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Key takeaways
Diverticulitis is an infection of the colon, often caused by fecal matter getting trapped in the diverticula, which are small pouches that can form in the digestive tract, leading to inflammation and infection.
Managing diverticulitis involves a combination of antibiotics, a liquid diet, and possibly surgery for severe cases. Home remedies like tea, heating pads, and over-the-counter laxatives play a supportive role.
A high-fiber diet, rich in fruits, vegetables, and nuts, is recommended to prevent diverticulitis. Avoiding medications like NSAIDs and foods that can exacerbate the condition is crucial for those at risk.
Immediate medical attention is necessary for severe diverticulitis symptoms, such as persistent abdominal pain or signs of infection. There is no long-term treatment for recurring bouts other than managing symptoms and reducing risk factors.
Pain management is essential to the treatment plan when someone is suffering. However, figuring out the right course of action for a particular condition can be difficult. There are many ways to worsen and prolong pain if not managed properly. People with diverticulitis often experience abdominal pain during or after eating a meal.
Eating is a part of everyday life, so coping with a condition that is worsened by eating can be challenging. To help people with these issues, two gastroenterologists share the best way to manage diverticulitis pain and promote digestive health.
What is diverticulitis?
Diverticulitis is a limited form of colitis, an inflammatory bowel disease that can be uncomfortable and painful. “Diverticulitis is an infection of the colon,” says Andrew Boxer, MD, a gastroenterologist with Gastroenterology Associates of New Jersey. It stems from diverticulosis, when small pouches (diverticula) develop in your digestive tract, mainly in the lower part of the large intestine.
“[Diverticulitis] occurs when diverticula, a small outpouching of the colon caused by a weakness in the colon wall, develop an infection,” he says.
Some cases of diverticulosis don’t progress to the point of infection, but it can be severe and require treatment when it turns into chronic, symptomatic diverticular disease. “We think that diverticulitis is caused by a backup of stool and other material into these little pockets [which causes] irritation, and then later infection,” says Ellen Stein, MD, a gastroenterologist at Rutgers. She says people prone to constipation “seem to get more diverticulitis than others.”
While mild diverticulitis often goes away without treatment, more severe cases can be dire. “Diverticulitis can be serious; it can be life-threatening,” Dr. Boxer says. Sometimes it requires surgery to remove the infected portion of the colon, which poses its own risks. And even after surgery, diverticulitis can sometimes recur. Managing symptoms of diverticulitis and avoiding constipation is a priority for people who have had it or are at risk of developing it.
Diet can have a lot to do with developing diverticulitis. “People who eat low volumes of fruits, vegetables, and nuts tend to get diverticulitis more often than those who eat a healthy fiber-rich diet,” says Dr. Stein. But even someone with a well-rounded diet could wind up with diverticulitis.
Stress can be another factor in developing the disease, but “there is no good evidence that stress causes diverticulitis,” says Dr. Boxer. However, maintaining a healthy, low-stress lifestyle will improve your overall health, including your colon, potentially decreasing your risk of developing diverticulitis.
Diverticulitis can result from other medications you take. Many pain meds, such as opioids or NSAIDs like ibuprofen, are not recommended for people with diverticulitis because they can worsen symptoms and cause a flare.
Issues often arise from drugs that include constipation as a side effect, such as antihistamines, anti-nausea medications, and some antidepressants. Iron, which is important to maintaining a healthy diet, can also cause constipation when consumed in foods like red meat and when taken as a supplement. You should give your full health history to your healthcare provider— including how you eat and what over-the-counter medications and supplements you take—to avoid increasing your risk of diverticulitis.
What triggers diverticulitis flare-ups?
It’s called an attack or flare-up when diverticulitis causes patients discomfort or pain; various triggers cause these. “Some people feel that small pieces of material, like the seeds from strawberries, crunchy small pieces of nuts, or other sharp things, can make diverticulitis worse,” says Dr. Stein. While there is no evidence that organic material directly causes flare-ups, she says people with diverticulitis “usually try to avoid these things that can get stuck in the diverticular pockets and then lead to infection or exacerbation.”
