Symptoms of Diverticulitis

Diverticula can occur as a natural side effect of aging. After years of use and uneven pressure from constipation and other bowel issues, the colon's lining can weaken, and parts of it can bulge through the colon wall, causing diverticulosis. Many adults over 60 have these pouches; usually, they do not cause any problems. However, if a pouch gets blocked or filled with stool, bacteria can grow inside, leading to infection and inflammation. Scientists are not sure exactly what causes diverticular disease, but they believe it may be a combination of multiple factors, including diets high in red meat and low in fiber, having obesity, smoking, a lack of physical activity, and taking certain medications, like steroids or nonsteroidal anti-inflammatory drugs (NSAIDs).

Pain is one of the first symptoms of diverticulitis. It most often appears in the lower left abdomen, but it can appear in the right side if that is where the pouches developed. The pain usually comes on suddenly and is typically sudden and sharp. However, it can also start mild and get worse over time.

Infection is a common cause of fever, and people with diverticulitis may have an increased body temperature. Many people might consider taking an over-the-counter NSAID to treat a fever, but this is not recommended without consulting a doctor. NSAIDs and aspirin are associated with an increased risk of diverticular disease, and taking them when experience diverticulitis can increase the risk of bleeding and other complications.

Diverticulitis can lead to boating as gas can get trapped in the inflamed areas of the colon. Someone with diverticulitis may experience abdominal pain that radiates throughout the abdomen and even into the back and shoulders. Passing gas or having a bowel movement may relieve this pain.  

Changes in bowel habits associated with diverticulitis can include constipation. When the colon becomes inflamed, it narrows, making it harder to pass stool. In cases of chronic diverticular disease, the lower colon can become narrowed or distorted, causing constipation or small stools. Because constipation from diverticulitis can lead to bowel obstruction, doctors may use imaging tests to evaluate the bowel structure.  

Diarrhea more than three times a day can be a sign of bowel obstruction. It occurs because the formed stool cannot move through the digestive tract, but liquid stool can move around it. Diahrrea can be a sign of serious complications, especially if there is blood present, and may require hospitalization for advanced treatment and monitoring.  

Infection and obstruction from diverticulitis can cause nausea. If the bowel is blocked and food cannot pass, fluid, food, and gas from the small intestine can back up into the stomach, causing nausea. Infections can also cause nausea, so it may occur in cases of diverticulitis even if a bowel obstruction is not present. Many gastrointestinal diseases can cause nausea, so it is important to talk to a doctor to determine the cause.

Vomiting can occur in diverticulitis for several reasons. If bowel obstruction is present and food, gas, and fluid from the small intestine are backing up into the stomach, the person may vomit dark green bile-colored fluids. If someone with diverticulitis is experiencing significant abdominal pain, this may also cause vomiting. Vomiting can be a sign of severe complications of diverticulitis. If vomiting occurs, seek medical attention.

People with diverticulitis may not be able to eat due to the pain that they are experiencing. In cases of bowel obstruction or if the loss of appetite and lack of eating is prolonged, there is a potential for weight loss and malnutrition. In this case, intravenous fluids and nutrients may be required, commonly in an in-patient hospital setting.

Rectal bleeding does not generally occur with diverticulitis. When it does occur, it can result from diverticular bleeding, which happens when the blood vessels leading to the pouches that have formed in the colon wall break open. Diverticular bleeding does not usually cause abdominal pain, but it can lead to the loss of a large amount of blood, putting someone at risk for anemia.

The sigmoid colon is the last section of the large intestine. It is s-shaped and is located on the lower left side of the abdomen. When someone has diverticulitis, the inflamed sigmoid colon can press against the bladder, which can lead to urinary urgency.

Fatigue is a normal part of the body's response to fighting off infection. A significant infection can cause severe physical and mental exhaustion that differs from everyday tiredness. Getting enough rest is an essential part of healing and recovering from diverticulitis.

Back pain from diverticulitis may result from gas and constipation, but it can also be a sign of severe complications. If you have diverticulitis and are experiencing sudden back or abdominal pain that worsens or is very severe, call your doctor or seek emergency care, as this can be a side of a life-threatening complication like bowel perforation.

Mucus in stool can also be a symptom of diverticulitis. When the colon is irritated and inflamed, solid bowel movements may not be able to pass, but liquid and mucus can still move through the gut around the obstruction.

Chills and sweating are the body's way of regulating body temperature; chills help to increase the core temperature, while sweating lowers body temperature. These symptoms are typically present when someone has a fever and can be a sign that the body is trying to fight off an infection, which is why they may occur when someone has diverticulitis.

A complication of diverticulitis is a colovesical fistula (CVF), a rare, abnormal connection between the colon and the bladder that allows fecal matter to enter the bladder, which can lead to frequent UTIs. While this is a rare complication, as many as 75% of CVFs are associated with diverticulitis.

Recognizing early symptoms of diverticulitis can ensure timely medical intervention and help avoid serious complications. If you are experiencing symptoms of diverticulitis, consult a healthcare professional for an accurate diagnosis and personalized treatment plan.