Causes, Symptoms and Treatments You Should Know
Your colon, also called the large intestine, is like a long tube that helps move waste out of your body. Sometimes, tiny bulges or pouches form in weak spots along the colon wall. These pouches are called diverticula. Having diverticula is known as diverticulosis. Many people have diverticulosis and never even know it.
But when those pouches become inflamed or infected, the condition is called diverticulitis. Unlike diverticulosis, which usually has no symptoms, diverticulitis can cause pain, fever, and other problems.
How Common Is It?
Diverticulosis is very common, especially as people age. In fact, about half of all people over age 60 have it. The good news is that only about 10%–25% of people with diverticulosis go on to develop diverticulitis. Still, when diverticulitis happens, it can range from mild discomfort to a serious infection that requires hospital care.
Causes of Diverticulitis
Doctors don’t know exactly why diverticula form, but there are some strong clues:
- Pressure in the colon. Over time, pressure from muscle contractions inside the colon may push the inner lining through weak spots in the wall, forming little pouches.
- Low-fiber diet. People who eat less fiber tend to have more constipation. Hard stools and straining increase pressure inside the colon, which may play a role in forming diverticula.
- Aging. The colon wall naturally weakens with age, making older adults more prone to diverticulosis.
- Other possible risks. Obesity, smoking, lack of exercise, and certain medications (like steroids, opioids, and anti-inflammatory drugs) may increase the risk of diverticulitis.
Symptoms of Diverticulitis
Diverticulosis alone usually doesn’t cause symptoms. Diverticulitis, on the other hand, often makes itself known. Symptoms may include:
- Pain or tenderness, usually on the lower left side of the abdomen
- Bloating or cramping
- Fever and chills
- Nausea and sometimes vomiting
- Diarrhea or constipation
- Loss of appetite
Some people may also notice blood in their stool if a diverticulum bleeds. This is usually painless but can be scary. If bleeding is heavy or doesn’t stop, it’s important to call a doctor right away.
Complications
While many cases of diverticulitis are mild, more severe cases can cause serious problems:
- Abscesses (pockets of pus in the abdomen)
- Peritonitis (a widespread, life-threatening infection in the abdominal cavity if a pouch ruptures)
- Bowel obstruction (blockage of the intestine)
- Fistulas (abnormal openings between the colon and other organs, like the bladder)
These complications often require hospital treatment, and sometimes surgery.
Diagnosis
Since diverticulosis often has no symptoms, it’s usually discovered during tests for other conditions, like a colonoscopy. For diverticulitis, doctors may order:
- CT scan. This is the most common way to confirm diverticulitis and check for complications.
- Ultrasound or MRI. Less common but sometimes used.
- Blood tests. These can show signs of infection.
Treatment
Treatment depends on how severe the diverticulitis is.
Mild Diverticulitis
- Antibiotics. Many people can take antibiotics at home to clear up the infection.
- Diet changes. A clear liquid diet for a few days may be recommended until symptoms improve. Then, soft foods are added back gradually.
- Rest. Giving the colon time to heal is key.
Severe Diverticulitis
- Hospital care. If pain is severe, fever is high, or there are complications, hospital treatment is needed.
- IV antibiotics. Medicine is given through a vein instead of by mouth.
- No food or drink. Resting the bowel may mean IV fluids only until inflammation improves.
- Surgery. If abscesses, perforations, or fistulas develop—or if infections keep coming back—surgery may be necessary to remove the diseased part of the colon.
Preventing Diverticulitis
Once diverticula form, they don’t go away. But you can lower your risk of flare-ups and complications. Here’s how:
- Eat more fiber. Fruits, vegetables, whole grains, beans, peas, and lentils add bulk to stool, making it easier to pass. This lowers pressure inside the colon.
- Stay hydrated. Drinking enough water helps fiber do its job.
- Exercise regularly. Movement keeps your bowels moving too.
- Don’t avoid nuts, seeds, or popcorn. In the past, doctors warned against these foods. Today, research shows they don’t increase the risk of diverticulitis. But if you notice certain foods trigger your symptoms, it’s fine to avoid them.
- Quit smoking. Smoking is linked to higher risk of complications.
When to See a Doctor
Call your doctor if you have:
- Severe abdominal pain that doesn’t go away
- Fever and chills with belly pain
- Blood in your stool
- Ongoing constipation or diarrhea
These could be signs of diverticulitis or another serious condition. Early care can prevent bigger problems later.
Living With Diverticulosis and Diverticulitis
For many people, diverticulosis never causes trouble. But if you develop diverticulitis, knowing the signs and getting treatment quickly can make a big difference. With the right diet, lifestyle, and medical care, most people recover well and return to normal life.