Diverticulitis Flare-Up: Symptoms And Risks - Healthline

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Could the Pain in Your Abdomen Be Caused by Diverticulitis?

Medically reviewed by Youssef (Joe) Soliman, MD — Written by James Roland — Updated on June 2, 2022

Basics
When to get care
Symptoms and causes
Diagnosis and treatment
Prevention
Bottom line

An illustration showing infection and inflammation in the diverticulum, which causes diverticulitis.

Little pockets or pouches, known as diverticula, can sometimes form along the lining of your large intestine, also known as your colon. Having this condition is known as diverticulosis.

Some people may have this condition but never know it.

Did you know?

In Western populations:

Diverticulosis occurs in about 10 percent of people over age 40.
Diverticulosis occurs in approximately 50 percent of people over age 60.
The risk of developing diverticulosis increases with age and affects roughly two-thirds of people over the age of 80.

What is diverticulitis?

Sometimes, though, the little pockets in your colon can become inflamed or infected. When these pockets become infected, it can cause a flare-up or attack known as diverticulitis.

Until it’s treated or the inflammation eases, diverticulitis can cause sharp pain, along with other symptoms.

Read on to learn the most common symptoms of diverticulitis, as well as the risk factors, how it’s diagnosed and treated, and steps you can take to prevent a flare-up.

When to see a doctor

Any time you have sudden, intense pain in your abdomen, it’s important to follow up with a doctor.

Along with sudden pain, other symptoms that should prompt you to see a doctor include:

fever and chills
nausea
constipation or diarrhea

Diverticulitis symptoms can be similar to several other digestive conditions. A doctor will be able to do the necessary tests and procedures to rule out other causes and to give you an accurate diagnosis.

What are the symptoms and causes of a diverticulitis attack?

In many cases, diverticulosis doesn’t cause any troublesome symptoms. You may never know you have the condition until you have a colonoscopy or some type of imaging that reveals the bulging pouches in your colon.

However, if the pockets in your colon wall become inflamed and infected, it becomes diverticulitis. Some people refer to it as a diverticulitis attack or flare-up.

The most common symptom is sharp, cramp-like pain in your lower abdomen. The pain may come on suddenly and persist for days without letting up.

Usually, the pain is on the left side of the lower abdomen. However, it can also occur on the lower right side of their abdomen.

Other symptoms of diverticulitis can include:

nausea
vomiting
chills
fever
constipation or diarrhea
bloating
tenderness over the affected area of your abdomen

The small pockets or pouches usually develop in weakened areas of the colon wall. Several factors can cause these pockets to form, such as increased pressure from gas, liquid, or waste.

When these pockets get blocked with waste, bacteria can build up causing swelling and infection. This is what’s known as diverticulitis.

Diagnosis and treatment of diverticulitis

It’s important to tell a doctor about all of your symptoms. This will help them eliminate other conditions and pinpoint the cause of your symptoms.

To start, a doctor will review your symptoms and your medical history. They’ll likely perform a physical exam, specifically checking the area of your abdomen that hurts.

If diverticulitis is suspected, the doctor may order a CT scan. This type of imaging test can help the doctor see inside your colon and identify the diverticula and their severity.

Other tests that may be ordered include:

blood and urine tests to look for infection
a liver enzyme test to check for liver disease
a stool test to check for infection in people with diarrhea
a pregnancy test to eliminate pregnancy as a cause

Your treatment will depend on whether your symptoms are mild or severe.

Medical treatments

If your symptoms are mild, a doctor will likely treat your diverticulitis with:

antibiotics to treat the infection
an over-the-counter (OTC) pain reliever such as acetaminophen (Tylenol)
a liquid-only diet for a few days to help your colon heal

If your symptoms are more severe, or you have other health conditions, you may need to be hospitalized until the infection starts to improve. In a hospital setting, your diverticulitis will likely be treated with:

antibiotics that are given intravenously
a needle inserted into the affected area if an abscess has formed and needs to be drained

In severe cases, surgery may be needed. This is typically the case when:

antibiotics don’t help to clear up the infection
an abscess is too large to be drained with a needle
diverticulitis has caused an obstruction in your colon
the colon wall has been perforated by an abscess or obstruction

At-home treatments

If your diverticulitis is mild, a doctor may recommend a clear liquid diet for a few days to give your colon time to heal. Don’t stay on a liquid diet longer than recommended by a doctor.

