What Does a Diverticulitis Attack Feel Like?
Learn the warning signs, sensations, and outcomes of a diverticulitis attack—from pain symptoms to recovery, complications, and emotional aftermath.
Diverticulitis is a condition affecting the digestive tract, in which small pouches called diverticula that form in the colon wall become inflamed or infected. When this happens, individuals may experience a range of symptoms that can vary in intensity and duration. Understanding what a diverticulitis attack feels like, how it is diagnosed, and its potential complications can help you seek prompt care and manage the condition effectively.
Understanding Diverticulitis
Diverticulitis occurs when diverticula—small, bulging pouches that can develop in the lining of your intestine—become inflamed or infected. Most commonly, these pockets form in the colon and usually cause no symptoms. However, when inflammation or infection sets in, a sudden ‘attack’ may occur, leading to acute discomfort and other health concerns.
- Diverticulosis: Presence of diverticula in the colon without symptoms.
- Diverticulitis: Inflammation or infection of diverticula causing symptoms and possibly severe outcomes.
Symptoms of a Diverticulitis Attack
The hallmark of a diverticulitis attack is abdominal pain—most often felt on the lower left side of the abdomen. This pain can range from mild to severe and is typically constant rather than cramping.
- Lower left abdominal pain: Sudden or severe, persistent, and may intensify with movement or touch.
- Fever: A low-grade fever is common, but higher fevers may indicate complications.
- Changes in bowel habits: Either diarrhea or constipation may occur. Up to half of affected people experience constipation, and about a quarter experience diarrhea.
- Nausea and vomiting: Often results from gastrointestinal upset or pain, and may indicate more serious inflammation.
- Loss of appetite: The discomfort often reduces the desire to eat.
- Bloating and abdominal distension: A sensation of fullness and swelling in the abdomen.
- Difficulty passing gas or stool: In severe attacks, bowel movements may stop.
- Urinary symptoms: Some individuals have urinary urgency, frequency, or discomfort due to inflammation near the bladder.
- General malaise: Feeling unwell is a frequent complaint during an attack.
These symptoms may overlap with other conditions, so a definitive diagnosis often requires medical evaluation.
Characteristics of Diverticulitis Pain
The pain associated with a diverticulitis attack has several distinguishing characteristics:
- Location: Most often the lower left abdomen, but occasionally can occur on the right side in some individuals.
- Nature: Sharp, constant, and may grow worse over several hours or days.
- Duration: It may last several days without treatment, and does not usually subside completely unless managed medically.
- Intensity: Can be mild and tolerable or severe and disabling, sometimes requiring hospitalization.
Unlike some digestive pains, diverticulitis pain is usually unrelenting rather than coming in waves or spasms.
Other Possible Symptoms
- Abdominal tenderness: Pain increases when you press on the area or move.
- Rectal bleeding: Although uncommon, bleeding may occur if a diverticulum ruptures, but this is more typical of diverticulosis.
- Chills and sweats: May accompany fever and infection.
- Mental symptoms: Feeling anxious or fearful due to pain or uncertainty about the illness.
When to Seek Immediate Medical Attention
Diverticulitis can lead to complications if left untreated. Immediate medical attention is needed if you experience:
- Rapid, severe abdominal pain
- Persistent or high fever
- Bloody stools
- Severe bloating with inability to pass gas or stool
- Uncontrolled vomiting
What others are reading
These may indicate a complication such as abscess, perforation, bowel obstruction, fistula, or peritonitis.
Diagnosing a Diverticulitis Attack
A doctor will diagnose diverticulitis through a combination of:
- Symptom review: Assessment of pain location, intensity, duration, and associated features.
- Physical examination: Palpation of the abdomen to detect tenderness and rigidity.
- Blood tests: Checking for signs of infection or inflammation, such as elevated white blood cell count.
- Imaging: CT scanning is the gold standard, revealing inflamed or infected diverticula, abscesses, or perforation.
- Urinalysis: Used to rule out urinary tract infection, which can mimic symptoms.
Diagnostic confirmation is important to distinguish diverticulitis from other abdominal emergencies, such as appendicitis, ovarian cysts, or inflammatory bowel disease.
Who Is at Risk for Diverticulitis?
Although diverticulosis is common in older adults, not everyone develops diverticulitis. Key risk factors include:
- Age (risk increases with each decade, particularly over 60 years old)
- Diet low in fiber
- Obesity
- Physical inactivity
- Smoking
- Certain medications (such as NSAIDs and steroids)
Managing and Treating a Diverticulitis Attack
Treatment approaches depend on the severity and presence of complications.
Uncomplicated Diverticulitis
- Typically managed at home with oral antibiotics.
- A clear liquid diet is often recommended for the first few days to rest the bowel.
- Pain management with acetaminophen or other physician-recommended analgesics.
- Gradual reintroduction of low-fiber foods as symptoms improve.
Complicated Diverticulitis
- Hospital admission may be necessary.
- Intravenous (IV) antibiotics are administered.