Keep in mind a high-fiber diverticulitis diet, which includes many fruits with seeds, can prevent constipation, which in turn can prevent diverticulitis. The balance between eating enough fiber and not consuming plant or nut matter you believe may make your diverticulitis symptoms worse or cause a blockage can be tricky.
Diverticulitis symptoms
The most commonly reported symptom of diverticulitis is abdominal pain. Other symptoms include:
- Abdominal pressure
- Bloating
- Fever
- Change in bowel habits
- Chills
- Nausea
- Vomiting
- Loss of appetite
- Constipation
- Diarrhea
- Rectal bleeding
Always seek medical attention for ongoing gastrointestinal issues to ensure you are not experiencing diverticulitis, other gastrointestinal diseases, or problems that can have a combination of these symptoms. Pay close attention to fever and chills, which can indicate the presence of an infection. When untreated, it can be serious.
How to relieve diverticulitis pain fast
While there are some home remedies for acute diverticulitis pain, it is usually treated with a combination of conservative treatments and antibiotics. Dr. Boxer says depending on the severity, a treatment plan might include antibiotics, bowel rest, a liquid diet, and occasionally surgery.
For home treatments:
- Tylenol or acetaminophen, but avoid ibuprofen products (nonsteroidal anti-inflammatory drugs) like Advil, as they may worsen flares
- Heating pad on the abdomen
- Tea, especially antioxidant-rich green tea
- Anti-inflammatory or antiviral herbs, such as garlic or frankincense
- Over-the-counter laxatives and fiber supplements like Metamucil or Citrucel are used to prevent future attacks but are avoided in the acute setting (always ask your healthcare provider before taking a laxative)
- Foods to relieve constipation, like avocado or pears
- Liquid diet
When treated with antibiotics, infection symptoms usually resolve in 24 to 48 hours, and most pain-management medications work within a half hour. Always check with your healthcare provider if you are experiencing significant pain or signs of infection, such as fever.
Although Dr. Boxer says there’s “no best drink” to relieve uncomplicated diverticulitis pain, drinking water is one of the most accessible remedies. “A clear liquid diet can help in the short term,” he says. Staying on a clear liquid diet—water, sports drinks such as Gatorade, clear soup, broth, etc.—during the initial treatment is essential to soothing your digestive system. You can reincorporate other foods once you’re feeling better.
Dr. Stein recommends a liquid diet for mild cases of diverticulitis, which is what most people experience. More painful flare-ups indicate a possible infection. She says these instances “may need antibiotics, a liquid diet, and time to resolve.” Dr. Stein says severe diverticulitis flare-ups with an abscess, fistula, or infected pocket of fluid may need drainage, antibiotics, and even surgery.
Diverticulitis can take days to weeks to calm down. “Most mild [and moderate] flares will take five to seven days to respond … and severe flares can take several weeks,” says Dr. Stein. You may need to rest and limit your physical activity if you’re experiencing symptoms or do not have as much energy as a result of a limited diet.
RELATED: Does diverticulitis go away?
When to see a doctor for diverticulitis pain
“[The] worst thing is when a patient gets complicated diverticulitis. This is when the colon bursts and infection spills into the abdomen (peritoneal cavity),” says Dr. Boxer. Infections in the peritoneal cavity can prove fatal.
If you are experiencing persistent abdominal pain or signs of infection, go to the doctor to rule out other medical conditions or to confirm and treat diverticulitis. “If ever there is concern, a patient should see a doctor,” Dr. Boxer says. “Alarm signs are increased pain, fever, nausea, and vomiting.”
If temporary treatments don’t work, seek medical advice. Unfortunately, Dr. Boxer says there is “no long-term treatment” for recurring bouts of diverticulitis. It’s essential to reduce your risk factors with a high-fiber diet and treat mild flare-ups so they don’t progress.
In severe cases, surgery can help repair or resolve diverticulitis issues.
Sources
- Diverticulosis and diverticulitis, The Mayo Clinic