Diverticulitis Treatment and Prevention

Diverticulitis is a condition caused by inflammation of the colon. It occurs at the site of diverticula, which are small pockets that can form in the wall of your colon. These small pockets tend to form as you and your intestine age, but only 10% to 25% of people with them experience inflammation (diverticulitis). 

So why do these diverticula form and become inflamed? Learn more about diverticulitis causes, treatment, and prevention. 

What causes diverticulitis?

Nothing can become inflamed before it exists. So the first step in inflammation of diverticula is the formation of diverticulosis in the colon. And scientists are still working to understand the exact cause of diverticulosis (and thus diverticulitis). Experts believe that the small pockets likely develop from increased pressure in the colon, which can result from things like constipation. But research trying to identify the exact risk factors for diverticulosis has produced mixed findings.

Researchers have identified the following as possible risk factors for diverticulosis:

• Increasing age

• Smoking

• Obesity

• Lack of physical activity

• Diets low in fiber or high in red meat (though research has produced mixed results, so it’s a bit controversial) 

• Taking aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

Once diverticula form in the colon, they run the risk of episodes of inflammation. Experts think diverticulitis happens when stool (poop) gets caught in the diverticula, builds up, and then irritates the lining of the colon. But, again, there’s ongoing research to better understand this process.

What are the symptoms of diverticulitis?

Some of the common symptoms of diverticulitis include: 

• Pain in your abdomen, most often in the lower left part of your abdomen

• Changes in your bowel habits, like constipation or diarrhea 

• Nausea

• Vomiting

• Fevers

• Chills

How do you diagnose diverticulitis?

If you’re experiencing any of the symptoms of diverticulitis, it’s best to see your healthcare provider for an official diagnosis. They can help figure out exactly what’s going on. And that can be tough because there are many other conditions that cause similar symptoms — like irritable bowel syndrome, inflammatory bowel disease, appendicitis, or a hernia. 

Here are a few things your healthcare provider will do to help make a diagnosis: 

• Ask you questions about your symptoms 

• Perform a physical exam to feel for the spot that seems most tender in your abdomen 

• Order blood tests, which can help check for infection 

• Order a CT scan — the most definitive way to look for diverticulitis — which shows possible complications of diverticulitis, like a blockage or hole in your colon 

How do you treat diverticulitis?

The first step in treating diverticulitis is determining if your case is “complicated” or “uncomplicated.” Your healthcare provider will then decide if you need to go to the hospital for treatment (for a complicated case) or if you can treat it at home (for an uncomplicated case).

Uncomplicated diverticulitis

If you just have local inflammation of diverticula without any other issues, you have uncomplicated diverticulitis. You can usually treat this at home. Your healthcare provider will recommend rest, a special diet of clear fluids (like water, broth, and juice), and possibly antibiotics, depending on how severe your case is.

While most people can treat uncomplicated diverticulitis at home, in certain situations some people need to be hospitalized. That may be the case if: 

• You’re experiencing severe pain.

• Your symptoms prevent you from being able to eat or drink.

• You have other health conditions that can make your condition worse, like being on medications that weaken your immune system. 

Complicated diverticulitis 

If you have an additional issue in your colon — beyond just inflammation of diverticula — you have complicated diverticulitis. These complications can include:

• Bleeding

• A bowel obstruction

• An abscess (a collection of pus that results from infection)

• A perforation (hole)

If you have complicated diverticulitis, you will need to stay in the hospital. Your treatment will likely include:

• Bowel rest, which means not eating or drinking for a period of time 

• Intravenous (IV) fluids to keep you hydrated while you can’t eat or drink

• IV antibiotics to prevent any serious infection 

If your CT scan shows an abscess, a healthcare provider may need to do a special procedure to remove the infected fluid with a needle. Or if you have a blockage or perforation in your colon, you might need surgery to repair the issue.

What happens after a diverticulitis diagnosis?

If you have an episode of complicated diverticulitis, your healthcare provider will recommend a colonoscopy about 4 to 6 weeks after your symptoms resolve. They recommend this to confirm the diagnosis and to rule out other causes of your symptoms, like a tumor. 

Will I get diverticulitis again?

If you have diverticulitis, you might be wondering if you’re more likely to get it again. Luckily, only 9% to 36% of people have another episode of diverticulitis. Here are a few factors that may increase your risk of having it again:

• Age under 50 

• Two previous episodes of diverticulitis 

• Use of corticosteroid medications

Complications after diverticulitis

Even if you don’t have diverticulitis again, you can still have complications after just one episode. 

While most complications of diverticulitis will improve with treatment, others might cause problems after the inflammation is gone. One of these complications is a fistula, or an abnormal connection between two parts of the body. With diverticulitis, this connection can happen between the colon and the skin. It can also occur between the colon and another organ, like the bladder or vagina. 

Sometimes this connection can heal on its own. Other times, it needs surgery to remove the connection and repair the holes.

What can you do to lower your chances of getting diverticulitis?

Since experts aren’t entirely sure on the cause of diverticulosis and diverticulitis, it can be hard to know the best way to prevent it. But here are a few things that may help:

• Quit smoking (if you smoke)

• Consider weight loss if you have a body mass index (BMI) of 30 or greater

• Increase physical activity

• Increase fiber in your diet

• Stay well hydrated

• Avoid NSAIDs 

You may have heard that you shouldn’t eat foods with kernels or nuts if you have diverticulosis. People once thought that these foods got stuck in the diverticula and caused inflammation. But research doesn’t support this thinking anymore. So nuts, corn, and popcorn are all fair game if you have diverticulosis. 

Why trust our experts?

Written by:

Elizabeth Miller, MD

Elizabeth Miller, MD, is a licensed physician in New York with a passion for medical education and healthcare communications. Originally from North Carolina, Dr. Miller completed her dual undergraduate degree from the University of North Carolina at Chapel Hill and her MD from Wake Forest School of Medicine.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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