Everything you need to know about diverticulitis
Diverticulitis is difficult enough to pronounce, let alone live with. Experts delve into this digestive condition and share the best ways to treat it.
Anyone who’s suffered a diverticulitis flare-up knows the pain can be excruciating.
Inflammation of the bowel can turn an otherwise happy digestive tract into a battleground.
But what exactly is diverticulitis? What causes the condition, and how do you treat it?
Diverticulosis vs. diverticulitis
Diverticulosis refers to the formation of small pouches – or diverticula – in weak spots along the bowel wall, Gut Doctor gastroenterologist Dr Vincent Ho says.
The condition affects one in 10 people aged over 45 and about 66 per cent of people over 70.
Most will never experience symptoms.
It’s when these pouches become inflamed or infected that diverticulosis turns into the painful condition known as diverticulitis, Dr Ho says.
What are the symptoms of diverticulitis?
Abdominal pain, particularly on the left side, is a hallmark of the condition, Royal North Shore Hospital gastroenterologist Dr May Wong says.
“This is because diverticula are most frequently found in the lower part of the colon, which is on the left side of the abdomen,” Dr Wong explains.
Other symptoms include fever, nausea, vomiting and changes in bowel habits or the appearance of the stool, including the presence of blood or mucus.
Dr Wong says complications such as small tears in the colon, infection or blockages can sometimes occur, so if symptoms are severe, it’s important to see a doctor.
What causes diverticulitis?
Gastroenterology registrar Dr Eddie Kim, of Lismore Base Hospital, says the underlying cause of diverticulitis is not known.
“Previously, it was thought that faecal matter became stuck in the pouches, causing increased pressure, inflammation, infection or tearing,” Dr Kim says.
“New theories include chronic inflammation and changes in the microbiome of the large intestine.”
Dr Ho says diet, age and genetics are the main risk factors.
“In particular, a low-fibre diet has been shown to increase pressure inside the colon and that can lead to these pouches forming,” Dr Ho explains.
Diverticulitis is usually diagnosed during an acute attack through a colonoscopy, barium enema, or CT scan to detect abscesses outside the bowel lining, or a stool test to check for the presence of blood or infections.
How do you treat diverticulitis?
Dr Ho says treating diverticulitis requires a multifaceted approach.
Paracetamol is the first line of defence against the pain, but heat packs can also be helpful.
Antibiotics are also sometimes prescribed to treat the condition, but Dr Ho says there’s some controversy about their use, with recent research suggesting antibiotic treatment may not be all that helpful.
“However, any decision about the use of antibiotics needs to factor in individual circumstances and should be made by your doctor after a thorough medical assessment,” Dr Ho says.
In severe cases, hospitalisation may be necessary and surgery might be considered if complications arise.
Foods to avoid with diverticulitis
Dr Wong says during a flare-up of diverticulitis, a low-fibre diet is often recommended.
“The thought process behind this restriction is to reduce the frequency of bowel movements to allow the inflamed or infected area of the large bowel to heal and recover,” she says.
After a diverticulitis episode, you should switch back to a high-fibre diet.
“This will promote softer, bulkier stools and maintain bowel movements, which is thought to reduce straining, promote gut microbiota, and reduce the risk of faecal matter becoming trapped in the pouches,” Dr Kim says.
Can diverticulitis be cured?
Adopting a high-fibre diet, staying hydrated and sticking to a healthy lifestyle can significantly reduce the frequency and severity of flare-ups.
Dr Ho says the good news is that the majority of people treated for diverticulitis don’t have a recurrence.
“For those who have recurrent attacks – especially if symptoms are severe – there is a benefit from surgery of the diseased bowel,” he says.
“Decisions about the type of surgery would be made by a surgeon and patient after a consideration of all the risks and benefits.”
More on digestive disorders and gut health:
- How to ease the pain of heartburn
- Why microscopic colitis could be the reason you have bowel pain
- Fast and easy ways to boost your gut health
- How to tell if your bowel movements are normal
Written by Dimity Barber.
