Diverticulitis is a disorder that develops when tiny, protruding pouches called diverticula, which can form in the digestive system’s lining, become inflamed or infected. This condition is usually found in the large intestine and can cause various symptoms, including abdominal pain, bloating, constipation, and diarrhea. While the exact cause of diverticulitis is unknown, factors such as a low-fiber diet, age, obesity, and smoking are known to increase the risk of developing the condition. Treatment involves a combination of antibiotics and dietary changes, but surgery may be necessary in severe cases.
What Causes Diverticulosis and Diverticulitis?
Diverticulitis occurs when these diverticula become inflamed or infected, typically due to blockage by fecal matter or undigested food, a low-fiber diet, aging, obesity, smoking, and other factors. Once a person has had diverticulitis, they may be more likely to experience additional episodes. Let us discuss this in more detail.
Causes of Diverticulitis
Diverticulitis occurs when the diverticula in the colon become inflamed or infected. The following factors may contribute to the development of diverticulitis:
Blockage of diverticula
Diverticula can become blocked by fecal matter or undigested food, which can cause inflammation and infection.
A diet low in fiber can lead to constipation and hard, small stools, increasing pressure on the colon wall and increasing the risk of diverticula formation. This pressure can also cause the diverticula to become inflamed or infected.
As we age, the walls of the colon become weaker and more susceptible to the formation of diverticula and more prone to infections.
Immune system disorders
Immune system disorders, such as HIV/AIDS, may increase the risk of developing diverticulitis.
Medications, such as steroids and nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the risk of diverticulitis.
Previous episodes of diverticulitis
Once a person has had diverticulitis, they may be more likely to experience additional episodes.
Trauma to the colon
Trauma to the colon, such as from a colonoscopy or surgery, may increase the risk of diverticulitis.
Use of proton pump inhibitors (PPIs)
PPIs, commonly used to treat acid reflux, may change the balance of bacterial colonies in the gut, increasing the risk of diverticulitis.
Use of immunosuppressant drugs
Certain immunosuppressant drugs, used to treat autoimmune diseases and prevent organ rejection after transplant surgery, may increase the risk of diverticulitis by weakening the immune system.
Heavy alcohol consumption may increase the risk of diverticulitis by disrupting the balance of bacteria in the gut and impairing immune function.
How is Diverticulitis Diagnosed?
Diverticulitis is typically diagnosed through medical history, physical examination, and diagnostic tests. The following are some standard methods used to diagnose diverticulitis.
Medical history of Diverticulitis
These include questions related to your symptoms, medical history, and any medications you are taking.
- Any abdominal pain, particularly on the left side?
- Fever or chills?
- Nausea or vomiting?
- Have you noticed changes in your bowel habits, such as diarrhea or constipation?
- Any previous episodes of diverticulitis or diverticulosis?
- Have you ever had a colonoscopy or other procedures done on your colon?
- Any medical conditions, such as immune system disorders, may increase your risk of diverticulitis.
- What medications, if any, are you taking?
- Have you had any recent trauma to your abdomen or colon?
Physical examination for Diverticulitis
A physical exam, including checking for abdomen tenderness and a rectal exam.
During an abdominal exam, your doctor will use their hands to feel for tenderness or swelling in your abdomen. They may also listen to your abdomen with a stethoscope to check for bowel sounds, which can help them identify any areas of inflammation or obstruction.
During a rectal exam, a gloved finger is introduced into the rectum to feel for any abnormalities, such as inflammation or tenderness in the colon or rectum. This can also help them check for any signs of bleeding or infection.
These exams can help your doctor identify any signs of diverticulitis, such as tenderness in the left lower side of the belly or a mass or inflammation in the rectum. Remember that not all cases of diverticulitis will present with these physical signs, and additional diagnostic tests may be necessary to confirm the diagnosis.
These can be done to check for signs of infection or inflammation.
Complete blood count
A CBC checks the levels of various types of blood cells, including WBCs. In cases of diverticulitis, a high white blood cell number may indicate the presence of an infection.
C-reactive protein (CRP)
CRP is a protein produced by the liver due to inflammation. Elevated levels of CRP can indicate the presence of inflammation caused by diverticulitis.
Erythrocyte sedimentation rate (ESR)
ESR measures how quickly red blood cells settle to the bottom of a test tube. Elevated ESR levels can indicate the presence of body inflammation, which can be caused by diverticulitis.
Liver function tests
LFTs can help identify liver damage or inflammation causing symptoms similar to diverticulitis.
Kidney function tests
Kidney function tests can help identify kidney damage or inflammation causing symptoms similar to diverticulitis.
