Diverticulitis, a painful condition affecting the digestive system, shares symptoms with a range of other ailments, making accurate diagnosis crucial. A healthcare professional will employ a combination of physical examinations and diagnostic tests to pinpoint the exact cause of your discomfort. This detailed guide will walk you through the diagnosis process for diverticulitis, ensuring you understand each step involved.
During an initial consultation, your healthcare provider will start with a thorough physical exam. This typically involves palpating different areas of your abdomen to identify specific locations of pain and tenderness. This hands-on assessment helps to narrow down the potential sources of your symptoms. For women, a pelvic exam might also be conducted to rule out any gynecological issues that could be mimicking diverticulitis.
To further investigate and exclude other possible conditions, several laboratory tests are commonly employed. These tests provide valuable insights into your overall health and can help confirm or eliminate diverticulitis as the cause of your symptoms.
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Blood Tests: These are essential in detecting signs of infection and evaluating your body’s immune response. Elevated white blood cell counts, for instance, can indicate inflammation or infection, common markers in diverticulitis.
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Urine Test: A urine analysis is performed to rule out urinary tract infections (UTIs) or kidney stones, as these conditions can sometimes present with symptoms similar to diverticulitis, such as lower abdominal pain.
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Stool Test: Analyzing a stool sample helps to exclude other gastrointestinal issues, such as infections caused by bacteria, viruses, or parasites. It can also help identify other causes of digestive upset that might be causing your symptoms.
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Pregnancy Test: For women of childbearing age, a pregnancy test is often recommended. This is because some pregnancy-related discomforts or complications can sometimes be confused with diverticulitis symptoms.
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Liver Enzyme Test: This blood test assesses liver function and helps to rule out liver disease. Liver problems can sometimes cause abdominal pain that might be mistaken for diverticulitis.
In addition to these laboratory tests, a Computerized Tomography (CT) scan is a pivotal imaging technique used in diagnosing diverticulitis. A CT scan provides detailed cross-sectional images of your abdomen and pelvis. This allows healthcare professionals to visualize the colon and identify inflamed diverticula, which are small, bulging pouches that can form in the lining of your digestive system. Furthermore, CT scans are highly effective in detecting complications associated with diverticulitis, such as abscesses (collections of pus), fistulas (abnormal connections between organs), or perforations in the colon wall. The clarity and detail offered by a CT scan make it invaluable for confirming diverticulitis and assessing its severity.
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Treatment
Diverticulitis treatment strategies are carefully tailored to the severity of your condition. The approach varies significantly depending on whether you have uncomplicated or complicated diverticulitis.
Uncomplicated Diverticulitis
When diverticulitis is classified as uncomplicated, it means the symptoms are mild, and there are no signs of serious complications like abscesses or perforations. In these cases, treatment can often be effectively managed at home.
Initially, your healthcare provider will likely prescribe a temporary liquid diet. This allows your digestive system to rest and recover, reducing strain on the inflamed area of the colon. As your symptoms gradually improve, you can start reintroducing solid foods back into your diet. The transition typically begins with low-fiber foods, which are gentle on the digestive system. Once you’ve fully recovered from the acute episode, it’s important to transition to a regular diet that is rich in high-fiber foods. A high-fiber diet is crucial for long-term management as it helps promote regular bowel movements and reduces the risk of future diverticulitis flare-ups. In some instances, a fiber supplement might also be recommended to ensure you’re getting enough fiber daily.
Antibiotics are frequently prescribed to treat uncomplicated diverticulitis, as infection often plays a role in the inflammation. It’s critical to complete the entire course of antibiotics as prescribed by your doctor, even if you start feeling better before finishing them. This ensures the infection is fully eradicated and reduces the risk of recurrence or antibiotic resistance.
Complicated Diverticulitis
Complicated diverticulitis indicates a more severe form of the condition, often involving significant symptoms or the presence of complications. In such cases, hospitalization is usually necessary to provide more intensive treatment and monitoring. In the hospital setting, antibiotics are administered intravenously (IV). IV antibiotics deliver medication directly into your bloodstream, ensuring rapid and effective treatment of the infection.
Surgery
Surgical intervention becomes necessary in certain situations related to diverticulitis. Relatively minor procedures can be employed to address specific issues like draining an abscess or controlling bleeding. However, more extensive surgery on the colon may be required under the following circumstances:
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History of Complicated Diverticulitis: If you have experienced complicated diverticulitis in the past, surgery might be recommended to prevent future severe episodes.
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Presence of Complications: Complications such as ruptures in the colon wall, fistulas, or extensive tissue damage often necessitate surgical repair.
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Recurrent Uncomplicated Diverticulitis: For individuals who experience multiple episodes of uncomplicated diverticulitis, despite medical management, elective surgery might be considered to improve long-term outcomes and quality of life.
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Weakened Immune System: Patients with compromised immune systems are at higher risk of severe diverticulitis and its complications. Surgery might be recommended more proactively in these individuals.
Surgery for diverticulitis can often be performed laparoscopically. This minimally invasive approach involves small incisions in the abdomen, through which specialized instruments and a camera are inserted. Laparoscopic surgery typically results in less pain, smaller scars, and a faster recovery compared to traditional open surgery. However, in some complex cases, open surgery, requiring a larger incision, may be necessary to achieve the best outcome.
There are generally two main surgical procedures for treating diverticulitis:
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Colon Resection with Primary Anastomosis: This procedure involves removing the diseased section of the colon and then reconnecting the remaining healthy segments. This aims to restore normal bowel function in a single surgical procedure.
