Signs and Symptoms of Diverticulitis

In many cases, diverticula cause no symptoms but occasionally they can become infected and/or inflamed, which is a condition called diverticulitis.

The most common symptom of diverticulitis is stomach pain (usually on the left side), but it can also cause a change in bowel habits (constipation or diarrhea), fever, and nausea or vomiting. Luckily, even with symptoms, the majority of cases of diverticulitis are not complicated and can be treated at home. However, 25 to 30 percent of the time there can be complications that require hospitalization.

The abdominal pain is the most common symptom of diverticulitis and it is usually constant and goes 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 diverticulitis may lead to feeling discomfort or pain primarily on that side. However, in a minority of cases, some people may have pain on the right or on both sides of the abdomen if there are diverticula in other parts of the colon.

Other common symptoms can include:

• chills
• constipation
• cramping
• bloating
• diarrhea (occasionally)
• gas
• fever
• lack of appetite
• nausea
• vomiting

Bleeding with diverticulitis isn’t common but can occur in some cases. If there are complications from the diverticulitis, such as a fistula, abscess, or bowel perforation, there can be other symptoms caused by those conditions. Symptoms of diverticulitis that are less common can include:

• bladder irritation or urinary symptoms
• blood in the stool
• rectal bleeding

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 blood and 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 either 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 which prevents the passage of stool. When diverticulitis leads to a bowel obstruction the symptoms can include abdominal pain, distention, and bloating; constipation or diarrhea; thin stools; and nausea and 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.

Diverticulitis can be managed at home, but the symptoms always require a trip to the doctor or the hospital for evaluation and direction for treatment at home or in the hospital.

Abdominal pain should prompt a call to a doctor, but when it is severe and 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.

In most cases diverticulitis is uncomplicated, but with severe symptoms there is a risk of complications that can be serious and life-threatening. Even if symptoms are thought to be from diverticulitis because it has happened before, calling a doctor is important in order to get the correct treatment and to ensure that more serious problems aren’t going to occur.