Diverticulitis occurs when small, bulging pouches, called diverticula, in the colon or large intestine become inflamed or infected. These pouches often develop in weaker areas of the colon wall. A sharp pain in the lower left side of the abdomen might be a sign of diverticulitis.
For those who have experienced the intense, steady pain of a diverticulitis attack, going through it again is something they’d want to avoid, but it can happen. In fact, over half of people who have had diverticulitis are likely to face another flare-up.
Diverticula often form as people age, especially if they are overweight, don’t exercise, or follow a low-fibre diet. Most people with these bulges in the colon wall don’t notice any problems, but if the diverticula becomes inflamed or infected, diverticulitis can cause significant discomfort.
Here in this blog, we will explore all about diverticulitis flare-ups, causes, and treatment options.
Symptoms of a Diverticulitis Attack or Flare-Up
In many cases, diverticulosis doesn’t cause any noticeable symptoms. You may not even realise you have it until a colonoscopy or imaging test reveals the small bulging pouches in your colon.
A diverticulitis attack can manifest in various ways, ranging from mild discomfort to severe symptoms. Here’s a closer look at the signs you may experience:
1. Bloating or Gas
You might feel a sense of fullness or swelling in your abdomen, often accompanied by excessive gas. This can cause discomfort and make your stomach feel tight.
2. Fever and Chills
If the diverticula is infected, your body may respond with a fever and chills. These symptoms indicate that the inflammation has triggered an immune response.
3. Nausea and Vomiting
In severe cases, nausea and vomiting may occur, particularly if the digestive system is significantly affected or blocked.
4. Loss of Appetite
The discomfort and inflammation from diverticulitis often lead to a reduced desire to eat, as meals can exacerbate the symptoms.
5. Tenderness in the Abdomen
The abdomen, especially the lower left side, may feel sore or tender to the touch. Pressing on this area can be painful, as inflammation irritates the surrounding tissues.
6. Changes in Bowel Movements
You may notice diarrhoea, constipation, or alternating patterns between the two. These changes are common as the inflamed colon struggles to function normally.
7. Blood in the Stool
Bleeding from the affected pouches can cause small amounts of blood to appear in your stool. This may vary from light streaks to more noticeable discolouration.
8. Pain That Worsens After Eating
The act of eating can increase pressure in the colon, worsening pain. However, relief often comes after passing gas or having a bowel movement, as this helps the internal pressure.
9. Frequent Urination or Irritation When Urinating
Diverticulitis can sometimes irritate nearby organs, such as the bladder, leading to an increased urge to urinate or discomfort during urination.
What are the Possible Risks of Diverticulitis?
Most cases of diverticulitis are mild. However, severe or ongoing cases can lead to serious complications, including:
- Gastrointestinal Bleeding: Diverticula can bleed heavily, sometimes leading to anaemia.
- Intestinal Obstruction: Severe swelling can cause temporary narrowing of the colon. If the swelling becomes chronic, it can lead to scarring (stricture), causing more long-term narrowing.
- Fistulas: Inflammation can cause the colon wall to erode and connect to another organ, like the small intestine, bladder, or vagina, creating an abnormal passage between them.
- Bladder Inflammation: Diverticulitis near the bladder can irritate it. A fistula can also cause an infection to spread to the bladder.
- Abscess: This is a pocket of pus that may need to be drained. If it bursts, it can cause a severe infection in the abdominal cavity (peritonitis), which is a medical emergency.
- Gastrointestinal Perforation: If a diverticulum swells and tears, it may allow bacteria from the intestines to enter the abdominal cavity. This can lead to peritonitis and potentially cause sepsis.
Factors That Increase the Risk of a Diverticulitis Flare-Up
The exact cause of a diverticulitis flare-up isn’t fully understood, but certain factors can increase the likelihood of it happening. You are more likely to experience a diverticulitis flare-up if you:
- Are over 40 years old.
- Are overweight or obese.
- Smoke addict
- Lead a sedentary lifestyle.
- Follow a diet that is high in animal products and low in fibre, which is common in many.
- Regularly take medicines like NSAIDs, steroids, or opioids.
- Obesity
- Eating a lot of red meat
- Heavy alcohol consumption
- Lack of physical activity
- Vitamin D deficiency, is often due to low sunlight exposure.
Certain medicines, especially if used over a long period, may also raise the risk of developing diverticulitis flare-ups. These include:
- Corticosteroids, like prednisone.
- Opioids, such as codeine and hydrocodone (Vicodin).
- Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil) and naproxen (Aleve).
- Blood thinners, including warfarin and clopidogrel (Plavix).
- Calcium channel blockers, like nifedipine (Procardia) and amlodipine (Norvasc).
In rare cases, certain genetic conditions have been linked to an increased risk of diverticulitis, such as:
- Marfan syndrome
- Ehlers-Danlos syndrome
- Williams-Beuren syndrome
- Coffin-Lowry syndrome
- Polycystic kidney disease (PKD)
What does a diverticulitis attack feel like?
Diverticulitis attack feels like sharp and sudden pain in the lower left side of the abdomen (area below the chest). Identifying a diverticulitis attack early can help you take action before complications develop.
Here’s learn how to recognise the diverticulitis attack:
1. Persistent Abdominal Pain
The hallmark symptom is persistent or sharp pain, usually on the lower left side of the abdomen. This pain may come on suddenly or develop gradually over time.
2. Accompanying Digestive Symptoms
Look for changes in your digestion, such as bloating, gas, diarrhoea, constipation, or difficulty passing stool. Pain may also improve after passing gas or having a bowel movement.
3. Systemic Signs of Infection
Fever, chills, nausea, and vomiting are indications that the diverticula may be infected. These symptoms suggest the inflammation is spreading and requires medical attention.
