Diverticulitis Symptoms Can Be Subtle—Here’s How To Spot Them Before They Turn Serious
Plus learn how to manage a mild flare-up at home with simple self-care remedies
A nagging cramp low in your belly. A wave of nausea that throws off your day. A fever that sneaks up without warning. On their own, these symptoms might seem harmless or easy to explain away. But together, they could point to a surprisingly common condition that sends thousands of women to the ER every year: diverticulitis. Here we reveal the diverticulitis symptoms you need to know, how to manage a flare-up at home and when you should call your doctor.
What is diverticulitis?
A diverticulitis attack happens when small pouches in the wall of the colon (a.k.a. large intestine) called diverticula become inflamed or infected. You can go your whole life without giving a second thought to these tiny structures.
“But once they start causing problems, that’s when we, as doctors, want to explore it further,” says Prateek Sharma, MD, professor of medicine at the University of Kansas School of Medicine and president of the American Society for Gastrointestinal Endoscopy.
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Paying attention to the early warning symptoms of diverticulitis and getting them checked out promptly can lead to simple, effective treatment that prevents the condition from becoming more serious, says Dr. Sharma.
Diverticulitis becomes more common with age
Diverticulitis is one of the leading gastrointestinal causes of emergency room visits and hospital admissions, especially among adults over 50. Women in this age group are particularly at risk, especially if they eat a low-fiber diet, don’t exercise regularly or frequently use nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium (Aleve).
Diverticulitis symptoms you need to know
When it comes to diverticulitis, inflammation typically shows up in the left lower side of the abdomen and the pain is usually persistent and crampy, Dr. Sharma says. Other symptoms of diverticulitis include:
- Bloating
- Constipation or diarrhea
- Nausea
- Fever or chills
What sets diverticulitis apart from a simple stomach bug or constipation is the presence of infection and fever. “If the pain is mild and you just have a little discomfort, it could be constipation or irritable bowel syndrome (IBS),” Dr. Sharma says. “It’s that combination of pain with fever that makes us concerned.”
He adds that one symptom not typical of diverticulitis is rectal bleeding. “Bleeding from the rectum could be from a multitude of causes, from hemorrhoids to large polyps to diverticular bleeding,” he explains. “But diverticulitis will not present with bleeding. That’s an important distinction.”
What to do if you have symptoms of diverticulitis
If you have diverticulitis symptoms, a healthcare professional will typically perform a physical exam, bloodwork or imaging to confirm a diagnosis.
More specifically, doctors typically order a CT scan to check for signs of inflammation in the colon wall, Dr. Sharma explains. This helps confirm the diagnosis and rule out other potential causes of abdominal pain, like appendicitis or ovarian issues.
For most people, mild diverticulitis can be treated at home. “The first line of defense is usually oral antibiotics like ciprofloxacin or metronidazole,” adds Dr. Sharma.
How to manage diverticulitis symptoms at home
In addition to taking any medication prescribed by your doctor, gentle self-care can help ease diverticulitis symptoms and support healing.
Switch to a soft diet
“During an attack, we recommend a soft or liquid diet—clear fluids, broths, teas and juices—to give your gut a rest,” says Dr. Sharma. “High-fiber foods can actually make symptoms worse at that point.” (Learn more about the best diet for diverticulitis here.)
Slowly add fiber back in
Once the infection improves and symptoms start to settle, fiber becomes a friend again. “Fruits, vegetables, whole grains and beans help prevent constipation, which is key to avoiding future diverticulitis attacks,” he says.
And drinking plenty of water is just as important. Fiber needs fluid to work properly, and dehydration can worsen symptoms of diverticulitis, Dr. Sharma says.
Go for a stroll
Gentle movement, like walking, also helps ease diverticulitis symptoms. “Your bowels move as frequently as you move,” Dr. Sharma adds. “Regular activity plays a big role in keeping your digestive system healthy.”
What about nuts, seeds and popcorn?
You may have heard that small, crunchy foods can trigger diverticulitis, but that idea is outdated. “There is no good science behind that advice,” says Dr. Sharma. “Fruits and fiber are actually healthy choices.”
That said, everyone’s body is different. “If someone tells me they notice symptoms after eating popcorn or nuts, I’ll say go easy on those foods,” he adds. “But for most people, they’re fine.”
When it’s more than a mild case
If pain becomes severe—or if nausea or vomiting worsen and fever is involved—it could be a sign of complicated diverticulitis, which happens when the infection spreads or leads to other issues like a blockage or abscess.
“There are patients with acute diverticulitis who may need to be admitted and treated with IV antibiotics,” Dr. Sharma says.
If the condition isn’t treated, it can cause more serious problems. And for those who have frequent flare-ups, surgery may be recommended. “If you keep getting repeated bouts of diverticulitis, then that segment of colon that’s getting reinfected may need to be removed,” he explains. “It’s a way to prevent future episodes.”
The bottom line on diverticulitis symptoms
You can’t feel diverticula forming, and you can’t always predict when one might get inflamed. But you can notice when something feels off. A shift in pain, a low-grade fever and even subtle changes in digestion are improtant clues.
“When diverticulitis is mild and caught early, we can usually treat it pretty easily with medications and rest,” says Dr. Sharma. “That’s why it’s so important to pay attention to symptoms and get evaluated.”
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