Diverticulitis

Diverticulitis is an advanced form of diverticular disease, although not everyone with diverticular disease experiences symptoms or needs treatment.

• Diverticula are out pouches in the wall of your intestines that happen when a section of weakened tissue bulges outward. Your chances of forming diverticula increase with age.
• Diverticulosis happens when a person has diverticula in the lining of the colon. Some people with diverticulosis experience no symptoms, while others experience discomfort and intestinal bleeding. However, this condition rarely requires surgery.
• Diverticulitis happens when diverticula become inflamed or infected. Diverticulitis is a very painful condition with symptoms that come and go without warning. Treatment can control symptoms and help you feel better. On rare occasions, infected diverticula can burst, requiring immediate surgery.

People who have diverticulosis can often go about their everyday lives without worry. Symptoms only occur when diverticula become inflamed or infected (acute diverticulitis). Acute diverticulitis includes severe symptoms that can stop you in your tracks.

Symptoms of acute diverticulitis include:

• Intense lower abdominal pain, typically on the left side, that does not go away
• Fever and chills
• An abdominal area that is tender to the touch
• Nausea and vomiting
• Diarrhea and constipation

Diverticula occur when weak spots in the lining of the bowel bulge outward. One possible cause is a diet low in fiber. However, researchers do not know what causes the diverticula to become inflamed, infected or burst open.

Our first goal is to rule out medical conditions with symptoms similar to diverticulitis, such as appendicitis, inflammatory bowel disease (IBD), or cancer. We can use imaging tests to pinpoint the location and severity of the diverticula, which helps you get the best possible care.

Tests we use to diagnose diverticulitis include:

• Computed tomography (CT) scan: A CT scan takes X-rays from different angles (slices) to produce images of your colon. CT scans show which part of the colon is affected and whether there are signs of complications, such as a small hole (perforation) or bleeding. Find out more: Computed Tomography Frequently Asked Questions (PDF)

• Blood test: Blood tests identify signs of inflammation or infection, but cannot be used alone to diagnose diverticulitis. If your blood test is positive, you may need additional tests.

Inflammation and infection from diverticulitis can lead to a range of complications. These complications can be uncomfortable and affect your daily life. Our team of experts works quickly to help you get relief and slow the progression of the disease.

Complications of diverticulitis include:

• Small holes (perforations) in the wall of your colon: A perforation happens when small diverticula rupture. Small perforations often heal without surgery. If you experience frequent perforations, we may recommend surgery to prevent future ruptures.
• Large perforations: A large perforation can put you at risk for additional complications, such as a life-threatening infection (sepsis), abscesses or fistulas. If you experience a large perforation, we deliver prompt surgical treatment. Learn more about treatments.
• Stricture: If you have frequent diverticulitis attacks, your body's natural healing process can cause a buildup of scar tissue. This buildup can lead to narrowing (strictures) in the colon, making it difficult for stool to pass through. You may need a colon resection to remove the diseased portion of the colon.
• Abscess: If a perforation is large and bacteria enters the abdominal cavity, a pocket of pus (abscess) may form. We commonly treat abscesses with the help of a radiologist who uses a special drain to draw out the pus.
• Fistula: If you have had an abscess for a long time or if you have inflammation in the bladder or vagina, a fistula may form. A fistula is an abnormal connection between two organs, such as the colon and the bladder or vagina. Fistulas often require surgery to remove the abnormal connection between organs and the diseased portions of the colon.

At UC Davis, you have access to the complete range of diverticulitis treatments. The treatment that is best for you depends on your symptoms, medical history and personal preferences. Our colorectal surgery experts work together to help you understand all of your options. We only recommend surgery if it will significantly improve your symptoms and quality of life.

Non-surgical treatments for diverticulitis include:

• Antibiotics you take by mouth (oral antibiotics)
• A low fiber or liquid diet to make stool easier to pass, so your colon can heal
• Pain medication

Surgical treatments for diverticulitis often involve minimally invasive colorectal surgery techniques, such as laparoscopy or robotic surgery. These techniques use sophisticated tools and advanced technology to carry out procedures through the smallest necessary incision. Minimally invasive colorectal surgery can help you recover quicker and minimize disruption to nearby tissue and organs. Find out more about minimally invasive colorectal surgery.

Surgical treatments for diverticulitis include:

• Colon resection: During a colon resection, we remove damaged colon tissue (colectomy). We are often able to connect the remaining sections of the colon so that you can retain normal bowel functioning.