4. Changes in Urination or Stool
Blood in the stool or increased urinary frequency and discomfort could point to complications from diverticulitis. These symptoms are not typical of other common digestive conditions.
5. Prolonged Symptoms Without Improvement
If abdominal pain and digestive symptoms persist for more than a few days without relief, it’s essential to consult a healthcare provider for evaluation and diagnosis.
What to Do When Diverticulitis Flare-Ups Occur?
When diverticulitis flares up, it can often be managed at home. However, certain situations may require medical attention from a professional.
Self-care and Home Remedies
For mild flare-ups, treatment focuses on diet changes and pain relief. Here are some helpful self-care options:
Clear Liquid Diet: Start with a clear liquid diet, then transition to a low-fibre diet as symptoms improve. You may need to further adjust your diet for diverticulitis to help recovery and prevent future flare-ups.
Stay Hydrated: Drink plenty of fluids, such as plain water, herbal tea, apple juice, or non-acidic, non-spicy, and non-sugary beverages.
Pain Relief: Use over-the-counter medicines to relieve diverticulitis pain. Avoid aspirin and NSAIDs, as they can worsen symptoms.
Heating Pad: Applying gentle heat with an electric heating pad or a hot water bottle can help ease abdominal cramps and pain.
Medications
Antibiotics are usually not recommended for mild diverticulitis, as they haven’t been shown to significantly help and can contribute to antibiotic resistance if misused. However, if symptoms are severe, oral antibiotics may be prescribed, typically for uncomplicated cases that don’t respond to home treatment. Common oral antibiotics include:
- Augmentin (amoxicillin/clavulanic acid)
- Cephalosporin plus metronidazole
For those hospitalised due to diverticulitis, injecting antibiotics may be necessary. These are delivered directly into a vein and may include:
- Cefazolin, cefuroxime, or ceftriaxone plus metronidazole
- Unasyn (ampicillin/sulbactam)
Diverticulitis Surgery
Most individuals with diverticulitis experience complications, such as abscesses (pockets of infected pus), bowel obstructions, or diverticular bleeding due to ruptured blood vessels. In these cases, surgery may be necessary to treat the complication and prevent severe issues like colon rupture, which can lead to peritonitis (inflammation of the abdominal cavity) and a life-threatening condition called sepsis.
The surgical approach typically involves a bowel resection or colectomy. If you’re looking for resection in Leicester, this typically involves removing the affected part of the colon and reattaching the healthy sections. This can be done using traditional open surgery or more commonly laparoscopic (keyhole) surgery. After removing the damaged section, the surgeon may reattach the remaining ends of the bowel or create an ileostomy, where the bowel is redirected through an opening in the abdominal wall.
When to Contact a Doctor?
If you’ve been diagnosed with diverticular disease, it’s important to reach out to your doctor for guidance on managing any new or worsening symptoms.
You should call a healthcare provider if you experience constipation, diarrhoea, vomiting, or a fever that lasts longer than a few days. These could be signs of a more serious issue.
Seek emergency medical help immediately if you have:
- Severe or sharp abdominal pain
- Rectal bleeding
- Fainting or feeling lightheaded
- Confusion or difficulty staying alert
- Trouble keeping food or water down
Don’t ignore these symptoms—they could indicate a serious complication that needs prompt attention.
Final Thoughts
As we age, the walls of our colon can weaken, leading to the formation of small pockets or pouches. If these pouches become infected, it can trigger a diverticulitis flare-up. Diverticulitis flare-ups can be painful and disruptive, but understanding the condition and making lifestyle changes, such as following a proper diverticulitis diet, can help manage symptoms and reduce future risks.
The most common symptom of diverticulitis is sharp, cramp-like pain, typically felt on the lower left side of the abdomen. Other symptoms may include fever, chills, nausea, vomiting, and changes in bowel habits, such as constipation or diarrhoea.
If you suspect you have symptoms of diverticulitis, it’s crucial to see a doctor and book your consultation to prevent the condition from worsening.
Frequently Asked Questions
1. What is the best treatment for diverticulitis?
For severe cases of diverticulitis, patients may need to receive intravenous antibiotics and fluids for several days. This helps the colon to rest. If a patient shows improvement after a few days, they are typically discharged with a prescription for a longer course of antibiotics.
2. What foods should I avoid with diverticulitis?
It’s best to stay away from certain foods if you have diverticulitis. This includes:
- Whole grains
- Fruits and vegetables with skin and seeds
- Nuts and seeds
- Beans
- Popcorn
3. Can I eat bananas if I have diverticulitis?
While fresh fruits like apples and pears are high in fibre when eaten with the skin, it’s better to choose lower-fibre options like applesauce if you’re experiencing symptoms. If you’re prone to constipation, it’s wise to avoid unripe bananas.
4. How can I relieve gas with diverticulitis?
Gradually increasing your fibre intake and staying well-hydrated can help manage gas. Remember that fibre needs water to be effective. It’s normal to have some extra gas during this adjustment period as long as no other symptoms like fever exist.
5. What colour is a stool with diverticulitis?
Diverticulitis can cause abdominal pain and fever, and in some cases, it can lead to bleeding from the rectum. This bleeding may appear as bright red blood, maroon stools, or black, tarry stools.
6. Can you feel lumps with diverticulitis?
Common symptoms include abdominal pain and a noticeable lump in the abdomen. Some patients may present with complications like perforation or peritonitis.
7. What are the warning signs of diverticulitis?
One of the first warning signs of diverticulitis is abdominal pain. Frequent stomach pain may indicate a problem with your digestive system. Pay close attention to pain in the lower abdomen, especially on the left or right side.
