Diverticulitis: Lower Left Belly Pain, Fever, Causes and When to Be Seen

What it involves

MedlinePlus explains that diverticula are small pouches that bulge outward through weak spots in the colon, and diverticulosis is having them. Diverticulitis is what happens when one or more of those pouches become inflamed, and it may come on suddenly and sometimes cause serious problems.

Who this is for

• Adults with belly pain, especially in the lower left side, that is new or keeps returning
• Patients with belly pain who also have fever, chills, nausea, or vomiting
• Patients who have been told they have diverticulosis and want to know how to avoid flare-ups
• Patients over 50 with bloating, cramping, or changes in their bowel habits

What to expect

• Questions about the pain, fever, bowel changes, and any past episodes
• An exam of the abdomen and a review of your medicines, including pain relievers
• Blood or stool tests or imaging, which MedlinePlus lists as ways diverticulitis is confirmed
• Treatment advice, or direction to emergency care if the pain is severe or complications are possible

Diverticulosis, diverticulitis, and diverticular disease

MedlinePlus separates three terms. Diverticulosis is having the pouches, which most people never notice. Diverticulitis is inflammation of one or more pouches. Diverticular disease covers the pouches causing long-term symptoms, bleeding, or diverticulitis and its complications. Diverticulosis is common with age: more than one-third of U.S. adults aged 50 to 59 have it, and more than two-thirds of people over 80, though most never develop problems.

Symptoms of an attack

MedlinePlus lists abdominal pain, most often in the lower left side, constipation or diarrhea, fever and chills, and nausea or vomiting. The pain is usually severe and sudden, though less often it is mild and builds over several days. Between attacks, diverticulosis can cause chronic bloating, constipation or diarrhea, and lower belly cramping. The abdominal pain guide covers other causes of belly pain.

What raises the risk

Researchers are not sure what causes diverticulitis, MedlinePlus says. It names genes and lifestyle factors including a diet low in fiber and high in red meat, lack of physical activity, certain medicines such as NSAIDs and steroids, obesity, and smoking. The quitting smoking guide and the obesity and BMI guide cover two of those. A fiber-rich diet helps constipation too, as the constipation guide explains.

Complications to know about

MedlinePlus says diverticular bleeding happens when a small blood vessel in a pouch wall bursts and can be severe. Diverticulitis can lead to an abscess, a fistula, an intestinal obstruction, a hole in the colon, or peritonitis, an infection of the abdominal lining. These are why severe pain, persistent vomiting, high fever, or blood in the stool should be treated as urgent. Visible blood is discussed in the hemorrhoids guide as well, but only an exam can say which it is.

How it is diagnosed and treated

MedlinePlus says a provider reviews your history, examines you, and may order blood tests, stool tests, imaging such as CT, ultrasound, or MRI, and sometimes a colonoscopy. Mild diverticulitis may be treated at home with antibiotics, except for very mild cases, a short clear liquid diet, and acetaminophen for pain rather than NSAIDs, which may raise the chance of complications. Severe cases or complications need hospital care, and surgery may be needed if it does not improve.

Preventing another attack

MedlinePlus lists eating a diet high in fiber and low in red meat, staying physically active, not smoking, and reaching and keeping a healthy weight. Your provider may recommend other changes based on your history. Colon screening is a separate topic, and the colorectal screening guide explains who should be screened and when.

Sources

• MedlinePlus — Diverticulosis and Diverticulitis
• MedlinePlus — Colonic Diseases