Most people don’t even know they have diverticula because they don’t usually cause symptoms. But in some cases, diverticula can become inflamed and cause symptoms such as pain, bleeding, diarrhea, or vomiting. This is called diverticulitis.
This article will describe what diverticulitis might feel like, other conditions that have similar symptoms, what may help in avoiding a flare-up, and what to do when one occurs.
Diverticulitis Pain
Abdominal pain is a common symptom of diverticulitis. It might be felt in the lower left quadrant of the abdomen, the lower right quadrant, or at the pubic bone. The pain might come and go or be constant.
The abdomen might also feel tender to the touch in some areas.
Other Diverticulitis Symptoms
The symptoms of diverticulitis can be similar to many other common digestive problems. Some of the symptoms can include:
Abdominal discomfort or painBloatingConstipationDiarrheaFeverLoss of appetiteNauseaMucus in the stool Urinary frequencyVomiting
When to See a Healthcare Provider
People may or may not know if they have diverticular disease. For those who know they have diverticula, it is important to see a healthcare provider if symptoms seem like they could be from diverticulitis.
However, because most people don’t know if they have diverticula, it may be difficult to decide when to see a healthcare provider. Sharp abdominal pain or bleeding from the rectum are always reasons to seek care as soon as possible.
When the symptoms are more subtle, it could be more challenging to know it’s time to see a healthcare provider. However, if constipation, diarrhea, vomiting, or fever have gone on for more than a few days, that’s also a time to talk to a healthcare provider.
Sharp abdominal pain, fainting, feeling confused, bleeding that doesn’t stop, or being unable to keep any food or water down are reasons to get care right away in an emergency department.
It’s important to have diverticulitis evaluated and treated. Without treatment, there could be complications such as anemia (a low number of healthy red blood cells) from blood loss, perforation (the contents of the large bowel leaking into the abdomen), peritonitis (infection of the abdominal cavity lining), abscesses (pockets of infection), or bowel obstruction.
Diverticulitis Diagnosis
A diagnosis of diverticulitis might be made using different tests. What tests are used will depend on what’s available, what insurance will cover, and how severe the symptoms are. Also, because the symptoms of diverticulitis are similar to many other conditions, it’s important to rule those things out.
First, your history and report of symptoms will be taken. This includes questions about how much pain is present, where the pain is located, if there is bleeding, diarrhea, or constipation, and any other symptoms that might be occurring. Based on the evaluation of these symptoms, there might be a need to order some tests.
Some of the tests that may be used in the diagnostic process include:
Blood tests: A blood test might show if there are more white blood cells than there should be, which could mean an infection. Colonoscopy: A colonoscopy (a flexible tube with a camera inserted through the rectum to view the colon) might not be used if it’s thought that there is a flare-up of diverticulitis. But it could be an option to look for diverticula, or it might be used several weeks after symptoms improve. Computed tomography (CT) scan: This is a type of X-ray that’s used to see the organs in the abdomen in cross-section, including the large intestine. Magnetic resonance imaging (MRI): An MRI uses a strong magnet to create images of the abdominal organs. Stool tests: Diverticulitis won’t be diagnosed with just a stool test, but the stool will be tested for an infection or other conditions that can cause symptoms. Ultrasound: An ultrasound is a type of test that uses sound waves to make an image of the organs inside the abdomen.
Conditions Commonly Mistaken for Diverticulitis
Some of the symptoms of diverticulitis can be common with other conditions. For that reason, it’s important to be seen by a healthcare provider for abdominal pain and especially for bleeding from the rectum.
If it’s already known that a person has diverticula, diverticulitis might be suspected right away. But it’s important to know what is causing the symptoms so it can be treated and complications prevented.
Some of the conditions that might also be considered when diagnosing diverticulitis are:
Abdominal aorta rupture or dissection: A rare condition where there is a tear in the wall of the aorta, which is the largest artery in the body Appendicitis: An inflammation of the appendix Cholecystitis or cholelithiasis: An inflammation of the gallbladder or presence of gallstones Colon cancer: A tumor or growth that begins in the colon Ectopic pregnancy: A fertilized egg that attaches outside the uterus, resulting in a pregnancy that cannot result in a live birth and that endangers the pregnant person Incarcerated hernia: A portion of the small intestine that pushes into the groin Inflammatory bowel disease (IBD, including Crohn’s disease and ulcerative colitis): A group of diseases that cause inflammation primarily in the digestive system Irritable bowel syndrome (IBS): A condition that causes diarrhea or constipation and pain in the large intestine Mittelschmerz: Pain in the abdomen that occurs when an egg is released from the ovary Ovarian cyst: A fluid-filled sac inside of the ovary Pancreatitis: An inflammation of the pancreas Pelvic inflammatory disease: An infection of the uterus, fallopian tubes, or ovaries Salpingitis: An infection of the fallopian tubes
Diverticulitis Treatment
Diverticulitis will be treated based on how serious it is and if there are any complications.
If symptoms are mild, diverticulitis could be treated at home. It might be recommended that a liquid diet be started for a few days. If symptoms get better, more foods might be added back into the diet.
For more serious symptoms, antibiotics might also be used along with the liquid diet. After seven to 10 days, the healthcare provider will make a decision about progress and give instructions on the next steps.
If the diverticulitis can’t be managed at home, hospitalization might be needed. This could include giving fluids and antibiotics intravenously (IV, through a line in a vein), as well as pain medication or other treatments as needed.
In rare cases, surgery might be used. This could mean removing the part of the bowel with the inflamed diverticula. It could also mean creating an ostomy so stool is diverted away from the affected part of the bowel.
In an ostomy, a small part of the intestine is brought through the abdomen and an appliance is worn over it to collect bowel movements. It might be reversed later if the diverticulitis improves.
Summary
Diverticular disease is common, especially as people get older. Most people don’t know they have diverticula but in some cases, these weakened areas in the colon can become inflamed and cause symptoms. Many people can be treated at home with a liquid diet, but others may need treatment in the hospital.
A Word From Verywell
It can sound scary when diverticula are found during a routine colonoscopy. But for most people, there won’t be any symptoms or reason for concern. But if there is inflammation that causes pain or other symptoms, treatment might be needed either at home or in the hospital. Most people recover uneventfully and get back to their regular diet and activities.
