Diverticulitis is the inflammation of one or more diverticula. These are pouch-like protrusions of the intestinal mucosa. In most cases, they can be in your intestines without causing any trouble, but similar to the appendix, they can become obstructed, start growing bacteria inside, and undergo inflammation. When this happens, patients start feeling what is known as a diverticulitis attack.
There are many causes of diverticulitis, and they are all difficult to trace. Risk factors include genetic, lifestyle, dietary factors, and many others. But one of the most important things to consider is that your diet should be high in dietary fiber, low in fats and red meats, and you should drink enough water throughout the day if you want to avoid the symptoms we are going to describe below.
The signs and symptoms of diverticulitis
Diverticulitis is not the same as diverticulosis. Most of us have diverticulosis, or will develop the condition at some point. We have at least one or two sac-like protrusion like the ones we mentioned above. But they rarely get infected, and that’s why not everyone with diverticulosis experiences symptoms of diverticulitis.
As mentioned above, diverticulitis is somewhat similar to appendicitis, and the signs and symptoms may be related to a certain degree, but usually not as intense. The most common manifestation of diverticulitis is abdominal pain, which is acute and can have different degrees of severity. It is more commonly located in the lower left quadrant of the abdomen because the majority of diverticula can be found in the sigmoid colon. If you have an Asian descent, there are chances you can feel this pain on the right side, instead.
But unlike appendicitis, which drives you to the emergency room almost right away, diverticulitis pain can linger for a few days or until you get your condition treated. In any case, if you feel moderate or severe acute pain, it is important to get evaluated by a professional as soon as possible because there are life-threatening causes you should rule out before thinking about diverticulitis.
Besides abdominal pain on the left side, people with a diverticulitis attack usually feel nausea and some of them may even vomit once or twice. Since there’s an inflammation process going on, it is normal to have a rise in body temperature, and with fever you may also experience chills and night sweats. And these episodes are usually associated with constipation.
How does it feel like?
But after the theory, the experience of the pain in cases of diverticulitis can be a bit different in the practice. Everybody can have a different experience, and pain is sometimes sharp, sometimes insidious, sometimes mild or moderate. In some cases, it feels like progressive pain that starts on the left lower part of the abdomen and progresses upwards. Some people may even experience tenderness to the touch while others only report a dull pain that lingers and sometimes comes and goes. In rare cases, patients may also have rectal bleeding, especially when there is very severe inflammation and irritation of the colon.
The symptoms typically last until treatment starts. After using antibiotics to treat the acute pain, the patient may see some improvement in the first day, but real changes start to become evident after 3 or 4 days. In 10 days or less, diverticulitis is usually resolved. If you don’t find relief in your third or fourth day, your doctor probably needs to check on you and rule out complications such as abscess formation. And if the pain is very severe with a sudden recrudescence, you might need to rule out a ruptured diverticulum, a very serious complication of diverticulitis.
Can probiotics help?
Probiotics are live bacteria that improve the microbial balance in the gut and have various effect over gastrointestinal health. They change the microbial ecology in the gut, modulate the immune function associated to the gastrointestinal tract, and enhance the barrier function of the epithelium in the intestines.
In and around inflamed diverticula, there is usually a local alteration of the gut microflora. This alteration is what causes the inflammatory condition that triggers a diverticulitis attack. Probiotics can help in this situation by changing the intestinal microflora back to normal and improving the immune response of the host.
Studies about diverticular disease and probiotics show that these bacterial strains can be very useful for patients with diverticulosis who have not developed diverticulitis. In other words, patients with diverticula that are not yet inflamed and in pain can prevent a diverticulitis attack. Also, patients who had a previous diverticulitis attack can prevent further episodes by using probiotics from yogurt, kefir, or probiotic supplements.
Note that the role of probiotics in diverticular disease is not treating the condition. The best treatment, and the only one that reduces the chance of complications is antibiotic therapy. Instead, probiotics can be used before and after the acute pain episode to prevent diverticulitis in the first place.
The studies and clinical trials on probiotics as a treatment for diverticulitis are still scarce, but they appear to point out at a therapeutic potential. In any case, probiotics and prebiotics can improve intestinal health in many ways, which include providing an extra source of dietary fiber that allows for a better intestinal transit, reduces the pressure in the gut, and prevents the formation of sac-like structures.
Pain symptoms of diverticulitis can be very different in each particular patient. In some cases, it is mild or moderate, but some patients with a complicated diverticulitis can have acute and very severe abdominal pain. It is usually located in the lower left quadrant of the abdomen, but some Asian descent patients may feel this pain in their right quadrant instead. The best treatment is through antibiotics, which improve the symptoms in 3 to 5 days and resolve the inflammation in 10 days. The best prevention strategy is increasing your dietary fiber intake, and you can also use probiotics to modulate your gut microbiota, prevent infection, and improve your immune function.
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