What Does a Diverticulitis Attack Feel Like?
Explore the causes, symptoms, diagnosis, and management options for diverticulitis attacks to support long-term digestive health and well-being.
Diverticulitis is a common and sometimes severe digestive disorder that results from the inflammation or infection of small pouches, called diverticula, which can form in the colon’s lining. Recognizing the signs, understanding what an attack feels like, and getting appropriate treatment are vital for managing symptoms and reducing long-term effects.
Understanding Diverticulosis and Diverticulitis
Diverticulosis occurs when pockets (diverticula) develop in the wall of your colon. These pouches are most common after age 60 and usually do not cause symptoms. Diverticulitis happens when one or more of these pouches become inflamed or infected, leading to painful symptoms that may require medical care.
Signs and Sensations During a Diverticulitis Attack
The experience of a diverticulitis attack can vary among individuals, but some symptoms are frequently reported:
- Distinct abdominal pain: Most often felt on the lower left side, ranging from sharp, sudden discomfort to a steady ache that can intensify over several hours.
- Fever: A mild to high body temperature often accompanies the pain.
- Nausea and vomiting: These symptoms may result from the digestive tract’s inability to function normally during an attack.
- Bloating and cramping: The abdomen may feel full, tight, and especially tender to the touch.
- Changes in bowel habits: Diarrhea, constipation, or difficulty passing gas can occur.
- Loss of appetite: Many people find it hard to eat or feel hungry during a flare-up.
“It’s hard to describe how excruciating it was,” recalls one patient, highlighting the intensely painful nature of some attacks. Not everyone will experience all of these symptoms; severity may range from mild, short-lived discomfort to prolonged and disabling pain requiring hospitalization.
Causes and Risk Factors for Diverticulitis
- Aging: Risk increases with age due to weakening of the colon wall.
- Diet: A low-fiber diet leads to constipation and pressure on the colon, potentially resulting in diverticula formation.
- Obesity and inactivity: Both are linked to higher risk for diverticulitis.
- Certain medications: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids may contribute.
- Genetics: Family history can increase susceptibility.
Typically, diverticulitis develops when one or more diverticula become blocked with waste, become inflamed, and may get infected. This leads to the hallmark symptoms described above.
Diagnosis: How Diverticulitis is Identified
If you experience the symptoms of a diverticulitis attack, especially severe or persistent abdominal pain and fever, seek medical attention promptly. Diagnosis involves:
- Physical examination: The provider evaluates abdominal tenderness and other signs.
- Blood tests: Checks for signs of inflammation or infection.
- Imaging: CT scans are considered the gold standard, revealing inflamed or infected areas and ruling out other causes.
- Stool tests or other procedures may be conducted to rule out alternative diagnoses.
What others are reading
Severity: Mild Vs. Severe Attacks
| Severity | Symptoms | Treatment |
|---|---|---|
| Mild (Uncomplicated) | Minimal pain, may resolve on its own, sometimes low fever | Oral antibiotics, clear liquid diet, bowel rest, sometimes outpatient care |
| Severe (Complicated) | Intense pain, high fever, vomiting, signs of infection, or complications (e.g., abscess, perforation) | Hospitalization, intravenous antibiotics, possible surgery, advanced imaging |
Mild cases often resolve within a few days. Severe cases may require urgent hospital care, particularly for older adults or those with underlying medical conditions.
Complications of Diverticulitis Attacks
If not treated promptly, diverticulitis can result in serious complications:
- Perforation of the colon: A hole can develop, leading to infection outside the colon (peritonitis).
- Abscess: A collection of pus may form due to the infection.
- Fistulas: Abnormal connections may develop between the colon and other organs.
- Bowel obstruction: Scarring may create a blockage in the colon.
- Recurring flare-ups: Over half of those with an initial attack are likely to experience another.
Immediate medical care is essential if you develop symptoms such as increasing pain, persistent vomiting, high fever, bloody stools, or signs of bowel obstruction.
Long-Term Physical and Psychological Impact
Research has shown that diverticulitis can continue to affect people long after the acute attack:
- Chronic abdominal pain, bloating, and bowel disturbance: Some patients continue to suffer symptoms akin to irritable bowel syndrome (IBS) long after their initial episode.
