The human intestinal tract is divided into two sections: the small and large intestine. The large intestine is also referred to as the colon. The typically painless condition of diverticulosis occurs when pockets known as diverticula are formed in the wall of the colon. Diverticula are usually found in areas where the colon’s outer wall has become weakened, allowing the inner wall to bulge through and form a pocket. Research has not been able to pinpoint any one cause for these diverticula to form, though a diet low in fiber is commonly thought to be a significant contributor.
The condition known as diverticulitis occurs when these diverticula become infected or inflamed. Many people with diverticulosis may not be aware of its presence, but diverticulitis is much more difficult to overlook. Mild to severe pain and various digestive problems are the hallmarks of this condition. The severity of a case of diverticulitis determines the appropriate treatment plan. A mild case is almost always treated with an antibiotic and diet changes, while a more severe case can require hospitalization or even surgery.
All or some of the following signs of diverticulitis may be present in an individual and should be evaluated by a physician.
1. Abdominal Pain
Lower abdominal pain is the most common symptom of acute diverticulitis. Though discomfort can be felt on either side of the body, left-sided pain is most common. Certain people experience referred pain that radiates from the abdominal area to the low back. Pain can be sharp and severe or feel like cramps, tenderness or a persistent ache that gets progressively worse. Discomfort can be exacerbated by movement or tight clothing such as a waistband.
The pain associated with diverticulitis is thought to be primarily the result of inflammation. This inflammatory response can cause tissue erosion in the wall of a diverticulum and subsequent irritation of the surrounding tissue. An enclosed pocket of infection called an abscess can also develop and cause pain in the affected area. If tissue erosion causes an opening large enough to perforate the intestinal wall, a more serious and painful infection called peritonitis can follow. Peritonitis occurs when bacteria enters the normally sterile abdominal cavity and infects the peritoneal lining. During an evaluation, a doctor will assess the patient’s pain level and administer tests to rule out other sources of abdominal pain, such as liver disease or pregnancy in women during their child-bearing stage of life.
2. Fever
The presence of abdominal pain combined with a fever is often enough to make a physician strongly suspect diverticulitis. Most people with a mild or moderate case of diverticulitis report a persistent low-grade temperature. However, a rapidly rising fever can indicate that a more severe infection is present and should be evaluated by a physician as soon as possible. Elevating core temperature is one of the human body’s natural defenses against an infection in any area. By raising the temperature, the body is attempting to create a hostile environment for the bacteria responsible for the infection and inhibit their growth and multiplication.
3. Nausea
Many people suffering from diverticulitis report a nauseous feeling before or during an attack that may or may not be accompanied by vomiting. The symptom of nausea is triggered when infected or inflamed cells in the colon release certain chemicals. The brain receives these chemical signals and initiates a nauseous sensation to discourage more food from entering a compromised digestive tract. Since nausea can have many different causes, it is considered a nonspecific symptom that must be evaluated in correlation with other symptoms. Persistent unexplained nausea should be assessed by a physician, especially in the presence of abdominal pain or other signs consistent with diverticulitis.
4. Bloating
A bloated or full feeling is a frequent complaint with diverticulitis. Excessive intestinal gas occurs in certain people and can lead to bloating. A bowel blockage can also produce a full feeling. A partial blockage can slow the progression of food through the digestive tract and cause a backup, while a complete obstruction allows no passage through the colon and is a serious problem requiring prompt medical attention. A doctor should be consulted in any case where bloating does not resolve quickly, is not improved by diet changes or is accompanied by any of the other signs or symptoms of diverticular disease.
5. Blood in Stools
Diverticulitis can cause blood in stools when the damage to the colon wall is significant enough to cause intestinal bleeding. If the bleeding is heavy, difficult to stop or is recurring, surgery may be required to remove the damaged portion of the colon in a procedure known as a bowel resection. Black, grainy blood that has the appearance of coffee grounds indicates an older bleed or one that occurred higher in the colon. Bright red blood is seen in a fresh bleed nearer the end of the intestinal tract. Any blood in stools is concerning and should be reported to a doctor right away.
6. Constipation
Constipation is not primarily determined by how often a bowel movement occurs but by the level of difficulty involved in passing the stool. Constipated stools are typically hard and dry, and can be painful to pass.
The progression of food through the intestinal tract is slowed when colon tissue becomes inflamed or diseased. The presence of an abscess, swelling or a blockage reduces the amount of space available and inhibits normal digestion. This increased time in the colon causes more water to be drawn out of the digesting food and can lead to hard stools. Consult a physician if constipation persists or other symptoms are present.
7. Diarrhea
Diarrhea can often be one of the body’s responses to diverticulitis when digestive function is compromised: In an effort to clear the diseased colon quickly, the brain sends a signal to stop the digestive process and eliminate the stool rapidly. Diarrhea is a common experience with any number of causes. When it occurs in short bouts and proper fluid intake is ensured, diarrhea is generally harmless. However, dehydration can occur if prolonged diarrhea is left untreated. Call the doctor if this symptom lasts longer than a few hours, has no other obvious cause or additional signs of diverticulitis are present.
8. Indigestion
Indigestion is a term commonly used to describe a variety of digestive upsets. Belching, acid reflux, ulcers and irregular bowel movements can all be referred to as “indigestion” by different people. Since the infection and inflammation of diverticulitis disrupts the normal intestinal function, problems with the digestive tract as a whole can occur. Many of these symptoms are the body’s way of trying to empty the intestines, whether by the mouth or the rectum.
Indigestion issues that go beyond what can be expected after eating a food that may not digest well or are persistent and worsening should be brought up with a doctor.
9. Chills
Experiencing a strong sensation of coldness known as the chills is less frequently seen but is still a common symptom of diverticular disease. Chills often occur in conjunction with a fever. Shivering or trembling typically accompany this cold feeling, and these rapid muscle movements can actually be one of the body’s ways of trying to achieve the higher target temperature.
If a cold feeling persists after putting on additional clothing or is accompanied by a fever, an infection of some kind should usually be suspected. Especially if other signs of diverticulitis are present, a trip to the doctor is wise.
10. Vomiting
Vomiting can occur before or during an acute diverticulitis attack. Regurgitation is one of the body’s natural defense mechanisms to keep additional food from entering a distressed digestive tract. In much the same way that the symptom of nausea is triggered, vomiting is initiated when the brain receives chemical signals that the colon is unable to function properly.
A short bout of throwing up is usually no great cause for concern and could be attributed to many factors. However, dehydration can quickly set in if vomiting persists. Especially in conjunction with any other signs of diverticulitis, a visit to the doctor is warranted.