A clear liquid diet can include items such as:

tea or coffee without milk or cream
broths
water, seltzer water, or flavored carbonated water
ice popsicles without chunks of fruit
fruit juice without pulp
gelatin

Once your symptoms start to improve, a doctor may recommend that you start adding low fiber foods to your daily food plan, such as:

yogurt, milk, and cheese
cooked or canned fruits without the skin
eggs
fish
white rice and pasta
refined white bread

Always check with a doctor before trying dietary changes.

Prevent a diverticulitis flare-up

Genetics may play a role, which means if you have family members who have this condition, you may be more likely to get it too. But there are other factors that may increase your risk of developing diverticulitis.

Some of the most common risk factors include:

Age: As you get older, your risk of developing diverticulitis increases.
Smoking: The nicotine and chemicals in cigarettes and other tobacco products can weaken the lining of your colon.
Not drinking enough water: If you’re dehydrated, your body will have a harder time with digestion, and waste may not pass through your colon as easily.
Medications: Some drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and steroids may weaken or irritate the colon wall.
Lack of exercise: Working out regularly seems to decrease the odds of developing diverticulitis.
Having overweight: Having extra weight can put more pressure on your colon.
Straining during a bowel movement: This can put extra pressure on the wall of the colon.

Although some of the risk factors for diverticulitis are out of your control, there are some steps you can take to lower your chances of developing this condition, such as:

Eating a high fiber diet: Try to limit red meat, full fat dairy, fried foods, and refined grains. Instead, eat more whole grains, fresh fruits and vegetables, legumes, nuts, and seeds.
Drinking plenty of water: Try to drink at least eight glasses of fluids a day. Being well hydrated can help prevent constipation and keep your digestive tract working properly.
Exercising regularly: Being active can help promote healthy bowel function.
Keeping your weight in a moderate range: Having a moderate weight can help reduce the pressure on your colon.
Avoiding smoking: Smoking can cause changes in all parts of your body and can have harmful effects on your digestive system too.
Limiting alcohol use: Drinking too much alcohol may disrupt the balance of good bacteria in your colon.
Using a stool softener: If you often strain during bowel movements, an OTC stool softener may help reduce the pressure on your colon.

The bottom line

As you get older, your colon wall can become weaker. This can cause small pockets or pouches to form in weakened areas of your colon. If these pouches get infected, it can cause a diverticulitis attack or flare-up.

The most common symptom of diverticulitis is a sharp cramp-like pain, usually on the left side of your lower abdomen. Other symptoms can include fever and chills, nausea, vomiting, and constipation or diarrhea.

If you think you may have symptoms of diverticulitis, it’s important that you follow up with a doctor to prevent it from becoming more severe.

Diverticulitis can be a painful and uncomfortable condition, but with the right treatment and preventive measures, it can be well controlled.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chiu T-C, et al. (2017). Right-sided colonic diverticulitis: Clinical features, sonographic appearances, and management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029290/
Definition & facts for diverticular disease. (2021).https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/definition-facts
Diagnosis of diverticular disease. (2021).https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/diagnosis
Diverticulosis and diverticulitis. (n.d.).https://iffgd.org/gi-disorders/diverticulosis-and-diverticulitis/
Eating, diet, & nutrition for diverticular disease. (2021).https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/eating-diet-nutrition
Strate LL, et al. (2017). Western dietary pattern increases, and prudent dietary pattern decreases, risk of incident diverticulitis in a prospective cohort study.https://www.gastrojournal.org/article/S0016-5085(17)30006-9/fulltext
Symptoms & causes of diverticulitis. (2021).https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/symptoms-causes
Treatment for diverticular disease. (2021).https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/treatment
Tursi A, et al. (2020). Colonic diverticular disease.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486966/

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Medically reviewed by Youssef (Joe) Soliman, MD — Written by James Roland — Updated on June 2, 2022

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