What Is Diverticulitis?

Diverticulitis is a condition that arises when small pouches, called diverticula, form in the lining of the intestine and become inflamed or infected. These pouches are more commonly found in the colon and often begin as a benign condition known as diverticulosis. When diverticulosis progresses to diverticulitis, symptoms can become painful and even severe.

While the exact cause is not fully understood, diverticulitis is believed to occur due to microscopic or macroscopic perforations in the diverticula, allowing intestinal bacteria to escape and trigger inflammation. It can cause sudden abdominal pain, fever, nausea, and changes in bowel habits.

Types of Diverticulitis

Diverticulitis is typically categorized into two main types:

Uncomplicated diverticulitis:

  • Inflammation is limited to the diverticula.

  • No signs of abscess, perforation, or other complications.

  • Often treated with dietary changes, rest, and medication.

Complicated diverticulitis:

  • Involves further issues such as abscesses, perforations, obstructions, or fistulas.

  • May require hospitalization, drainage, or surgery.

Accurate diagnosis using imaging is key to determining the type and guiding treatment.

Symptoms To Watch For

Diverticulitis symptoms tend to appear suddenly and worsen over time. Key signs include:

  • Persistent abdominal pain, often on the lower left side

  • Nausea or vomiting

  • Fever and chills

  • Bloating or abdominal tenderness

  • Constipation or, in some cases, diarrhea

  • Urinary changes or discomfort

Repeated episodes typically present with similar symptoms, and recognizing the pattern can help with early intervention.

Causes and Risk Factors

Though the exact cause is unknown, diverticulitis results from the inflammation or infection of diverticula in the intestinal wall. Factors that may contribute include:

  • Perforation of diverticula

  • Changes in gut bacteria or microbiome

  • Fecal matter or undigested food becoming trapped in the pouches

Risk factors that may increase the likelihood of developing diverticulitis include:

  • Age over 40

  • Low-fiber diet

  • Obesity

  • Smoking

  • Sedentary lifestyle

  • Chronic use of NSAIDs or steroids

  • Family history of diverticular disease

How It’s Diagnosed

Diagnosis begins with a thorough medical history and physical examination. Due to symptom overlap with conditions like appendicitis or ovarian cysts, imaging is essential.

Common diagnostic tools include:

  • CT scan: Gold standard for visualizing inflammation, abscesses, or perforations

  • Ultrasound: Non-invasive and radiation-free option, useful in certain cases

  • Colonoscopy: Usually performed after recovery to assess the colon and rule out cancer

  • X-ray: Helps detect free air or obstruction

  • Blood tests: Elevated white blood cells or CRP levels can indicate inflammation

  • Pregnancy test: To rule out pregnancy in people of reproductive age

Treatment Options

Treatment depends on the severity of the inflammation and whether the diverticulitis is complicated or uncomplicated.

Uncomplicated diverticulitis:

  • Rest and reduced physical activity

  • Clear liquid diet until symptoms improve

  • Oral antibiotics (if prescribed)

  • Gradual reintroduction of solid, low-fiber foods

Complicated diverticulitis:

  • Hospitalization and intravenous antibiotics

  • Percutaneous drainage: Removal of abscesses via needle and catheter

  • Surgery:

    • Bowel resection: Removal of affected portion of the colon

    • Colostomy or ileostomy: May be necessary if resection isn’t immediately possible

Treatment goals include managing infection, relieving symptoms, and preventing future episodes.

Prevention Strategies

Preventing diverticulitis often involves long-term lifestyle changes, especially for those with a history of diverticulosis. These preventive strategies include:

  • Increase dietary fiber: Whole grains, fruits, and vegetables can help soften stool and reduce pressure in the colon

  • Stay hydrated: Drink at least 8–10 cups of fluids daily

  • Regular exercise: Physical activity supports bowel function

  • Avoid smoking: Smoking is linked to higher rates of diverticular complications

  • Limit red meat intake: Particularly processed meats

  • Use NSAIDs with caution: Prolonged use can increase risk

Preventive care is most effective when implemented early in people diagnosed with diverticulosis.

Possible Complications

Approximately 20% of individuals with diverticulitis experience complications. These can be serious and may require advanced medical intervention:

  • Abscesses: Pockets of pus in or around the colon

  • Intestinal obstruction: Blockage that prevents bowel contents from passing

  • Fistulas: Abnormal connections between organs (e.g., colon and bladder)

  • Perforation: A hole in the colon that can lead to peritonitis

  • Sepsis: A life-threatening response to severe infection

Timely diagnosis and treatment reduce the risk of complications significantly.

Living With Diverticulitis

Managing diverticulitis, especially recurrent cases, requires a personalized approach. Many individuals can live normal lives by incorporating preventive strategies and staying alert to symptoms.

Daily management tips:

  • Keep track of symptoms and flare-ups

  • Maintain a healthy, high-fiber diet (post-recovery)

  • Limit alcohol and processed food intake

  • Take prescribed medications consistently

  • Follow up regularly with a gastroenterologist

Some people may develop anxiety or depression related to recurring episodes. Mental health support is an important part of holistic care.

Frequently Asked Questions

Is diverticulitis the same as diverticulosis? No. Diverticulosis refers to the presence of pouches in the colon. Diverticulitis occurs when those pouches become inflamed or infected.

Can I eat seeds or nuts with diverticulitis? Contrary to past advice, recent research shows no clear link between seeds or nuts and flare-ups. Always follow your healthcare provider’s recommendations.

Will I need surgery? Not always. Most uncomplicated cases are managed medically. Surgery is reserved for those with complications or frequent recurrences.