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Colon Resection with Colostomy: In situations where there is significant inflammation or infection, or if immediate reconnection of the colon is considered risky, a colostomy might be performed. This involves separating the healthy and diseased sections of the colon. The healthy section is then brought through an opening created in the abdominal wall, forming a stoma. Waste is temporarily collected in a colostomy bag attached to the stoma. This allows the diseased section of the colon to rest and heal. Once healing is complete, a subsequent surgery can be performed to reconnect the two sections of the colon and close the colostomy.
Other surgical procedures might be necessary to address specific complications of diverticulitis, such as peritonitis (infection of the abdominal lining) or fistulas.
Follow-up Care
Following treatment for diverticulitis, your healthcare provider may recommend a colonoscopy. This is typically scheduled about six weeks or more after your symptoms have resolved. A colonoscopy is a crucial follow-up exam that allows for a detailed visual inspection of your colon and rectum using a flexible camera-equipped tube. The purpose of a colonoscopy in this context is to screen for any abnormalities, such as polyps or cancer, in the colon. The recommendation for a colonoscopy, and its timing, will depend on factors such as when you last had a colonoscopy and the severity of your diverticulitis episode. It’s an important step in ensuring long-term digestive health after diverticulitis.
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Alternative medicine
While conventional medical treatments are the cornerstone of diverticulitis management, some individuals explore alternative medicine approaches. Probiotic supplements, which aim to boost beneficial bacteria in the colon, have been studied in small clinical trials. Some of these studies suggest that probiotics might potentially reduce the risk of recurrent diverticulitis episodes. However, it’s important to emphasize that current scientific evidence supporting the routine use of probiotics for diverticulitis is still limited. Therefore, it’s crucial to have an informed discussion with your healthcare professional before starting any probiotic or other dietary supplements to ensure they are appropriate for your specific situation and won’t interfere with your prescribed medical treatment.
Preparing for your appointment
If you are experiencing symptoms suggestive of diverticulitis, you might be referred to a gastroenterologist. This is a doctor who specializes in disorders of the digestive system. Being well-prepared for your appointment can significantly enhance the consultation and ensure you receive the most effective care.
What you can do
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Pre-Appointment Restrictions: Be mindful of any instructions provided by the clinic or doctor’s office regarding pre-appointment preparations. This might include dietary restrictions, such as fasting or avoiding solid foods on the day before your appointment.
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Symptom Journal: Keep a detailed record of your symptoms, noting when they started, how often they occur, what makes them better or worse, and their severity. Include any symptoms, even if they seem unrelated to your digestive system, as this information can be valuable for your healthcare provider.
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Medication List: Compile a comprehensive list of all medications you are currently taking. Include prescription drugs, over-the-counter medications, vitamins, and supplements. For each item, note the dosage and the reason you are taking it.
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Medical History: Summarize your key medical history, including any pre-existing health conditions, past surgeries, and hospitalizations.
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Personal Information: Note down any significant personal information that might be relevant to your health, such as recent life changes or stressors, as these can sometimes impact digestive health.
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Bring a Support Person: Consider asking a family member or friend to accompany you to your appointment. Having someone with you can be helpful for remembering what the healthcare professional says and providing emotional support.
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Questions to Ask: Prepare a list of questions you want to ask your doctor. Prioritize your most important concerns so you can ensure they are addressed during the appointment.
Questions to ask your doctor
- “What is the most likely cause of my symptoms?”
- “What kinds of tests do I need? Will there be any special preparation required for these tests?”
- “What treatment options are available for my condition?”
- “How can I prevent diverticulitis from recurring in the future?”
- “Are there any specific foods I should eliminate or incorporate into my diet?”
- “I have other existing health conditions. How can diverticulitis and these conditions be managed together effectively?”
In addition to your prepared questions, don’t hesitate to ask any further questions that arise during your consultation. Open communication with your healthcare provider is key to understanding your condition and treatment plan.
What to expect from your doctor
Your healthcare professional will likely ask you a series of questions to gain a comprehensive understanding of your symptoms and medical history. Be prepared to answer questions such as:
- “When did your symptoms first begin? How severe are they on a scale of mild, moderate, or severe?”
- “Have your symptoms been continuous, or do they come and go?”
- “Are there any factors or activities that seem to improve or worsen your symptoms?”
- “Have you experienced a fever?”
- “What medications and pain relievers are you currently taking?”
- “Have you noticed any pain or changes related to urination?”
- “Have you ever had a colonoscopy or any other screening tests for colon cancer?”
Diverticulitis care at Mayo Clinic
Symptoms & causesDoctors & departments
Oct. 22, 2024
- AskMayoExpert. Diverticulitis. Mayo Clinic; 2023.
- Diverticular disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/all-content. Accessed March 22, 2024.
- Gunby SA, et al. Acute colonic diverticulitis. Annals of Internal Medicine. 2024; doi:10.7326/AITC202403190.
- Ferri FF. Diverticular disease (diverticulosis, diverticulitis, diverticular hemorrhage). In: Ferri’s Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed March 25, 2024.
- Diverticulosis and diverticulitis. American College of Gastroenterology. https://gi.org/topics/diverticulosis-and-diverticulitis/. Accessed March 22, 2024.
- Peery AF, et al. AGA clinical practice update on medical management of colonic diverticulitis: Expert review. Gastroenterology. 2021; doi:10.1053/j.gastro.2020.09.059.
- Ami TR. Allscripts EPSi. Mayo Clinic. April 17, 2024.
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