It’s important to note that while blood tests can help provide clues to diverticulitis, they are not definitive diagnostic tools. Additional diagnostic tests, such as imaging studies or colonoscopies, may be needed to confirm the diagnosis.
Imaging tests, such as a CT scan or ultrasound, may be used to confirm the diagnosis of diverticulitis and determine the severity of the condition. These tests can also help rule out other conditions that can cause similar symptoms.
A CT scan uses X-rays and computer technology to produce detailed body images. During a CT scan for diverticulitis, a contrast dye may be injected into the body to help highlight any areas of inflammation or infection. CT scans can provide detailed information about the extent and severity of diverticulitis and identify any complications, such as abscesses or perforations.
It uses high-frequency sound waves to produce images of the body. During an ultrasound for diverticulitis, a probe may be placed on the abdomen to create images of the colon and surrounding tissues. Ultrasound can help identify areas of inflammation or abscesses and is often used to diagnose complications such as diverticular abscesses.
It is a type of X-ray that uses contrast dye to produce images of the colon. During a barium enema for diverticulitis, the dye is inserted into the rectum through a tube, and X-rays are taken to make images of the colon. This test can help identify any areas of inflammation or diverticula in the colon.
Magnetic resonance imaging (MRI)
An MRI uses powerful magnets and radio waves to produce detailed body images. The use of CT scans or ultrasound for diagnosing diverticulitis is less common but can help identify complications such as abscesses or fistulas.
These imaging tests can help confirm the diagnosis of diverticulitis and determine the severity of the condition. They can also help identify any complications that may require immediate medical attention.
The recommendation of a colonoscopy is to rule out other conditions and examine the colon for abnormalities. A colonoscopy uses a long, flexible tube with a camera on end to explore the inside of the colon. During a colonoscopy for diverticulitis, the doctor can look for any signs of diverticula, inflammation, or other abnormalities in the colon. A colonoscopy rules out other disorders that can cause similar symptoms, such as(IBD) inflammatory bowel disease or colon cancer.
To prepare for a colonoscopy, the patient must follow a specific diet and may need to take laxatives to empty the bowel. During the procedure, the doctor may give sedatives to help them relax and reduce any discomfort. The doctor then inserts the colonoscope through the rectum and into the colon and carefully examines the colon for abnormalities. The doctor may take a biopsy in case of suspicious findings for further evaluation.
How to Relieve Diverticulitis Pain Fast?
Severe abdominal pain, fever, and nausea are among the symptoms of diverticulitis.
Here are some tips to help relieve diverticulitis pain quickly:
Rest your bowels
During an episode of diverticulitis, you must give your digestive system a break. Avoid solid foods and stick to a liquid or low-fiber diet for a few days. This will give your bowels time to rest and heal.
Take pain relief medication.
Over-the-counter medication such as acetaminophen or ibuprofen can help relieve pain associated with diverticulitis.
Apply heat to the affected area.
Applying a warm compress or heating pad to your belly can help ease pain associated with diverticulitis.
Drinking plenty of liquids, especially water, can help relieve constipation and reduce pressure on the colon. It can also help prevent dehydration, which is common with diverticulitis.
Try relaxation techniques
Stress and anxiety can make diverticulitis pain worse. Relaxing techniques such as deep breathing, meditation, or yoga can help reduce stress and ease pain.
Add probiotics to your diet
Probiotics are beneficial bacteria that can help reduce inflammation and improve gut health. You can find probiotics in kefir, yogurt, and sauerkraut or take a probiotic supplement.
Use a stool softener.
Straining during bowel movements can worsen diverticulitis symptoms. Using a stool softener can make bowel movements easier and less painful.
Eat foods rich in fiber
Once your symptoms have improved, gradually introduce fiber-rich foods into your diet. This can help prevent future episodes of diverticulitis. Good sources of fiber include fruits, whole grains, vegetables and legumes.
Avoid trigger foods
Some foods can aggravate diverticulitis symptoms. Common trigger foods include nuts, seeds, popcorn, and corn. Keeping a food diary to help you identify any foods that may be causing your symptoms.
You may be prescribed antibiotics or other medications to help treat your diverticulitis. Taking all medicines as prescribed is important to ensure a full recovery.
What is the Best Medication for Diverticulitis?
The treatment for diverticulitis typically involves antibiotics to treat the infection and rest to allow the bowel to heal. The antibiotic choice depends on the disease’s severity and the individual’s medical history.
Some commonly used antibiotics for the treatment of diverticulitis include:
- Ciprofloxacin and metronidazole
- Augmentin (amoxicillin-clavulanate)
- Trimethoprim-sulfamethoxazole (Bactrim)
- Ceftriaxone (Rocephin) and metronidazole
- Moxifloxacin (Avelox)
Prescription of Pain relief medication such as Acetaminophen (Tylenol) may help alleviate pain and inflammation.
