Diverticulitis

Abdominal pain has numerous potential causes. And diverticulitis is one known culprit. Unfortunately, the complications of diverticulitis can be deadly if not treated.

A gastroenterologist can help manage your condition and prevent life-threatening complications.

This page will first discuss what diverticulitis is. We’ll then highlight the symptoms of diverticulitis and potential complications that can occur. We’ll also explore the causes of diverticulitis and how we diagnose this condition. Lastly, we’ll discuss treatment for diverticulitis.

Diverticulitis is the inflammation of the diverticula, which are small pouches in the lining of the digestive tract. Diverticula form when areas of the digestive tract weaken or give way. These pouches are most commonly found in the colon.

If you have diverticula, you have a condition known as diverticulosis. Diverticulosis occurs in more than half of people over age 60. This condition often goes undetected and causes no symptoms. Many times, it is only discovered when the diverticula become inflamed or infected. This results in diverticulitis.

Diverticulitis may occur suddenly with severe symptoms. Or it may be a chronic condition that repeatedly recurs over time. The most common symptoms of diverticulitis include:

• Abdominal pain
• Abdominal tenderness
• Fever

Diverticulitis most often affects the sigmoid colon, the last part of the large intestine. This results in lower left abdominal pain that feels sharp and constant.

Other symptoms of diverticulitis may include:

• Bloating
• Blood in the stool
• Constipation
• Diarrhea
• Fatigue
• Loss of appetite
• Nausea

Diverticulitis can lead to life-threatening complications if left untreated. This is why you should get prompt medical attention if you experience new or worsening digestive symptoms. We’ll discuss the potential complications of diverticulitis below.

Abscess

An abscess is a pocket of pus caused by infection. Treatment involves antibiotics. In some cases, you may need surgery to drain the pus.

Stricture

Inflammation of the diverticula can lead to narrowing of the intestines, or stricture. A stricture can increase your chances of intestinal obstruction. Signs of stricture may include:

• Thin stools
• Constipation
• Inability to pass gas or stool

Perforation

Diverticulitis may cause a perforation or tear in the intestinal wall. This may occur when trapped fecal matter places increased pressure on the diverticula. Perforation can lead to serious complications because it allows the bacteria to spread to other areas of the body.

Peritonitis

If the infection spreads beyond the diverticula, it can lead to an abdominal wall infection known as peritonitis. This is a life-threatening complication that needs emergency medical treatment.

Signs of peritonitis include:

• Severe abdominal pain with movement
• Abdominal bloating
• Stiffness in the stomach muscles

If you experience any of the above symptoms, you should go to the nearest emergency room.

Fistula

A fistula is an abnormal connection between the colon and another organ. This complication can occur as a result of an abscess. A fistula may connect the colon to other organs such as:

• Bladder
• Skin
• Small intestine

Treatment may involve antibiotics or surgery, depending on the severity of the fistula.

Intestinal Obstruction

Diverticulitis may lead to intestinal obstruction. This occurs when stool becomes lodged in the intestine. Signs of intestinal obstruction include:

• Inability to pass gas or stool
• Vomiting
• Bloating

A complete blockage of the large intestine needs emergency surgery to remove the obstruction.

Diverticula form in the lining of the digestive tract when excess pressure weakens the intestinal walls. This may occur as a result of a low-fiber diet. If you don’t eat enough fiber, your stools become hard and strain the digestive tract.

Diverticulitis occurs when the diverticula become inflamed or infected. An infection may develop when fecal matter becomes stuck in the diverticula. This creates a breeding ground for bacteria.

Other factors that may contribute to diverticulitis include:

• Diet high in fat and red meat
• Age
• Obesity 
• Smoking
• Nonsteroidal anti-inflammatory drugs

Dr. Islam says: “You do NOT need to stop eating nuts, seeds or popcorn. This is a misconception that gets circulated online and I wanted to clarify this point.”

The diagnosis of diverticulitis begins with a review of your:

• Symptoms
• Personal medical history
• Family medical history

We’ll then complete a physical examination to assess your condition. Diverticulitis shares the same symptoms as other diseases such as colon cancer. So diagnostic testing is essential to obtaining an accurate diagnosis.

The following tests can confirm a diagnosis of diverticulitis:

• Colonoscopy
• CT scan

Treatment for diverticulitis depends on the severity of your condition and may include:

• Antibiotics
• Diet changes
• Surgery

Initially, you may need to follow a clear liquid diet until symptoms of diverticulitis subside. This will promote the healing of the diverticula by keeping your colon empty.

A clear liquid diet includes see-through foods that are liquid at room temperature. You can eat the following foods on this diet:

• Strained fruit juices
• Gatorade
• Tea
• Bouillon
• Jell-O
• Popsicles

Once your symptoms lessen, you can slowly resume eating low-fiber foods. This limits muscle contractions in the digestive tract, which allows your colon to continue healing.

Low-fiber foods include:

• White rice
• Low-fiber cereals
• Squash
• Spinach
• Beets
• Eggs
• Chicken
• Fish

After your colon heals, you can slowly begin to add more fiber to your diet. A high-fiber diet can improve your gut health by:

• Growing healthy bacteria
• Improving stool frequency
• Softening stools

Plant-based foods are the best sources of fiber. These foods include:

• Fruit
• Vegetables
• Beans
• Lentils
• Whole-grains
• Nuts and seeds

Because fiber absorbs water in the colon, you need to drink plenty of fluids to prevent constipation.

Adding fiber to your diet will reduce your risk of recurrent diverticulitis. But you should also avoid foods that may cause inflammation or digestive discomfort.

Foods to avoid with diverticulitis include:

• Fried foods
• Refined grains
• Red meat
• Trans-fats
• Sugary foods
• Fatty foods

Diverticulitis can repeatedly recur if you don’t make changes to improve your gut health. Eating a high-fiber diet can reduce your risk of diverticulitis.

Dr. Sameer Islam is a gastroenterologist and West Texas native. He helps you heal your digestive conditions with natural treatments when possible.

If you want to restore your gut health, you can schedule an appointment online or call our office at 806-696-4440.