep your weight in a healthy range: Being a healthy weight can help reduce the pressure on your colon.
- Don’t smoke: Smoking can cause changes in all parts of your body, and can have harmful effects on your digestive system, too.
- Limit alcohol use: Drinking too much alcohol may disrupt the balance of good bacteria in your colon.
- Use a stool softener: If you often strain during bowel movements, an over-the-counter stool softener may help reduce the pressure on your colon.
As you get older, your colon wall can become weaker. This can cause small pockets or pouches to form in weakened areas of your colon. If these pouches get infected, it can cause a diverticulitis attack or flare-up.
The most common symptom of diverticulitis is a sharp cramp-like pain, usually on the left side of your lower abdomen. Other symptoms can include fever and chills, nausea, vomiting, and constipation or diarrhea.
If you think you may have symptoms of diverticulitis, it’s important that you follow up with your doctor to prevent it from becoming more severe.
Diverticulitis can be a painful and uncomfortable condition, but with the right treatment and preventive measures, it can be well controlled.