Diverticulitis
Most diverticulitis resolves without surgery.
With timely care and the right long-term plan, most flare-ups heal completely. Understanding the difference between diverticulosis and diverticulitis is where it starts.
Diverticula are small, bulging pouches that can form in the wall of the colon, most often in the lower-left portion (the sigmoid colon). They're remarkably common, especially with age, and usually cause no problems at all. When these pouches become inflamed or infected, the condition becomes diverticulitis, which requires prompt medical care.
Dealing with abdominal pain or a diverticulitis flare? Book a consultation.
Book a consultation
Diverticulosis vs Diverticulitis
These terms sound similar and are often confused, but they mean different things. Understanding which one you have shapes everything that follows.
The quiet one
Diverticulosis
What it is: Having diverticula (pouches) in the colon wall, without inflammation or infection.
How common: Very. Roughly half of adults over 60 have diverticulosis, often without knowing it.
What it feels like: Usually nothing. Most people are discovered incidentally during a colonoscopy.
Treatment: No specific treatment needed. Dietary habits may help prevent progression.
The active one
Diverticulitis
What it is: Inflammation or infection of one or more of those pouches.
How common: Happens in roughly 10 to 25 percent of people who have diverticulosis.
What it feels like: Pain (usually lower left), tenderness, fever, and changes in bowel habits.
Treatment: Antibiotics, rest, dietary adjustments; surgery in select cases.
Causes and Risk Factors
Diverticulitis occurs when weakened areas of the colon wall give way under increased pressure, which can lead to the development of diverticula. Why some of these pouches become inflamed or infected isn't fully understood. Several factors raise risk.
Age
Risk rises steadily after 40. By age 60, diverticulosis is present in roughly half of adults.
Low-fiber diet
Historically linked to diverticular disease. Adequate fiber helps maintain healthy stool form and regular bowel movements, reducing colon pressure.
Constipation
Straining and hard stools increase pressure on the colon wall over time.
Obesity and sedentary lifestyle
Both independently linked to higher rates of diverticulitis.
Smoking
Associated with higher risk of complications, including perforation and abscess formation.
Certain medications
NSAIDs, steroids, and opioids have been linked to increased risk.
Family history
Genetics plays a larger role than previously thought. A family history raises personal risk.
Common Symptoms
Symptoms of diverticulitis can vary from mild to severe. Typical signs include:
Persistent abdominal pain, usually on the lower left side
Tenderness or sensitivity in the lower abdomen
Fever and chills
Constipation or diarrhea
Nausea or vomiting
Bloating and gas
Loss of appetite
Because these symptoms can mimic other conditions, an accurate diagnosis matters. Persistent abdominal pain with fever deserves prompt evaluation.
When to Seek Emergency Care
!Don't wait if you experience any of these
- Severe or rapidly worsening abdominal pain
- High fever or chills with shaking
- Inability to keep down fluids
- Abdomen that feels rigid or extremely tender to the touch
- Significant rectal bleeding
- Signs of confusion or extreme weakness
These can indicate complications like perforation, abscess, or peritonitis, which require urgent evaluation. Go to an emergency room or call emergency services.
How Diverticulitis Is Diagnosed
During your initial consultation, Dr. Chung will thoroughly evaluate your medical history and current symptoms. Diagnostic testing typically includes:
Physical examination
An abdominal exam to check for tenderness, rigidity, and other signs of inflammation.
Blood tests
Check for elevated white blood cell count and other inflammation markers that suggest infection.
CT scan
The gold standard for diagnosing acute diverticulitis. Identifies inflammation, abscesses, perforations, and other complications.
Colonoscopy
Usually performed after the acute inflammation has settled, to confirm diverticulosis and rule out other conditions like colon cancer.
Treatment Approaches
For most cases
Conservative treatment
Most cases of uncomplicated diverticulitis respond well to rest, a temporary liquid or low-fiber diet, hydration, and antibiotics. This approach is typically sufficient to calm the inflammation and heal the infection. Mild cases can often be managed at home; more severe cases may require hospitalization for IV antibiotics.
Long-term
Dietary and lifestyle management
Increasing dietary fiber, staying well hydrated, and engaging in regular physical activity like walking can significantly reduce the frequency and severity of flare-ups. Weight management and not smoking also contribute meaningfully to prevention.
When needed
Surgery
Surgery is reserved for patients with recurrent episodes, severe complications, or in emergencies. The most common procedure is a sigmoid colectomy, which removes the affected portion of the colon. When appropriate, Dr. Chung performs this minimally invasively using laparoscopic or robotic-assisted techniques, which typically means smaller incisions and faster recovery.
Diet and Diverticulitis: What the Evidence Says
Old advice
Avoid nuts, seeds, and popcorn because they might lodge in diverticula and trigger inflammation.
Current evidence
No restriction needed. Large studies have not shown increased risk of diverticulitis from consuming nuts, seeds, or popcorn. In fact, a high-fiber diet that includes whole foods like these may help reduce risk.
Prevention
You can't eliminate the risk of diverticulitis entirely, but you can meaningfully lower it.
✓Eat a high-fiber diet (25 to 30 grams daily) with plenty of fruits, vegetables, legumes, and whole grains.
✓Stay well hydrated, especially when increasing fiber intake.
✓Stay physically active. Regular exercise is linked to lower diverticulitis risk.
✓Maintain a healthy weight.
✓Limit red and processed meats.
✓Don't smoke. If you do, quitting lowers risk over time.
✓Use NSAIDs and opioid pain medications sparingly when possible.
Potential Complications
Untreated or severe diverticulitis can lead to complications including intestinal blockages, abscesses (pockets of infection), fistulas (abnormal connections between the colon and other organs), and perforation of the colon wall. Perforation can cause peritonitis, a serious infection of the abdominal cavity that requires emergency surgery.
The good news is that most cases of diverticulitis are caught and treated before complications develop. Prompt evaluation when symptoms appear is the best way to keep a flare-up simple.
Get an expert evaluation
Whether you're managing recurrent diverticulitis, recovering from a flare, or trying to prevent another episode, Dr. Chung can help you build a plan that fits your situation.
Book a consultation
Call (714) 988-8690
