What is diverticulitis?
Sometimes the walls of the intestines become weak in certain spots. This is due to aging, irritation, and scarring (all very normal). If there’s pressure on the intestinal tract, from constipation for example, it causes bulges and creates little pouches. These pouches are called diverticula. They can become inflamed, swollen, and get infected. That leads to stomach pain, nausea, and sometimes a fever.
When diverticula pouches are inflamed, it’s called diverticulitis. It can happen anywhere in the lining of the large intestine, but usually, it’s in the lower part of the intestines. (Also known as the sigmoid colon because of its S-shape.)
What does a diverticulitis attack feel like?
The most common symptoms are sudden fever, chills, nausea, vomiting, and abdominal pain.
- Constant dull or severe belly pain (often in one area, based on where the diverticulitis is).
- Nausea and vomiting
There is a difference between diverticulosis—just having diverticula, which is super common in people in the West as they age—and diverticulitis, which is an infection of a diverticula. —Dr. Shria Kumar
Causes of diverticulitis
Diverticulosis is mostly a problem in Western countries (Europe, Australia, New Zealand, North America, and South America). It is believed to be at least partly caused by the diet and lifestyle in these countries (more sedentary, more processed foods, more red meat, and not eating enough fiber). A lack of fiber can lead to constipation, which can put pressure on the walls of the intestine, leading to these outpouchings.
Risk factors of diverticulitis
Most people in the US above age 65 have diverticulosis. And for most, it causes absolutely no symptoms or problems whatsoever. Those who develop diverticulitis (infection related to diverticulosis) can usually be managed by oral antibiotics alone. —Dr. Kumar
- Living in the Western world (Europe, Australia, New Zealand, North America, South America).
- Age (over 50 years).
- Eating a low-fiber diet.
- Long-standing constipation (not having regular bowel movements).
- Eating too much red meat.
- Family history (genetics).
If you have a fever and abdominal pain, call your doctor right away. They may refer you to a gastroenterologist (specializing in the digestive tract). If you have diverticulitis, it means you have an infection, and will need antibiotics.
If you’re dizzy, or can’t eat or drink, you should call 911 or go to the emergency room.
What is the best treatment for diverticulitis?
You will be given antibiotics to treat the infection (the diverticulITIS). But this does not actually cure the diverticula pouches in the colon (called diverticulOSIS).
After taking antibiotics and the infection has gone away (your symptoms are better and your colon has had time to heal), your doctor will want to do a colonoscopy (in 4-6 weeks). A colonoscopy uses a long flexible tube with a camera to examine the colon. It is usually done in an outpatient facility under general anesthesia.
The doctor will check that the infection was not from something else like inflammatory bowel disease or cancer. If the colon looks healthy and the doctor sees diverticula pouches, it will confirm that you have diverticulitis.
Ask your doctor: Do I need a colonoscopy? If you haven’t had a recent colonoscopy but have an episode of diverticulitis, you will need a colonoscopy to ensure that it was due to the diverticula infection and not another cause. —Dr. Kumar
Is diverticulitis serious?
Some attacks of diverticulitis can get really bad. Sometimes complications develop if the infection is left untreated. These include severe infection (requiring hospitalization) or perforation (a hole forming) in the infected area.
If you’ve had diverticulosis before or have already been in the hospital for rectal bleeding, your doctor may suggest seeing a surgeon. While rare, sometimes the pouches, along with parts of the intestine, will need to be removed.
The best prevention is to reduce the risk of getting diverticula. Follow a healthy lifestyle: Eat a balanced, nutritious diet and exercise regularly. Make sure you have daily bowel movements.
- Eat a high-fiber diet.
- Drink enough water! This is a great way to prevent constipation.
- Limit your red meat.
- Quit smoking.
- Exercise—aim for 4 to 5 days a week for a total of at least 150 minutes.
- Talk to your doctor if you don’t have daily bowel movements. This may seem normal for you, but you and your doctor together can decide if your bowel movements are adequate based on how often you go, how hard your bowel movements are, and your diet.
Dr. Kumar is a gastroenterologist, who completed her fellowship at the Hospital of the University of Pennsylvania in Philadelphia. She received her undergraduate degrees in Religious Studies and Chemistry from New York University (2010) and graduated from the Albert Einstein College of Medicine (2014), where she was inducted into the Alpha Omega Alpha Honor Medical Society. She is completing her therapeutic endoscopy fellowship at MD Anderson Cancer Center in Houston. She joined Buoy Health in 2020. She believes in the importance of patients being educated about their health, and joined Buoy in order to be part of a platform that helps disseminate clear and verified advice directly to patients.