Diverticulitis occurs when small pouches, known as diverticula, that form in the lining of the intestine become inflamed or infected. While many individuals with diverticula remain asymptomatic, some may experience significant discomfort and complications.
One of the most severe complications is the rupture of these inflamed pouches, leading to a perforation in the bowel wall.
Identifying the signs of a ruptured diverticulitis is crucial for timely medical intervention.
Signs and Symptoms of Perforated Diverticulitis
Diverticulitis can present with a range of symptoms, including:
Abdominal Pain: Typically severe and constant, often localised on the lower left side of the abdomen. The pain may start as mild discomfort and gradually worsen over time.
Fever: A high fever (above 100.4°F or 38°C) sign of infection, often accompanied by chills and sweating.
Digestive Changes: Symptoms such as constipation or, in some cases, diarrhoea may occur due to inflammation in the colon.
Nausea and Vomiting: This can result from irritation of the digestive tract or an associated infection.
Distended Abdomen or Palpable Colon: The abdomen may appear bloated or swollen, and in some cases, a hardened or thickened section of the colon can be felt when pressing on the abdomen. This can indicate severe inflammation or a blockage.
Rectal Bleeding: Though not common, some individuals with diverticulitis may experience bright red or dark-coloured blood in their stool, indicating bleeding from the inflamed or damaged diverticula.
Constipation or Diarrhoea: Changes in bowel movements are typical, with constipation being more prevalent. However, some people may experience diarrhoea due to irritation in the colon.
Indicators of a Ruptured Diverticulum
A rupture, or perforation, of a diverticulum, is a serious medical emergency. Signs include:
- Sudden, Severe Abdominal Pain: A sharp, intense pain that spreads across the abdomen.
- Peritonitis Symptoms: Inflammation of the abdominal lining, leading to a rigid, tender abdomen.
- Signs of Sepsis: Rapid heart rate, rapid breathing, fever, chills, and confusion.
- Decreased Urination: A potential sign of systemic infection or sepsis.
Complications Arising from a Rupture
Diverticulitis is mild and uncomplicated in about 80% of cases but you should always know when to go to the hospital with diverticulitis. However, if the condition becomes severe or persists, it can lead to serious complications, including:
Gastrointestinal Bleeding: In some cases, diverticula may bleed excessively, leading to significant blood loss and anaemia.
Intestinal Obstruction: Severe inflammation can cause swelling in the colon, leading to a temporary narrowing of the passage. Over time, chronic inflammation may result in scarring (stricture), which can cause long-term blockages.
Fistulas: If the inflamed colon wall erodes, it may form an abnormal connection (fistula) with nearby organs such as the small intestine, bladder, or vagina. This can lead to infections and other complications.
Bladder Inflammation: If diverticulitis develops near the bladder, it can cause irritation and discomfort. In some cases, a fistula between the colon and bladder can allow bacteria to spread, leading to urinary tract infections (UTIs).
Abscess Formation: A collection of pus, known as an abscess, may develop around an inflamed diverticulum. This may need to be drained to prevent further infection. If an abscess ruptures, the infection can spread into the abdominal cavity, causing peritonitis, which is a medical emergency.
Gastrointestinal Perforation: If a diverticulum becomes severely swollen and bursts, it can create a tear in the bowel wall, allowing bacteria and intestinal contents to leak into the abdominal cavity. This can result in peritonitis, a life-threatening condition that may lead to sepsis if left untreated.
What to Do if You Suspect a Rupture?
If you think your diverticulitis has ruptured, it’s important to act fast. A rupture is a medical emergency that can lead to serious complications, so don’t wait to see if the pain goes away on its own. Here’s what you should do:
Get Medical Help Immediately – A ruptured diverticulum can cause life-threatening infections like peritonitis or sepsis. Call emergency services or go to the nearest hospital as soon as possible. The sooner you get treatment, the better your chances of avoiding serious complications.
Avoid Self-Treatment – Do not try to relieve the pain with over-the-counter medications, home remedies, or by waiting it out. Painkillers, anti-inflammatory drugs, or even trying to change your diet could make things worse. Only a doctor can properly diagnose and treat a rupture.
Follow Your Doctor’s Advice – Once you receive medical care, make sure to carefully follow your doctor’s instructions. This may include taking prescribed medications, following a specific diet, resting, or even preparing for surgery if needed. Proper follow-up care is crucial to ensure a full recovery and prevent future complications.
Final Thoughts
Diverticulitis is a rare problem that can occur with diverticulosis. Even less common are the complications that come with diverticulitis itself. Visit a healthcare provider immediately if you have symptoms of diverticulitis. They will determine the right treatment for you and decide if you can be treated at home or if you need to be hospitalised. If you experience this, book your consultation now.
FAQ’s on Perforated Diverticular
1. What does ruptured diverticulitis feel like?
One of the most noticeable symptoms of ruptured diverticulitis is abdominal pain, usually in the lower left side. The pain often comes on suddenly and can be very intense. In some cases, it may start as mild discomfort and get worse over time. The pain can also come and go, changing in intensity throughout the day.
2. How do you know if diverticulitis is leaking?
If diverticulitis leads to a tear in the colon, pus or stool can leak into the abdominal cavity, causing a serious infection called peritonitis. People with a perforated colon usually feel extremely unwell. Symptoms include severe abdominal pain, a rapid heart rate, and changes in blood pressure. If you experience these signs, seek medical help immediately.
3. What happens if a diverticulum bursts?
When a diverticulum ruptures, bacteria and waste from the intestines can spill into the abdominal cavity, leading to peritonitis—an infection that requires emergency medical treatment. If left untreated, this can lead to sepsis, a life-threatening condition where the infection spreads throughout the body.
4. What are some unusual symptoms of diverticulitis?
While abdominal pain—especially on the lower left side—is the most common symptom, diverticulitis can also cause other issues. If an infection is present, you may experience fever, nausea, vomiting, chills, cramping, and constipation. Some people may also feel an overall sense of discomfort or sensitivity in their belly.
