Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with increased risk of diverticulitis. But that observation isn’t definitive: One study found that NSAIDs as a class of drugs more than tripled the risk of diverticulitis, but that aspirin, also an NSAID, did not increase risk. Diverticulitis develops from a condition called diverticulosis, in which small, saclike pouches called diverticula form on the wall of the digestive tract, per the Cleveland Clinic. By themselves, these pouches are not dangerous, but when they become ruptured, diverticulitis occurs. Once that happens, it’s important to seek medical attention. Caught early and with mild symptoms, diverticulitis can be treated with bowel rest, a liquid diet, and an over-the-counter pain medicine like acetaminophen (Tylenol). In the past, doctors prescribed antibiotics to treat uncomplicated diverticulitis, but guidance published in March 2022 from the American College of Physicians states that most cases can be treated without this medication. “For uncomplicated diverticulitis, we no longer routinely treat with antibiotics,” says Rabia De Latour, MD, a gastroenterologist at NYU Langone Health. “The data that we have on routine antibiotic use for uncomplicated diverticulitis did not show a clear benefit, and thus regularly administering them for uncomplicated cases has fallen out of favor.” However, if left unchecked, diverticulitis may require surgery to remove infected portions of the colon. “The acute onset of abdominal pain should always be evaluated by a professional to help identify if the cause of the pain is potentially life-threatening,” says Donald Tsynman, MD, a gastroenterologist at Gastroenterology East, P.A. & Endoscopy Center in Greeneville, North Carolina. “It’s definitely not something you should ever ignore.” With that in mind, it’s key to be able to recognize the signs and symptoms of diverticulitis.
NauseaVomitingFeverChillsNight sweatsA tender feeling in the abdomenConstipation
The pain might also be accompanied by a tender feeling, which could indicate the presence of an abscess, or pocket of pus that can form in a ruptured diverticulum, says Johnny Altawil, MD, a gastroenterologist at Gastrointestinal Associates in Knoxville, Tennessee. “That’s a really bad complication, requiring either drainage or surgery.” RELATED: What Is Abdominal Pain? Dr. Altawil adds that if the diverticulitis has progressed to the point that there are complications, the pain may also be accompanied by the feeling of a palpable mass in the abdomen. “It can feel like there’s something big just sitting in your gut,” he says. “If it remains uncomplicated, which is usually the case, you should see some improvement in two to three days,” De Latour says. “If symptoms continue to improve or resolve, then we advance to a regular diet and recommend a colonoscopy to screen for atomic abnormalities in six to eight weeks.” If there is no improvement in the pain or other symptoms after three days, Altawil typically does an additional assessment to check for potentially serious complications. However, rectal bleeding is a rare symptom on its own, he notes: “If someone comes in and says that they have rectal bleeding only, I don’t think of diverticulitis unless other symptoms are present. By itself, rectal bleeding points away from diverticulitis.”
A physical examCT scan of the abdomenBlood testsUrine testsLiver function testsStool testsPregnancy tests, to rule out pregnancy as the cause of pain in women of childbearing age
Tsynman adds: “All symptoms of abdominal pain that are out of the ordinary and last longer than seconds to minutes should prompt a person to follow up with their physician. It’s really that simple.” Additional reporting by Ashley Welch
