Diverticulitis Symptoms

Diverticulitis can cause symptoms like a change in bowel habits, gas, chills, and nausea. The most common symptom of diverticulitis is left-sided abdominal pain.

Diverticula are small pockets that can form in the colon (large intestine) in areas of intestinal wall weakness. They don't cause symptoms unless they become infected and/or inflamed. When this happens it is known as diverticulitis.

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

This article discusses some of the common symptoms of diverticulitis along with its causes and potential complications. It also covers treatment for this condition.

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. The sigmoid colon 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 occurs 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:

• Chills
• Nausea
• Constipation
• Cramping
• Bloating
• Diarrhea (occasionally)
• Gas
• Fever
• Lack of appetite
  
• Vomiting
  

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

Less common symptoms of diverticulitis can include:

• Bladder irritation or urinary symptoms
• Blood in the stool
• Rectal bleeding

Causes of Diverticulitis

The causes of diverticulitis can vary. Genetics may play a role in up to 50% of diverticulitis cases.

In some cases, as with older age or genetics, a risk factor can't be changed. Other factors, diet or smoking, can be changed through lifestyle choices.

Additional causes include:

• Bacterial infection
• Changes in nerve and muscle capacity
• Alcohol consumption
• Obesity
  

Studies have shown the use of corticosteroid medications also is a risk factor in developing diverticulitis and can contribute to complications.

Complications

While they are not common, several different complications 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. 

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.

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.

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.

Treatment

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.

Home Remedies

Rest may help reduce the pain of diverticulitis, as can a heating pad placed on the abdomen. You also may consider trying a liquid diet while you have symptoms.

Be sure to talk with your healthcare provider about over-the-counter pain medications such as Tylenol (acetaminophen) because non-steroidal anti-inflammatory drugs (NSAIDs) may not be recommended.

Diet

After the first few days, during which some people may benefit from a diet of clear liquids, you may start adding back some low-fiber foods. You can slowly add certain foods including:

• Well-cooked vegetables
• Canned or cooked fruits
• Meat and eggs
• Dairy products

Keep track of how different foods are digested and how they might affect your symptoms. As you recover, you may change to high-fiber foods to prevent further episodes of acute diverticulitis.

Surgery

Surgery may not be needed in many cases, even among people who experience a complication of diverticulitis. Antibiotics, for example, are a standard treatment, although they may be used less often than they once were in people with uncomplicated diverticulitis.

Surgical treatment will depend on the specific situation. A small abscess may not require surgery but fistula caused by diverticulitis typically is treated with surgery. So are cases in which people have become unstable because of severe sepsis (infection).

People with recurring painful episodes due to chronic diverticulitis also may benefit from surgery.

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.

Prevention

High-quality diet choices may help to prevent diverticulitis. For example, red meat consumption may increase the risk of diverticulitis. Research suggests that alcohol use may be associated with a higher risk of bleeding from diverticulosis, but not diverticulitis or other complications.

Other lifestyle factors include:

• Maintaining a healthy weight
• Exercising and staying physically active
• Avoiding or stopping smoking

It's also recommended that people living with diverticulitis avoid regular use of NSAIDs (defined as two or more times per week). Aspirin used to prevent cardiovascular disease is an exception.

Diverticulitis Doctor Discussion Guide

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Summary

Diverticulitis is a condition that happens when small pockets that form in your large intestines, called diverticula, become infected and inflamed. The symptoms include left-sided abdominal pain, along with chills, nausea, and changes in bowel habits like gas or constipation.

There are many causes, including exercise, smoking cessation, and dietary changes, that you can control. Other risk factors, such as an older age, cannot be changed.

Treatments vary based on the severity of your symptoms and any complications, such as a perforation that requires surgical care. Your healthcare provider or a gastroenterologist (digestive system specialist) can discuss your treatment options with you.