Does Diverticulitis Affect Life Expectancy?

Diverticulitis doesn't affect the life expectancy of most people with the condition. While complications from diverticulitis can be fatal, this outcome is not common.

Diverticular disease is a common condition, especially in people over age 60. Diverticulosis is the presence of bulges or pouches called diverticula in the lining of the colon. They don't usually cause any symptoms, and most people don't know they are there unless they are discovered during a test that looks at the large intestine.

If they become inflamed, however, they cause a condition known as diverticulitis. This can lead to abdominal pain, constipation and/or diarrhea, and, in some cases, bleeding. This article will discuss how having diverticulitis may affect life expectancy and what may lead to it being a life-threatening condition. 

How Does Diverticulitis Impact Life Expectancy?

Having diverticula in the colon doesn't lead to symptoms or complications for most people. However, about 5% of people with diverticular disease might go on to develop diverticulitis. In about 20% of those people, their condition will be considered "complicated" diverticulitis.

Complications of diverticulitis can include:

• Abscesses: An abscess is a pocket of pus in the body.
• Bleeding: Diverticula can sometimes bleed (though it's not common). Severe blood loss could be life-threatening.
• Bowel obstructions: A blockage that prevents stool from moving through the colon can be painful and may require treatment in the hospital.
• Bowel surgery: Surgery to remove a portion of the bowel is considered a complication of diverticulitis. 
• Fistulae: A fistula is an abnormal connection between two organs or an organ and the skin. 
• Perforation: This is a hole in the intestines. A study in the United Kingdom showed that about 20% of people died within a year after having a perforation due to diverticulitis.

One study showed that mortality (death) rates in people with diverticulitis weren't any higher than for people in the general population. However, in this research, the risk of death linked to diverticulitis was higher in older people, men, and people who had diverticulitis recently (as opposed to several years prior).

Having one or more complications of diverticulitis also increased the risk of death in this study.

Note that when research or health authorities are cited, the terms for sex or gender from the source are used. 

Differences in Women and Men

Diverticular disease is more common as people get older. Diverticulitis also is more common in men who are under the age of 60 than in women in this age group. After the age of 60, it becomes more common in women.

There may be differences between how often females die from complications of diverticular disease vs. males. One study showed that diverticulitis as a cause of death for females was almost twice that of males.

These numbers don’t give much context as to why that might be. It is noted, however, that females in the study were more likely to develop sepsis (the body's extreme, life-threatening response to a severe infection), and males were more likely to have surgical complications. The authors call for more careful monitoring of diverticulitis in females.

Effect of Acute Diverticulitis

After having one bout of diverticulitis, most people (about 84%) will not go on to have another. Having a second round of the disease, though, may raise the incidence of death.

Some of the factors that may increase the risk of death from recurrent diverticulitis include:

• Developing an abscess
• Being older than age 50
• Having a bowel obstruction
• Having a history of smoking tobacco cigarettes 
• Having peritonitis (inflammation of the lining of the abdomen) 
• Developing sepsis (an infection of the blood)

Is Diverticulitis Life-Threatening?

In most cases, diverticulitis is not life-threatening. One study of more than 200,000 people showed that with a first flare-up of diverticulitis, 2.7% of people who were hospitalized died.

Upon a second flare-up of diverticulitis, mortality was 2.2% in those who received treatment. In people who underwent surgery to treat that second flare-up, 4.6% died. 

Living a Long Life With Diverticulitis 

For most people, diverticulitis won’t affect their life span. Many people don’t even know they have diverticular disease. Only a small percentage will have symptoms, and an even smaller number will have complications.

People can take measures to lower their risk of diverticular disease and/or of diverticulitis becoming a problem. One study showed that following a “lower risk” lifestyle may decrease the incidence of diverticulitis by as much as half. The researchers noted that the following can help:

• Having fewer than four servings of red meat per week
• Eating at least 23 grams of fiber a day
• Getting two hours of “vigorous” exercise per week
• Maintaining a body mass index (BMI) of between 18.5 and 24.9
• Having no history of smoking cigarettes 

While the exact causes of diverticular disease aren’t completely understood, there are a few factors that may increase the risk, as follows:

• Genetics: Diverticular disease may be largely due to a person’s genetic makeup. It was thought for many years that a low-fiber diet was the biggest culprit in developing diverticula. Some studies that included people of different ethnicities living in the same geographic area pointed more toward there being a strong genetic factor for the disease. While nothing can be done to change your genes, knowing if there is a family history of the disease can be helpful.
• Age: Diverticular disease is more common as people get older, though younger people can also develop diverticula. Getting the recommended colorectal cancer screenings can help uncover diverticular disease that’s not causing any symptoms.
• BMI: BMI is controversial as a measure of health. However, it has long been used as a tool in many different studies on diverticular disease. A BMI higher than 30 was found to be a risk factor for diverticulitis in men. 
• Red meat: Some research has shown that eating a diet high in red meat may increase the risk of diverticular disease. However, it’s not settled science, as another study showed that this is not the case. Because it’s generally accepted that a diet high in red meat is a risk factor for colon cancer, it may have an effect on diverticular disease as well.
• Lack of exercise: Getting regular physical activity may lower the risk of diverticulitis and diverticular bleeding. In a 2020 review of studies, men who had more "vigorous" activity had a lower risk of disease and disease severity than those who exercised less.
• Low-fiber diet: A long-term diet low in fiber is no longer recommended for diverticular disease. For those who can tolerate it without pain or other symptoms, eating high fiber is recommended. Getting fiber through eating fruits and vegetables is considered the best way. Using a fiber supplement may also be helpful. People with diverticular disease should ask their healthcare provider about which supplement might help.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Taking NSAIDs on a regular basis was shown to be a risk factor for developing diverticulitis. These drugs may also increase the risk of an abscess, a perforation, or bleeding. It’s recommended that people who have had diverticulitis talk to a healthcare provider about the use of NSAIDs.
• Other medications: Aspirin, calcium-channel blockers, opioids, and steroids have all been associated with a higher risk of complications in diverticular disease.

Summary

In most cases, diverticulitis is not considered to be a life-threatening or life-limiting condition. However, symptoms of diverticulitis, such as abdominal pain, constipation and/or diarrhea, and lower-digestive-tract bleeding, can cause complications that can raise the risk of mortality.

Diverticulitis is usually treated at home with rest and a liquid or low-fiber diet to start. For people who have complications, treatment in the hospital is needed to prevent further problems. 

People who are at risk of diverticular disease or who have already been diagnosed should talk to a healthcare provider about lowering their risk of diverticulitis.