Gastroenterology

Bloated, Constipated or Worse? It Might Be Diverticulitis

January 17, 2020
Scott Baker, MD

Author:

Bloated, Constipated or Worse? It Might Be Diverticulitis

It’s easy to take your digestive system for granted, until something goes wrong. In fact, a lot goes on undetected in your intestines.

What is Diverticulitis?

Sometimes small pouches or sacs form in the intestine lining, usually in the lower part of the large intestine or colon. These marble-sized pouches, called diverticulum, occur when a weak section of your colon gives way and allows a bulge to form.

If you develop a pouch you have called diverticulosis, but these pouches are usually harmless and don’t cause symptoms. It’s estimated that more than one in three (35 percent) adults in the U.S. age 50 and younger have diverticulosis – and most never develop problems.

When a pouch does become inflamed – either by a tear or a stool blockage – a painful condition called diverticulitis can occur. Researchers have found that less than 5 percent of people with diverticulosis develop diverticulitis, though an estimated 200,000 people are hospitalized with diverticulitis each year.

Diverticulitis can be mild and require only rest, diet changes and possibly antibiotics to resolve. Sometimes it’s more serious and even life-threatening – so it’s important to pay attention to symptoms and seek prompt medical care.

Know the symptoms of diverticulitis

Diverticulosis can cause bloating, constipation/diarrhea and cramping/pain in the lower abdomen.

Diverticulitis can cause severe pain in the lower left abdomen that starts as mild and worsens, or occurs suddenly with changing intensity. Symptoms also include constipation/diarrhea, fever/chills, nausea/vomiting.

Diverticular bleeding is signaled by a sudden, large amount of red or maroon-colored blood in stool causing dizziness, light-headedness or weakness.

What Should I Do if I Suspect Diverticulitis?

Call your provider if you have:

  • Fever, chills, abdominal swelling or vomiting
  • Blood in your stool
  • Severe or persistent pain

Seek medical help immediately if your abdomen becomes rigid and there’s pain with movement. This is a sign of peritonitis, a dangerous infection.

About one in four people with acute diverticulitis develop complications. These include:

  • Abscess – collection of pus causing painful infection
  • Fistula – abnormal passage/tunnel, usually between the colon and bladder or colon and vagina
  • Peritonitis – pouch rupture or tear that allows contents of intestine to leak into abdomen
  • Intestinal obstruction – partial or full blockage of the bowel that prevents stool from passing

Complications are serious and require prompt or immediate medical attention. Some can be treated with intravenous fluids and antibiotics. A needle may be inserted into your abdomen to drain pus from an abscess. In more severe cases, surgery may be needed to drain an abscess, repair a fistula or remove infected segments of colon. With a bowel resection, the surgeon removes infected colon and reattaches healthy segments. In more severe cases, infected bowel is removed and a colostomy is created to temporarily or permanently empty stool into a bag that attaches to the skin.

Can diverticulitis be prevented?

You can help prevent diverticulitis by exercising regularly, eating fiber and drinking plenty of water and fluids. Pay attention to these risk factors:

  • Aging
  • Obesity
  • Smoking
  • Lack of exercise
  • Diets heavy in fat and low in fiber
  • Medications (steroids, opioids, nonsteroidal anti-inflammatories)

While symptoms can be similar, the cause of diverticulitis is different from other digestive system conditions, such as irritable bowel syndrome and inflammatory bowel disease. Diverticulitis does not cause other bowel disorders.

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