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Diverticulitis Guide

Signs and Symptoms of Diverticulitis

By
Amber J. Tresca
Amber J. Tresca
Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.
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Updated on August 06, 2022
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 by
Robert Burakoff, MD, MPH
Dr. Burakoff
Medically reviewed by Robert Burakoff, MD, MPH

Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.

 

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Diverticula are small pockets that can form in the colon (large intestine) in areas of intestinal wall weakness. They don't cause symptoms but they can become infected and/or inflamed. This condition is called diverticulitis.

The most common symptom of diverticulitis is left-sided abdominal pain, but it can also cause a change in bowel habits, fever, and nausea or vomiting.

Even with symptoms, most cases of diverticulitis can be treated at home. However, complications can occur, sometimes requiring treatment in the hospital.

diverticulitis symptoms

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Frequent Symptoms of Diverticulitis

Abdominal pain is the most common symptom of diverticulitis. It is often chronic and can go on for several days.

In most cases, the diverticula form in the last part of the large intestine, which is called the sigmoid colon. It is located on the left side of the abdomen, which is why stomach pain from diverticulitis usually affects the left side of the abdomen. The pain usually occurs after eating.

In some cases, the pain can affect the right or both sides of the abdomen. This may occur if there are diverticula in other parts of the colon. The pain of diverticulitis is located in the lower part of the abdomen and is not felt higher up, like under the ribs, as is the case with some other digestive conditions.

Other common symptoms of diverticulitis can include:

Rare Symptoms of Diverticulitis

Complications from diverticulitis, such as a fistula, abscess, or bowel perforation can cause other symptoms.

Less common symptoms of diverticulitis can include:

Complications

While they are not common, there are several different complications that may occur along with diverticulitis.

Abscess

An abscess is a bacterial infection that causes a pocket of pus to form. Abscesses associated with diverticulitis may cause fever and abdominal pain. They are treated with antibiotics and/or drainage.

Fistula

A fistula is a tunnel that forms in the body and connects areas of the body that are not normally connected—such as two organs or an organ and the skin. 

Symptoms of a fistula (which depends on location) can include a break in the skin, swelling, pain, passing air while urinating, passing stool through the vagina, a visible skin break, or drainage from the area.

A fistula may be treated with surgery or with the use of a seton, which is a thread that is gradually tightened until the fistula is closed.

Bowel Obstruction

A bowel obstruction is a blockage in the intestine that prevents the passage of stool. When diverticulitis leads to a bowel obstruction the symptoms can include:

  • Abdominal pain
  • Distention (swelling) and bloating
  • Constipation
  • Thin stools
  • Nausea
  • Vomiting

An obstruction might be treated in the hospital through the use of a nasogastric (NG) tube, or in some cases may require surgery.

Perforation

A perforation is a hole in the colon. It is a serious condition that requires treatment immediately in order to prevent complications such as peritonitis, which is a potentially fatal infection.

The symptoms of a perforation can include severe abdominal pain, fever, chills, bleeding from the rectum, and nausea and vomiting.

When to Worry About Left-Sided Abdominal Pain

Diverticulitis can be managed at home, but you should always see a healthcare provider if you have symptoms. They will evaluate you and will provide instructions for treatment at home or tell you to go to the hospital.

Abdominal pain should prompt a call to your healthcare provider. When it is severe or accompanied by other symptoms such as fever, nausea, vomiting, and rectal bleeding, it is a reason to go to the emergency department right away or even to call 911.

Diverticulitis Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

A Word From Verywell

In most cases diverticulitis is uncomplicated, but severe symptoms could signal that you're having complications that can be serious and life-threatening. Even if your diverticulitis symptoms feel like a flare-up that you've had before, call your healthcare provider.

Frequently Asked Questions

  • What's the difference between diverticulitis and diverticulosis?

    Diverticulosis is when small pockets, or pouches, form on the inside of your colon where its walls have become weaker. Diverticulitis is a condition that occurs when these pockets become infected or inflamed.

    Learn More: Diverticulosis vs. Diverticulitis
  • What foods should I avoid if I have diverticulitis?

    Generally speaking, there is no specific food associated with an increased risk of diverticulitis, opposite to what was thought in the past that seeds and nuts can lodge in the diverticulum and increase the risk of diverticulitis. However, red meat consumption and western dietary pattern may increase the risk of diverticulitis. Research also suggests that alcohol use might be associated with an increased risk of bleeding from diverticulosis, but not diverticulitis or other complications.

    Learn More: What to Eat When You Have Diverticulitis
  • Will diverticulitis symptoms return if I've had them before?

    It's possible. Recurrence of acute diverticulitis within 10 years will happen in 8% to 36% of cases. Lifestyle changes, medication, and careful monitoring by your healthcare provider can help prevent this.

    Learn More: Signs of a Diverticulitis Flare-Up and How to Manage It
  • What else can cause symptoms of diverticulitis?

    There are other medical conditions that can be mistaken for diverticulitis because of similar symptoms. These conditions include irritable bowel syndrome, inflammatory bowel disease, appendicitis, and cholecystitis (gallbladder inflammation).

  • Can diverticulitis go away on its own?

    It can. Many people with uncomplicated diverticulitis will see their symptoms go away in about a week. It's still important that you speak to a healthcare provider so they can diagnose the severity of your case and discuss treatment with you.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Diverticular Diseases.

  2. Imaeda H, Hibi T. The burden of diverticular disease and its complications: West versus east. Inflamm Intest Dis. 2018;3(2):61-68. doi:10.1159/000492178

  3. Onur MR, Akpinar E, Karaosmanoglu AD, Isayev C, Karcaaltincaba M. Diverticulitis: a comprehensive review with usual and unusual complications. Insights Imaging. 2017;8(1):19-27. doi:10.1007/s13244-016-0532-3

  4. Carabotti M, Falangone F, Cuomo R, Annibale B. Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review. Nutrients. 2021 Apr 14;13(4):1288. doi:10.3390/nu13041288

  5. Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, Fitterman N, Shamliyan T, Wilt TJ, et al. Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians. Ann Intern Med. 2022 Mar;175(3):416-431. doi:10.7326/M21-2711

  6. Pulzato I, Boero E, Shaipi E, Cardinale L. "Sigmoid diverticulitis mimicking cholecystitis" a clinical challenge. Ultrasound J. 2019 Jun 11;11(1):14. doi:10.1186/s13089-019-0127-6.

  7. National Institutes of Health. Diverticular disease and diverticulitis: Treating acute diverticulitis.

Additional Reading

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.

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