Diverticulitis: More Than A Stomachache

Persistent lower abdominal pain that does not improve or sudden changes in your bathroom habits can make everyday life uncomfortable and can sometimes signal something more serious than an upset stomach.

If you are having constant lower abdominal pain that seems to last— or have intestinal discomfort that’s only getting worse — it’s time to see your doctor. You may have diverticulitis.

According to Samer Kawak, MD, a Indianapolis colorectal surgeon with Franciscan Physician Network, diverticulitis develops when diverticulosis, a common gastrointestinal problem, becomes inflamed. Left untreated, diverticulitis can cause lingering pain and lead to infection.

Key Takeaways: Diverticulitis

• Diverticulitis can cause abdominal pain, cramping and sudden bowel changes. Symptoms often occur on the lower left side of the abdomen.
• Most cases improve with rest and dietary changes, but some require antibiotics or surgery.
• Age, genetics and lifestyle behaviors can contribute to your risk of diverticulitis.
• Healthy lifestyle changes can help prevent diverticulitis or reduce your risk of it coming back.

What's The Difference Between Diverticulosis And Diverticulitis?

If you've been told you have diverticulosis, you may wonder whether it could turn into something more painful. That's where diverticulitis comes in. Diverticulosis and diverticulitis are related gastrointestinal issues. Diverticulosis is a common digestive condition that affects most American adults as we age. It happens when pockets (diverticula) develop along the weak spots in your large intestine (colon). These pockets can then become inflamed and in some cases infected. 

It’s possible to have diverticulosis and not know it. Most people don’t experience symptoms. But when the pockets in your colon get irritated, you develop diverticulitis, said Dr. Kawak, who practices at Franciscan Physician Network Indiana Colon & Rectal Specialists Indianapolis. It’s a more serious condition — especially if those bacteria-filled pouches burst.

“Diverticulosis is related to increased pressure in your colon,” he said. “When there’s pressure and a pocket can form over time. The progression to diverticulitis occurs when those pockets become inflamed." 

Could Your Abdominal Pain Be Diverticulitis?

Sudden, intense pain on your left side is the most common symptom of diverticulitis. Or you may experience mild pain anywhere in your colon that increases over time.

Dr. Kawak said other signs of diverticulitis may include:

• Abdominal cramping or tenderness
• Bowel changes (sudden constipation or diarrhea)
• Fever and chills
• Loss of appetite
• Nausea

When Should You See A Doctor For Diverticulitis Symptoms?

Because diverticulitis symptoms can mimic other health conditions, a complete physical exam and a conversation about what you’re feeling can help your doctor rule out other problems, Dr. Kawak said.

“A lot of times, we’ll have a high suspicion of diverticulitis based on the physical exam and if the patient shares they have left-sided abdominal pain after eating that just won’t go away,” he said.

To deliver the most accurate diagnosis, your doctor may order these tests:

• Blood tests to detect infection or immune-system activity
• Liver enzyme test to rule out liver disease
• Stool test
• Urine test

Based on your physical exam and test results, Dr. Kawak said your doctor may request a CT scan. Those images can identify any inflamed pockets or other problems in your colon.

How Do Doctors Treat Diverticulitis?

Your diverticulitis treatment depends on the severity of your condition, Dr. Kawak said. Patients who don’t have any complications — such as a hole, infection or blockage in the colon — can usually recover at home with a few changes in activity.

“Bowel rest is the treatment we recommend for people who have uncomplicated diverticulitis,” he said. “I tell people to stick to a liquid diet for a day or two. Then, transition to a low-fiber diet before you add more high-fiber foods.”

If you have complicated diverticulitis, you may need to spend a few days in the hospital. During your stay, your treatment may include:

• Image-guided drainage for any abscesses (infected areas filled with pus)
• Intravenous antibiotics and fluids
• Pain-relieving medications like acetaminophen 

Surgery is the next step for treatment if your diverticulitis symptoms don’t improve or you develop new or additional complications. A colectomy or colon resection removes the part of your colon most affected by diverticulitis.

Am I At Risk For Diverticulitis?

According to Dr. Kawak, your genetics play the biggest role in whether you develop diverticulitis. Roughly 50 percent of people who experience this condition have a family history. Your age also contributes to your risk for diverticulitis.

“Most of my patients who develop this condition are over 40 or 50,” Dr. Kawak said. “About 35 percent of patients under 50 have diverticulosis to begin with, and the number climbs to about 50 percent after 50. That link between age and diverticulosis means there’s also a higher rate of diverticulitis in those patients.”

But your genetics and age aren’t the only factors that boost your risk of diverticulitis. Others include:

• A low-fiber diet
• Irregular bowel movements
• Lack of exercise
• Not drinking enough water
• Obesity
• Smoking

Can I Prevent Diverticulitis?

Once you have diverticulosis, it never goes away. But that doesn’t mean diverticulitis is definitely in your future, Dr. Kawak said. You can adopt healthy lifestyle changes that may reduce the risk you’ll develop this painful, inflammatory condition:

• Don’t smoke or quit smoking
• Eat a high-fiber diet that limits red meat and includes beans, fruits, vegetables and whole grains
• Exercise regularly, aiming for 150 minutes of moderate activity per week
• Maintain a healthy weight for you

Can I Keep Diverticulitis From Coming Back?

Even if you’ve experienced diverticulitis in the past, these changes may help you avoid another bout in the future. Your doctor may also recommend certain medications that can reduce your risk.

Ongoing abdominal pain, bowel changes or repeat diverticulitis flare-ups shouldn't be ignored. Schedule an appointment with a Franciscan Health gastroenterology specialist or colon and rectal surgeon to find the cause of your symptoms and get personalized treatment.