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Diverticulitis

Acute Colonic Diverticular Inflammation — Diagnosis and Step-wise Management

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Diverticulitis?

Diverticulosis refers to asymptomatic outpouchings of colonic mucosa through the muscularis layer; diverticulitis is inflammation, usually from microperforation of a diverticulum.

Sigmoid colon most commonly affected (90% in Western populations); right-sided in Asian populations.

Hinchey classification stages complicated disease: I phlegmon/small abscess, II large abscess, III purulent peritonitis, IV feculent peritonitis.

CT with contrast is the diagnostic test of choice; colonoscopy is deferred until 6–8 weeks after resolution to exclude malignancy.

Symptoms

Left lower quadrant abdominal pain (or right-sided in Asian patients)
Fever, chills, and leukocytosis
Nausea, vomiting, and change in bowel habits
Tenderness and palpable mass on examination
Dysuria or pneumaturia if colovesical fistula
Signs of peritonitis: rigid abdomen, rebound tenderness (severe cases)

Risk Factors

Age over 50 years
Low-fiber, high-red-meat Western diet
Obesity and sedentary lifestyle
Smoking and NSAID or opioid use
Prior diverticulitis episode (30–40% recurrence)
Immunosuppression (higher risk of complicated disease)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent left (or right) lower quadrant abdominal pain with fever
  • Known diverticulosis with new symptoms: change in bowel habits, bleeding, pain
  • Severe symptoms: peritonitis, sepsis, urinary symptoms suggesting fistula

Treatment Methods

01
Uncomplicated diverticulitis: oral antibiotics (ciprofloxacin plus metronidazole or amoxicillin-clavulanate) for 7–10 days; some mild cases managed without antibiotics
02
Outpatient management with clear liquids advancing to regular diet; follow-up in 2–3 days
03
Hospitalization for severe symptoms, intolerance to oral intake, or failure of outpatient therapy; IV antibiotics and bowel rest
04
Complicated disease: CT-guided percutaneous drainage for abscesses over 4 cm; surgery for perforation, obstruction, or fistula
05
Elective sigmoid resection considered after complicated diverticulitis, recurrent attacks, or fistula
06
Long-term: high-fiber diet, adequate hydration, regular exercise, smoking cessation; colonoscopy 6–8 weeks post-recovery

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.