- Surgical intervention may be required for serious complications such as perforation, abscess, peritonitis, or obstruction.
- Management of sepsis or shock in critical cases.
When to Resume a Regular Diet
If symptoms subside after a few days (often within 3 to 5 days), patients can gradually return to a regular, higher-fiber diet, as recommended by their doctor.
Recovery After an Attack
Recovery time varies:
- Mild cases: Frequently resolve in a few days with rest, fluids, and antibiotics.
- Moderate to severe cases: May require several weeks of recuperation, especially if complications occurred.
- After treatment: It is crucial to follow-up with dietary and lifestyle modifications to minimize recurrence risks.
Long-Term and Ongoing Effects
For many, symptoms resolve completely between attacks. However, studies show that some individuals may experience:
- Chronic abdominal pain, bloating, or discomfort lasting weeks or months after the initial episode.
- Post-diverticulitis irritable bowel syndrome (aftereffect with increased sensitivity, bowel habit changes, or pain).
- Mental health concerns: Feelings of anxiety, depression, fear of recurrence, or social isolation.
- Bothersome digestive issues: Incomplete evacuation, continued watery stools, or persistent nausea.
Quality of Life Impact
Studies highlight the profound emotional and social toll of recurring or chronic diverticulitis symptoms, including reduced confidence in social settings and fear of travel. These impacts are often overlooked but can be addressed with support and tailored care.
Recurrence and Prevention
More than half of people who experience a diverticulitis attack may have a recurrence. Preventive strategies focus on:
- Maintaining a high-fiber diet
- Staying well hydrated
- Regular physical activity
- Managing weight and underlying medical conditions
- Avoiding smoking and unnecessary use of NSAIDs
Potential Complications of Diverticulitis
| Complication | Description | Warning Signs |
|---|---|---|
| Abscess | Pus-filled pocket near inflamed diverticulum | Pain, tenderness, fever, persistent illness |
| Perforation | Tear or hole in the colon wall | Sudden severe pain, peritonitis |
| Peritonitis | Infection of the abdominal cavity lining | Severe pain, rigidity, shock |
| Bowel obstruction | Blockage of the colon, causing backup | Severe pain, bloating, vomiting, inability to pass gas or stool |
| Fistula | Abnormal connection between colon and other organ | Abnormal discharge, recurrent urinary tract infections |
Living With Diverticulitis: Coping Strategies
- Keep a symptom diary to track warning signs and triggers.
- Discuss recurring or persistent symptoms with your gastroenterologist.
- Seek mental health support to address anxiety or depression related to chronic digestive conditions.
- Regular follow-up to reassess dietary needs and treatment strategies.
Frequently Asked Questions (FAQs) About Diverticulitis Attacks
What triggers a diverticulitis attack?
Triggers are not always clear, but a low-fiber diet, constipation, obesity, lack of exercise, and certain medications may increase the risk. Physical strain and certain foods might also play a role for susceptible individuals.
How long does a typical attack last?
Mild attacks often resolve within a few days of starting treatment, while more severe or complicated attacks may last longer or require hospitalization.
Will diverticulitis always cause pain?
Most attacks include abdominal pain, but some people, especially older adults, may experience only mild discomfort or less obvious symptoms.
How is diverticulitis different from irritable bowel syndrome (IBS)?
While both can cause abdominal pain and bowel changes, diverticulitis is caused by inflammation or infection of colon pouches, whereas IBS is a functional gastrointestinal disorder without underlying inflammation or infection.
Can I prevent future attacks?
Adopting a diet high in fiber, drinking sufficient fluids, maintaining a healthy lifestyle, and managing weight may reduce the risk of recurrence. Your doctor may recommend tailored prevention plans based on your medical history.
When should I see a doctor?
Seek prompt medical attention if you experience severe or persistent abdominal pain, fever, vomiting, or rectal bleeding, or if you have any concerns about your symptoms.
Key Takeaways
- Diverticulitis attacks can range from mild discomfort to severe pain and complications.
- Recognizing symptoms early and seeking medical attention can improve outcomes.
- Ongoing symptoms and psychological impacts are common and deserve medical attention and support.
- Lifestyle modifications and medical treatment offer effective ways to manage and prevent future attacks.
References
- https://www.bswhealth.com/blog/diverticulitis-flare-up-strategies
- https://www.health.harvard.edu/blog/looking-out-for-diverticulitis-202108162572
- https://www.uclahealth.org/news/release/diverticulitis-patients-reveal-psychological-and-physical-symptoms-long-after-acute-attacks
- https://www.hackensackmeridianhealth.org/en/healthu/2021/07/21/signs-your-diverticulitis-could-be-in-a-flare-up
- https://my.clevelandclinic.org/health/diseases/10352-diverticulitis
- https://utswmed.org/medblog/diverticulitis-symptoms-treatment/
- https://www.holycrosshealth.org/newsroom/stories/digestive-health/scotts-diverticulitis-story
- https://www.adventhealth.com/news/national-digestive-disease-awareness-month-polk-county-woman-shares-about-terrifying-experience
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