What Is Diverticulitis?
Diverticulosis means having small pouches (diverticula) in the colon wall — extremely common and usually harmless. Diverticulitis occurs when one or more of these pouches become inflamed or infected, causing significant pain.
Symptoms of Diverticulitis
- Left lower abdominal pain (most common) — or right side in some Asian populations
- Fever
- Nausea and vomiting
- Change in bowel habits (constipation or diarrhoea)
- Bloating
- Rarely: rectal bleeding
Seek Emergency Care If:Severe abdominal pain, high fever, signs of perforation (board-rigid abdomen, collapse) — these suggest complicated diverticulitis requiring emergency surgery.
Blood Tests
| Test | Finding |
|---|---|
| Full Blood Count | Elevated WBC in active infection |
| CRP | Elevated — correlates with severity |
| ESR | Elevated |
| Kidney function | Dehydration assessment; fistula to bladder if pneumaturia |
| Urine dipstick | Pneumaturia (air in urine) or faecaluria suggest colovesical fistula |
Treatment by Severity
| Severity | Treatment |
|---|---|
| Mild (Hinchey I) | Oral antibiotics; liquid diet; outpatient management |
| Moderate (Hinchey II — abscess) | IV antibiotics; CT-guided drainage if abscess ≥3cm |
| Severe (Hinchey III/IV — perforation) | Emergency surgery (Hartmann's procedure or primary anastomosis) |
FAQs
Do all diverticula cause diverticulitis?
No — most people with diverticulosis never get diverticulitis. Only about 5% develop inflammation.
Can diet prevent diverticulitis?
High-fibre diet reduces diverticulosis risk. After an attack: low-fibre initially, then gradual reintroduction of fibre. The old advice to avoid nuts and seeds is no longer supported.
What surgery is done for diverticulitis?
Hartmann's procedure (colostomy formation) or primary anastomosis depending on circumstances. After recovery, many patients have stoma reversal.
Medical Disclaimer: Diverticulitis with perforation signs is a surgical emergency. Patients with fever and severe abdominal pain should seek immediate hospital assessment.