Take antibiotics per the doctor’s prescription and the entire course. In complicated cases, hospitalization for intravenous antibiotics and bowel rest may be necessary.
What Worsens Diverticulosis?
In most cases, diverticulosis is not symptomatic and does not cause any problems. Diverticulitis, a more serious disorder when the diverticula become inflamed or infected, can aggravate diverticulosis and increase the likelihood of acquiring it. These factors include a low-fiber diet, lack of exercise, smoking, obesity, certain medications, age, and genetics. Making healthy choices such as eating a high-fiber diet, staying active, avoiding smoking, maintaining a healthy weight, and talking to your doctor before taking any new medications can help reduce the risk of developing diverticulitis and other digestive problems. It’s important to note that not all cases of diverticulosis progress to diverticulitis, and many people with diverticulosis never experience any symptoms or complications.
Who is at Risk for Diverticulitis?
Diverticulitis is more common in older adults, particularly those over 50 years. Other risk factors for diverticulitis include:
- A history of diverticulosis
- A family history of diverticulitis
- A low-fiber diet
- Sedentary lifestyle
- Use of certain medications, such as steroids and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Immune system disorders, such as HIV/AIDS
- Trauma to the colon, such as from surgery or a colonoscopy
- Use of proton pump inhibitors (PPIs) for acid reflux.
It’s important to note that while these factors may increase the risk of diverticulitis, not everyone with these risk factors will develop the condition. Additionally, some people may develop diverticulitis without any known risk factors.
What’s the Difference Between Diverticulosis and Diverticulitis?
Diverticulosis and diverticulitis are related conditions that involve the formation of small pouch-like extensions (diverticula) in the digestive system lining, most commonly in the large intestine. However, they differ in their symptoms and severity.
It refers to diverticula in the intestinal wall without any inflammation or infection. Many people with diverticulosis are asymptomatic, but some may experience mild symptoms such as bloating, cramping, and constipation.
On the other hand, diverticulitis occurs when the diverticula become inflamed or infected, leading to more severe symptoms such as abdominal pain (usually on the left side), fever, nausea, vomiting, diarrhea or constipation, and a change in bowel habits. Diverticulitis can be a serious condition requiring prompt medical attention, leading to complications such as abscesses, perforations, or sepsis.
In summary, diverticulosis refers to the presence of diverticula without inflammation, while diverticulitis refers to the inflammation or infection of diverticula.
What Drugs to Avoid in Diverticulitis?
When you have diverticulitis, there are certain drugs that you should avoid. These drugs can worsen the condition or increase the risk of complications. Here are some medications to avoid in diverticulitis:
Nonsteroidal anti-inflammatory drugs
NSAIDs like ibuprofen and naproxen can worsen inflammation in the digestive tract and increase the risk of bleeding and perforation. Acetaminophen (Tylenol) is a safer option if you need pain relief.
Codeine and morphine can slow down bowel movements and increase the risk of constipation and worsening diverticulitis. Use caution and only as prescribed by a doctor.
Dicyclomine (Bentyl) can decrease muscle contractions in the digestive tract and worsen constipation.
These can be helpful for constipation, but caution is a must. Stimulant laxatives can cause cramping and increase the risk of bleeding and perforation. Bulk-forming laxatives like psyllium (Metamucil) are a safer option.
These can be dangerous in diverticulitis, as they can increase the risk of perforation and infection. Avoid its use.
Prednisone can increase the risk of infection and perforation in the digestive tract. Caution is important and under the guidance of a doctor.
Calcium channel blockers
Diltiazem and verapamil can decrease blood flow to the digestive tract and increase the risk of ischemic colitis, a condition where the blood supply to the colon is reduced. Caution should be used in people with diverticulitis.
Antibiotics that can disrupt the microbiome
While antibiotics are commonly used to treat diverticulitis, some can disturb the balance of bacterial growth in the gut, worsening symptoms or increasing the risk of recurrence. Your doctor will choose the appropriate antibiotic based on the severity of the infection and your medical history.
These can worsen constipation and should be avoided or used with care in people with diverticulitis.
What are the Warning Signs of Diverticulitis?
The warning signs of diverticulitis can vary in severity, but some common symptoms include the following:
The most common symptom of diverticulitis is abdominal pain, often in the left lower abdomen. The pain may be continuous or intermittent, ranging from mild to severe.
If you have diverticulitis, you may develop a fever, a sign of infection.
Nausea and vomiting
Some people with diverticulitis may experience nausea and vomiting, which can indicate inflammation in the digestive tract.
