Diverticulitis symptoms and treatment 

A sudden stomachache, bloating or changes in your bathroom habits can leave you wondering what's going on. In some cases, these symptoms may be linked to diverticulitis. 

Diverticulosis happens when small pouches, called diverticula, form in the wall of the colon. It’s common, especially as people get older, and often doesn’t cause symptoms. Many people find out they have it during routine care, such as a colonoscopy or CT scan.

Diverticulitis happens when those pouches become inflamed or infected. That can cause belly pain, fever, changes in bowel habits and other symptoms that may need medical care.

Here’s what to know about diverticulitis symptoms, causes, treatment and when to seek care. 

Diverticulitis symptoms

Diverticulitis symptoms can vary depending on the severity of the flare-up and whether an infection is present.

Common symptoms include:

• Abdominal pain, usually on the lower left side
• Bloating and gas
• Changes in bowel habits
• Fatigue
• Fever
• Loss of appetite
• Nausea or vomiting
• Rectal bleeding

Many of these symptoms can also occur with other gastrointestinal conditions. However, ongoing abdominal pain, fever, sustained changes in bowel movements or rectal bleeding should be evaluated by a provider.

What causes diverticulitis?

Diverticulosis develops when pressure inside the colon causes the inner lining to push through weak spots in the intestinal wall, creating small pouches. Once diverticula form, stool balls can become trapped inside them, which may trigger inflammation or infection.

Several factors may increase the risk of developing diverticulosis and diverticulitis, including age, family history, obesity, smoking, low fiber intake, physical inactivity and the use of certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). 

Diverticulitis diet

If you have diverticulosis without symptoms, you usually don’t need major diet changes. In general, a high-fiber diet supports colon health and may help prevent more diverticula from forming.

During a diverticulitis flare, your provider may recommend temporary adjustments to give your digestive tract time to recover. Depending on the severity of your symptoms, this may include a clear liquid diet followed by a low-fiber diet for a short period of time. As symptoms improve, most people can gradually return to their usual eating habits.

Many people have heard they should avoid popcorn, nuts or seeds. Current evidence doesn’t support that restriction for people with diverticulosis who don’t have symptoms. 

When to seek care

Contact your provider if you experience:

• Fever
• Nausea or vomiting that prevents you from eating or drinking
• Persistent abdominal pain
• Rectal bleeding
• Symptoms that continue to worsen

Seek emergency medical care if you develop severe abdominal pain, inability to eat or drink, signs of dehydration, or other symptoms that feel urgent or severe. 

How diverticulitis is diagnosed

To diagnose diverticulitis, your doctor will ask about your symptoms and health history and do a physical exam. Blood work or imaging may help confirm the diagnosis and rule out other conditions. 

Diverticulitis treatment

Treatment depends on the severity of your symptoms and whether complications are present.

Mild cases may improve with dietary modifications, rest and close monitoring. More significant infections may require antibiotics, and severe cases sometimes require hospitalization. Surgery is usually reserved for complications, such as an abscess, perforation, stricture or fistula or for recurrent episodes that significantly affect your quality of life.

Your provider can recommend the treatment approach that is most appropriate for your situation.  

If you’re due for colorectal cancer screening or haven’t had a recent colonoscopy, your doctor may recommend one after your symptoms have resolved. 

Managing diverticulitis

While diverticulitis can be painful and disruptive, many people recover fully with prompt treatment and appropriate follow-up care.

If you’re experiencing symptoms that concern you, don’t ignore them. Early evaluation can help identify the cause of your discomfort and get you on the path to feeling better.