- Mental health effects: Anxiety, depression, and social isolation may arise after recurrent or severe attacks.
- Quality-of-life disruption: Fear of another episode may impact day-to-day living and travel.
Physicians are working to develop new questionnaires and screening tools to assess quality-of-life impacts and better manage ongoing symptoms for sufferers.
Treatment and Management Options
Management of diverticulitis depends on the severity of the attack and whether complicating factors exist:
- Antibiotics: Most mild cases are treated with oral antibiotics.
- Diet modification: Clear fluids and low-fiber diets may be recommended during acute phases, with gradual transition to regular foods as symptoms subside.
- Pain management: Over-the-counter pain relief may be used under supervision.
- Surgery: Required in severe or complicated cases to remove affected bowel segments.
- Hospitalization: Reserved for severe attacks or individuals with underlying health conditions; intravenous antibiotics may be needed.
Treatment usually leads to improvement within several days for uncomplicated cases. For those not improving within a week, further investigation is necessary.
Lifestyle and Prevention Strategies
- High-fiber diet: Eating whole grains, fruits, vegetables, and legumes helps maintain bowel health.
- Regular physical activity: Movement supports digestive regularity and decreases risk.
- Maintain healthy weight: Excess weight increases risk of diverticulitis.
- Limit NSAIDs and steroids: Use only as directed by your healthcare provider.
- Stay hydrated: Water supports the function of fiber and overall colon health.
Not all diverticulitis attacks can be prevented, but these interventions can reduce risk for recurrence and improve overall digestive health.
When to Seek Medical Attention
- Severe, persistent, or increasing abdominal pain
- Fever above 101°F (38.3°C)
- Bloody stools
- Continued vomiting or inability to keep fluids down
- Signs of obstruction (no bowel movement, excessive bloating)
If any of these symptoms occur, prompt evaluation is required to avoid complications and ensure proper care.
Living With Diverticulitis: Long-Term Care and Support
Some individuals continue to experience symptoms and lifestyle limitations after recovery. Strategies include:
- Working closely with your gastroenterologist to monitor symptoms
- Joining support groups for digestive health concerns
- Managing stress, anxiety, and depression that may result from chronic digestive symptoms
- Seeking dietary counseling or mental health support if ongoing symptoms or mood issues persist
Frequently Asked Questions (FAQs)
What triggers a diverticulitis attack?
Diverticulitis most often develops when diverticula in the colon become blocked, inflamed, or infected. Risk factors include low-fiber diets, aging, obesity, and medications that affect colon health.
Can diverticulitis resolve on its own?
Mild episodes sometimes resolve without medical intervention, especially when pain is minimal and improvement occurs within 48 hours. However, any persistent or worsening symptoms need medical assessment.
Are repeated attacks common?
More than half of individuals who experience one attack are likely to have another, making prevention and long-term management essential.
Does diverticulitis lead to lasting problems?
Some people develop chronic digestive symptoms, psychological distress, and a four-fold higher risk of irritable bowel syndrome after an attack. Shared decision-making with your provider can help address these challenges.
What should I eat during recovery?
During acute attacks, a clear liquid or low-fiber diet may be prescribed. As symptoms improve, a gradual return to a balanced, high-fiber diet supports healing.
When is surgery necessary?
Surgery may be required if complications arise, such as abscess, fistula, perforation, or if attacks become frequent or severe.
Can lifestyle changes prevent future attacks?
Increased dietary fiber, regular exercise, and the management of comorbid health conditions can reduce recurrence risk and improve digestive health overall.
Additional Resources
- Digestive health specialists
- Registered dietitians for dietary planning
- Mental health counselors for psychological support
- Patient advocacy and support groups
Awareness, early recognition, timely treatment, and comprehensive care all play critical roles in helping people manage diverticulitis attacks and reclaim digestive well-being.
References
- https://www.health.harvard.edu/blog/looking-out-for-diverticulitis-202108162572
- https://www.bswhealth.com/blog/surviving-diverticulitis
- 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://www.adventhealth.com/news/national-digestive-disease-awareness-month-polk-county-woman-shares-about-terrifying-experience
- 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
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