Changes in bowel habits
Diverticulitis can cause changes in bowel movements, such as diarrhea or constipation.
In some cases, diverticulitis can cause rectal bleeding, which can be bright red or maroon.
Bloating and gas
Diverticulitis can cause bloating and gas, which can be uncomfortable and painful.
Tenderness in the abdomen
If you have diverticulitis, your belly may be tender to the touch, especially on the lower left side.
Difficulty passing gas
Diverticulitis can cause a blockage in the intestine, making it difficult to pass gas.
In some cases, diverticulitis can cause fatigue, a sign of inflammation or infection.
Chills and sweats
If you have diverticulitis, you may experience chills and sweats, which are signs of a fever and infection.
Diverticulitis can cause dehydration, especially if you have diarrhea or vomiting.
Rabid heart rate
In some cases, diverticulitis can cause a rapid heartbeat, a sign of dehydration or an infection.
If you have diverticulitis, you may experience difficulty urinating, which can indicate inflammation or disease affecting the urinary tract.
Severe abdominal pain
In some cases, diverticulitis can cause severe abdominal pain that may require emergency medical attention.
In severe cases of diverticulitis, an abscess can form near the infected diverticula, causing additional pain and discomfort.
If left untreated, diverticulitis can lead to perforation or a hole in the continuity of the intestine. This can cause severe complications and requires immediate medical attention.
In rare cases, diverticulitis can cause an abnormal connection in two organs or tissues, also known as a fistula. This can cause pain, infection, and other complications.
Diverticulitis can be a serious condition, and prompt medical attention can help prevent complications and improve outcomes.
FAQs About Diverticulitis Answered By Your Doctors Online Team
Diverticulitis is inflammation or infection in the diverticula, which are small bulges that can form in the walls of the colon. Certain foods, such as nuts, seeds, and popcorn, can irritate the colon and increase the risk of diverticulitis. Other contributing factors include lack of physical activity, smoking, obesity, and certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Diverticulitis can be serious, especially if left untreated or complications arise. Treatment of mild cases can often be with antibiotics and changes in diet, but severe cases may require hospitalization and surgery. Complications of diverticulitis can include abscesses, fistulas, perforations, and even sepsis.
Foods that are hard to digest or may irritate the colon’s lining can aggravate diverticulitis. These foods may include nuts, seeds, popcorn, corn, and spicy or fried foods. High-fat and low-fiber foods like red meat and processed foods may also be problematic.
Diverticulitis can often be treated successfully, and symptoms can improve with appropriate treatment. Mild cases of diverticulitis may be treated with antibiotics and changes in diet, while more severe cases may require hospitalization and surgery. While the acute symptoms of diverticulitis can go away with treatment, managing the condition is essential to prevent future episodes. This may involve maintaining a high-fiber diet, staying hydrated, and engaging in regular physical activity. Surgery may be necessary to remove the affected portion of the colon in some cases.
Metamucil, a fiber supplement, may be beneficial for managing diverticulitis. Increasing fiber intake can help regulate bowel movements and prevent constipation, which can aggravate diverticulitis symptoms. However, it’s essential to speak with a healthcare professional to determine if fiber supplements are appropriate for individualized treatment and to discuss the proper dosage and any potential side effects.
Yogurt can be a beneficial food for those with diverticulitis as it contains probiotics, beneficial bacteria that can improve gut health. Probiotics help reduce inflammation and improve immune function in the gut. Additionally, yogurt is a good source of calcium and protein. Choosing plain, low-fat yogurt without added sugars or artificial sweeteners is essential to avoid exacerbating symptoms.
Surgery for diverticulitis is considered in severe or recurrent diverticulitis cases or if complications such as abscesses, fistulas, or perforations occur. Other reasons for surgery may include bowel obstruction or the presence of a large polyp or tumor in the colon. Surgery may involve removing the affected portion of the colon, known as a colectomy, or creating a colostomy or ileostomy, in which an opening is made in the abdomen to eliminate stool. The decision to undergo surgery will depend on individualized factors such as the severity of symptoms, overall health, and the potential risks and benefits of the procedure.
A complete cure for diverticulitis is not possible as it is a chronic condition but successful management with appropriate treatment is possible. Treatment may include antibiotics to treat infections and changes in diet to prevent future flare-ups. Surgery may be necessary to remove the affected portion of the colon in some cases.
Diverticulosis, the presence of small pockets or pouches in the colon, is a common condition that may be reversible with changes in diet and lifestyle. Increasing fiber intake and staying hydrated can help with bowel movements and avoid constipation, which can contribute to the development of diverticula. Engaging in regular physical activity is also beneficial. Medications such as laxatives or stool softeners may sometimes be necessary.