What is Diverticulitis?

Diverticulitis develops when small pouches form in the walls of the large intestine or colon, trapping undigested food or waste and leading to inflammation or infection. Diverticulitis is a severe infection and considered the 2nd phase of the diverticular disease.

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Diverticulitis is caused by inflammation or a small tear in a diverticulum, often the result of high or abnormal pressure in the colon. If the tear is large, stool in the colon can spill into the abdominal cavity, causing infection or inflammation.

Risk Factors

Diverticulitis is very common, affecting more than half of Americans over age 60. Risk factors include:

  • Older age (Ages 60+)
  • Low-fiber diet

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  • Abdominal pain (typically in the left lower abdomen)
  • Chills or fever
  • Nausea or vomiting
  • Weight loss

Diagnostic Tests

  • Abdominal palpation
  • CT scan
  • High white blood cell count

When to See a Doctor 

It’s important that you see a doctor about a week after your symptoms begin to show. Typically, within four to eight weeks, they'll set up a colonoscopy to monitor healing and spot any potential issues in your colon.

If your symptoms persist, worsen, or reappear after reintroducing foods into your diet, it's vital to follow up with your healthcare provider.

In case of diverticulitis, head to the ER if you experience:

  • Blood in your stools. 
  • Persistent Fever above 100.4°F (38°C)
  • Nausea
  • Vomiting
  • Chills


Acute diverticulitis is treated with antibiotics and after the infection has improved, eating high-fiber foods and using bulk additives like psyllium may help reduce the risk of reoccurrence. The involved portion of the colon may need to be removed for patients with:

  • Abscess
  • Hole (perforation) in the colon
  • Fistula (abnormal connections between different parts of the colon or the colon and another body area)
  • Repeated attacks of diverticulitis

If you want to know to manage diverticulitis flare ups, our Charleston GI doctors are here to help!


Truthfully, there is no hard evidence on ways to prevent diverticulitis. At the same time, some patients have benefited from lifestyle changes and dieting which include:

  • Quit smoking
  • Increasing fiber intake
  • More exercise
  • Better weight management

Understanding Diverticular Disease

Diverticular disease is a condition that affects the large intestine, or colon.

First is the presence of a first phase called Diverticulosis. With Diverticulosis, it occurs when small defects in the muscle of the wall of the large intestine or colon allow small pockets or pouches (diverticula) to form. 

Then, there is the infection known as Diverticulitis. Diverticulitis is an infection or inflammation of these abnormal pouches. 

Together, these conditions are called diverticular disease.

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Diverticulitis Frequently Asked Questions

What is a diverticulitis flare up?

Diverticulitis (flare-up) occurs when your intestines have little pouches called diverticula. These pouches get all inflamed and infected, that's a flare-up of diverticulitis. Then, comes symptoms like constant diarrhea, cramping, and overall bowel fussiness. Symptoms can range from intense pain and abdominal cramps to bleeding, bloating, and fever.

How long does a flare-up of diverticulitis last?

Honestly, recovering from diverticulitis might take up to two weeks. In the initial days of recuperating from straightforward diverticulitis in the comfort of your home, you'll be on a liquid diet, taking it easy, and using the prescribed medications for pain relief.

Can diverticulitis cause chest pain?
The most common symptom associated with diverticulitis is a sharp, cramp-like pain in the lower abdomen. The pain may occur suddenly and last for days. If you are experiencing this type of pain, contact your GI specialist today.

Can you eat spaghetti with diverticulitis?
A low-fiber diet is recommended to manage diverticulitis symptoms. While meatballs and meaty spaghetti sauces are not advised, plain, white pasta is allowed.

Can you eat peanut butter with diverticulitis?
As long as you are not currently experiencing a diverticulitis flare-up, high-fiber foods like peanut butter and nuts are safe to consume.

Can you eat oatmeal with diverticulitis?
Oatmeal is a great source of fiber – which is important for patients with diverticulitis or diverticulosis. But be sure to avoid eating high-fiber foods while experiencing a flare-up or abdominal discomfort.

