Small pouches, called diverticula, can form in the wall of the large bowel as we get older. Simply having them is known as diverticulosis and often causes no symptoms at all. Diverticulitis is when one or more of these pouches becomes inflamed or infected, which can cause pain, a change in bowel habit and feeling unwell. Most flare-ups settle with the right care, and an assessment confirms the diagnosis and rules out other causes.
What causes diverticulitis?
Inflamed diverticula
A pouch in the bowel wall becomes irritated or infected.
Low-fibre diet
Linked to the pouches forming in the first place.
Ageing bowel wall
Diverticula become more common with age.
Trapped stool
Can block a pouch and trigger inflammation.
Not fully understood
The exact trigger varies, but lifestyle plays a part.
When to seek assessment promptly
- Lower abdominal pain, often on the left, that persists
- A change in bowel habit with feeling unwell
- Repeated episodes of similar pain
- Bleeding from the bowel
- Symptoms that do not settle within a few days
How it is investigated and treated
A mild flare may settle with rest, fluids and, in some cases, antibiotics. A more severe flare, or one that is not improving, needs medical assessment. A CT scan is often used to confirm diverticulitis and check for complications during a flare, and once things have settled Mr Kimble may recommend a colonoscopy to look at the bowel lining and make sure nothing else is being missed. A diet with plenty of fibre and fluids, along with regular activity, helps reduce flare-ups. Surgery is not needed for most people and is considered mainly for complications such as an abscess, a narrowing of the bowel or repeated severe attacks.
Seek medical help promptly if you have severe tummy pain, a high fever, are being sick and cannot keep fluids down, or notice significant rectal bleeding, as these can signal a complication that needs urgent care.