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Diverticulitis

Diverticulitis is a digestion problem that happens when pouches that form in the wall of your large intestine get inflamed or infected. This can be very painful. Symptoms may last from a few hours to several days.

It's usually treated with a liquid diet, antibiotics, and pain relievers. A hospital stay or even surgery to remove the diseased part of the colon may be needed if complications develop or other treatments don't help.

  • Symptoms

    What are the symptoms of diverticulitis?

    Belly pain, often in the lower left side, is the most common symptom of diverticulitis. The pain is sometimes worse when you move. Other symptoms include fever, chills, bloating, and gas. You may also have diarrhea or constipation. Symptoms can last from a few hours to several days, or longer if not treated.

  • Causes

    What causes diverticulitis?

    Doctors aren't sure what causes diverticulitis. Bacteria grow in pouches (diverticula) that sometimes grow in the wall of the colon. This bacteria can lead to inflammation or infection.

    It is not known why some people who have these diverticula (a condition called diverticulosis) get diverticulitis and others do not.

    Doctors think diverticula form when high pressure inside the colon pushes against weak spots in the colon wall. Uncoordinated movements of the colon can also contribute to the development of diverticula.

    In most cases, a diet with good fiber makes stool that is bulky and can move easily through the colon. If a diet is low in fiber, the colon must exert more pressure than usual to move small, hard stool. A low-fiber diet also can increase the time stool remains in the bowel. This adds to the high pressure. Pouches may form when the high pressure pushes against weak spots in the colon.

  • Prevention

    Preventing diverticulitis

    You can do some things to help prevent diverticulitis.

    • Eat a high-fiber diet that is low in fat and red meat.

      Whole-grain breads and cereals, brown rice, and fresh fruits and vegetables can all be part of a high-fiber diet.

    • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed.

      Read and follow all instructions on the label.

    • Practice healthy bowel habits.

      You can try eating at regular times, not straining during a bowel movement, and getting plenty of fluids each day.

    • Schedule time each day for a bowel movement.

      Having a daily routine may help.

    • Drink plenty of water.
    • Exercise regularly.
  • Diagnosis

    How is diverticulitis diagnosed?

    To diagnose diverticulitis, your doctor will ask questions about your symptoms and examine you. He or she may do tests to see if you have an infection or to make sure that you don't have other problems. Tests may include:

    • Blood tests, such as a complete blood count (CBC). A CBC may show if you have an infection.
    • Other tests, such as an CT scan, ultrasound, MRI, or X-ray of your belly. These may provide clues about the cause of belly pain and other symptoms.
    • A digital rectal exam. This looks for tenderness or a mass in the lower pelvic area.
    • A fecal occult blood test. This looks for blood in your stool.
    • Flexible sigmoidoscopy and colonoscopy. These may be done if you have bleeding or to look for narrow spots or growths in the bowel.
  • Treatment

    How is diverticulitis treated?

    Treatment depends on how bad your symptoms are. If the pain is mild, you are able to drink liquids, and you have no signs of complications, treatment may include:

    • Medicines such as antibiotics and pain relievers.
    • Changes in diet. These changes start with a clear-liquid or bland diet that is low in fiber. You follow this diet until the pain goes away. You then increase how much fiber you eat.
    • Home treatment. This could include using a heating pad or trying deep breathing.

    If the pain is severe, you are not able to drink liquids, or you have complications of diverticulitis, you may need a hospital stay. Treatment will include:

    • Antibiotics given in a vein (intravenous, or IV).
    • Fluids and food given through your vein only (no food or drink by mouth) for up to a week. This allows the bowel to rest.

    Sometimes surgery is needed to treat some problems or repeated attacks.

  • When to call

    Diverticulitis: When to call

    Call your doctor now or seek immediate medical care if:

    • You have a fever.
    • You are vomiting.
    • You have new or worse belly pain.
    • You cannot pass stools or gas.

    Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

  • Self-care

    How can you care for yourself when you have diverticulitis?

    • Drink plenty of fluids, enough so that your urine is light yellow or clear like water. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • Stay with liquids or a bland diet (plain rice, bananas, dry toast or crackers, applesauce) until you are feeling better. Then you can return to regular foods and slowly increase the amount of fiber in your diet.
    • Use a heating pad set on low on your belly to relieve mild cramps and pain.
    • Get extra rest until you are feeling better.
    • Be safe with medicines. Read and follow all instructions on the label.
      • If the doctor gave you a prescription medicine for pain, take it as prescribed.
      • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
    • Do not use laxatives or enemas unless your doctor tells you to use them.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.