Does gluten affect diverticulitis?
Diagnosing a gluten intolerance can be difficult, especially because many GI conditions and diseases present similar symptoms – like gas, bloating and diarrhea. For instance, Crohn’s disease, irritable bowel syndrome, lactose intolerance, diverticulitis, and inflammatory bowel disease share symptoms with gluten intolerance. That is why it is important to consult a board-certified gastroenterologist, like the ones you’ll find at Charleston GI!

What is the difference between diverticulosis vs diverticulitis?

Diverticulosis occurs when small defects in the muscle of the wall of the large intestine or colon allow small pouches to develop. Diverticulitis, a more serious condition, occurs when the small pouches become inflamed or infected.

How do you pronounce diverticulitis?
The proper pronunciation for diverticulitis is dai·vr·ti·kyuh·lai·tuhs.

Why do you need bed rest with diverticulitis?
Diverticulitis is often treated with diet/lifestyle changes, antibiotics, and for more severe cases, surgery. To treat mild diverticulitis, your GI specialist may recommend bed rest, a liquid diet, stool softeners, antibiotics, and possibly antispasmodic drugs.

Can diverticulitis cause liver problems?
Diverticulitis mainly affects the large intestine. But in rare cases, liver issues can occur due to Pyogenic liver abscesses – a potentially life-threatening complication. To learn more about liver problems associated with diverticulitis, contact your GI doctor today.

Can I eat tomato sauce with diverticulitis?
Tomato puree or tomato sauce is fine, as long as it does not have any added meat, mushrooms or chunks that may disrupt digestion. Watch for pips, the small, hard pieces of the tomato, and stick to smooth sauces.

Is it safe to take aspirin with diverticulitis?
Painkillers like aspirin or ibuprofen should be avoided due to the increased risk of internal bleeding. These medications may also upset your stomach. For pain relief, acetaminophen is recommended.

Can I claim disability benefits for diverticulitis?
If you suffer from severe diverticulitis that has not responded well to treatment and prevented you from working, you may be eligible for disability benefits. Check with your local Social Security office to learn more about eligibility or to claim benefits.

Can a GI doctor see diverticulitis with an X-ray?
While standard X-rays do not typically show diverticulitis, a left-sided pelvic mass, localized ileus, or partial bowel obstruction may be visible. For complicated diverticulitis cases, your stomach doctor may also notice pneumoperitoneum, portal venous gas, and extraluminal air-fluid levels.

Can diverticulitis cause pregnancy issues?
If left untreated, the body’s inflammatory response to diverticulitis may cause preterm labor. Cases of diverticulitis are rare in pregnant women, so there are no specific protocols for treatment. If you are pregnant and suffering from diverticulitis symptoms, schedule an appointment with one of our GI doctors.

Can diverticulitis occur after giving birth?
After a vaginal delivery, fistulas may occur. This is more likely if a large tear occurred during delivery, but is still uncommon.

Can I have diverticulitis and a sex life?
Because masses on the urethra or an infection of the glands surrounding it can cause pain during intercourse, it is best to consult your gastroenterologist. Your GI doctor will consider the severity of your diverticulitis before making a recommendation involving sexual intercourse.

What is the difference between IBS and diverticulitis symptoms?
Both GI conditions involve abdominal pain, but the pain associated with IBS is often described as a cramping sensation – and is typically relieved with elimination. The pain from diverticular disease, in contrast, is constant and usually focused in the left lower quadrant of the abdomen.

Can I eat blueberries with diverticulitis?
While it was once believed that the seeds in fruits and berries should be avoided in diverticulitis patients. This guidance has been updated, and it is now considered safe to consume blueberries and other fruits.

Can diverticulitis cause urinary problems?
Patients may experience urinary symptoms, like an increased urge to urinate or urinary urgency. They may also notice a change in bowel habits, including constipation or diarrhea.

Does alcohol affect diverticulitis?
Our GI specialists recommend avoiding alcohol when recovering from diverticulitis. Alcohol may aggravate your condition and increase your risk of a flare-up.


To learn more about treatment for GI tract issues in Charleston, SC, get in touch today! Charleston Gastroenterology is committed to a higher standard of caring – and we provide a range of medical treatments to help you feel your best.

If you are experiencing painful gi tract symptoms, schedule your appointment today! No referral needed.