What are the symptoms of diverticulitis. How does diverticulitis develop. What are the risk factors for diverticulitis. How common is diverticulitis. What complications can arise from diverticulitis.

Understanding Diverticular Disease and Diverticulitis

Diverticular disease encompasses a spectrum of conditions related to small pouches (diverticula) that form in the lining of the intestine. These pouches occur when the intestinal wall bulges through weak areas of muscle. While often harmless, diverticula can lead to various bowel problems and discomfort. The condition can be categorized into three main types:

• Diverticulosis: The presence of diverticula without symptoms or complications
• Diverticular disease: When diverticula cause symptoms or lead to problems
• Diverticulitis: Inflammation or infection of the diverticula

Diverticular disease may result in recurring or persistent symptoms, referred to as chronic diverticular disease. While diverticulitis can usually be treated effectively, it has the potential for serious consequences if the inflammation spreads.

Recognizing the Symptoms of Diverticulitis

Diverticulitis can manifest with a range of symptoms, some of which may be mistaken for other gastrointestinal conditions. How can you identify the signs of diverticulitis? The most common symptoms include:

• Sudden, dull pain in the abdomen, typically on the lower left side
• Mild fever
• Constipation or diarrhea
• Bloating and abdominal distension
• Nausea and occasional cramping

It’s important to note that diverticulitis rarely causes vomiting. When a doctor examines a patient with suspected diverticulitis, they may observe a reflex known as muscular defense, where the abdominal muscles automatically tense up when pressure is applied.

Exploring the Causes and Risk Factors of Diverticulitis

Understanding the underlying causes and risk factors of diverticulitis is crucial for prevention and management. What contributes to the development of diverticula and their subsequent inflammation? Several factors play a role:

• Weak areas in the intestinal muscles, particularly in the sigmoid colon
• Genetic predisposition
• Weak connective tissue
• Problems with intestinal motility
• Advanced age
• Obesity

While the influence of lifestyle factors is not fully determined, certain habits may increase the risk of diverticular disease:

• Low-fiber diet leading to constipation and hard stools
• High consumption of red meat
• Smoking
• Sedentary lifestyle

The exact mechanism of diverticular inflammation remains unclear, but reduced blood supply and the formation of hard stool in the diverticula are believed to contribute. Individuals with weakened immune systems or severe kidney disease may be at higher risk for complications.

The Prevalence of Diverticulitis Across Age Groups

How common is diverticulitis, and who is most affected by this condition? The prevalence of diverticula increases significantly with age:

• Approximately 10% of people under 50 have diverticula
• About 50% of individuals over 70 have diverticula

Interestingly, the presence of diverticula is equally common in men and women. However, only about 1% of people with diverticula develop diverticulitis within ten years. While diverticulitis can occur at any age, it becomes more prevalent in older populations.

Potential Complications and Long-Term Effects of Diverticulitis

While many cases of diverticulitis resolve with proper treatment, the condition can lead to serious complications if left unchecked. What are the potential long-term effects and complications of diverticulitis?

• Chronic digestive problems and abdominal pain
• Recurrence of diverticulitis (about 20% of patients experience a recurrence within a few years)
• Abscesses (collections of pus)
• Fistulas (abnormal connections between organs)
• Intestinal perforation (a rare but serious complication)
• Peritonitis (inflammation of the abdominal lining)

In rare cases, complications such as intestinal perforation can lead to life-threatening conditions like peritonitis, which requires immediate medical attention.

Diagnostic Approaches for Diverticulitis

Accurate diagnosis of diverticulitis is crucial for appropriate treatment and management. How do healthcare professionals diagnose this condition? The diagnostic process typically involves:

1. Medical history review and physical examination
2. Blood tests to check for signs of infection and inflammation
3. Imaging studies such as CT scans or ultrasounds to visualize the affected area
4. Colonoscopy (usually performed after the acute phase has resolved)

In some cases, additional tests may be necessary to rule out other conditions with similar symptoms, such as irritable bowel syndrome or colorectal cancer.

Treatment Options and Management Strategies for Diverticulitis

The treatment of diverticulitis depends on the severity of the condition and the presence of complications. What are the primary approaches to managing diverticulitis?

Mild Cases

• Oral antibiotics
• Temporary liquid or low-fiber diet
• Pain management
• Rest and monitoring

Severe Cases or Complications

• Hospitalization
• Intravenous antibiotics
• Bowel rest (nothing by mouth)
• Drainage of abscesses
• Surgery in cases of perforation or recurrent episodes

After the acute phase, patients are typically advised to gradually increase fiber intake and maintain a high-fiber diet to prevent future episodes. Regular exercise and maintaining a healthy weight are also recommended as part of long-term management.

Preventive Measures and Lifestyle Modifications for Diverticular Health

While not all cases of diverticulitis can be prevented, certain lifestyle modifications may reduce the risk of developing the condition or experiencing recurrent episodes. How can individuals promote diverticular health?

• Adopt a high-fiber diet rich in fruits, vegetables, and whole grains
• Stay well-hydrated to promote healthy bowel function
• Exercise regularly to maintain healthy bowel motility
• Manage weight to reduce the risk of obesity-related complications
• Quit smoking and limit alcohol consumption
• Avoid excessive use of NSAIDs and other medications that may increase risk

It’s important to consult with a healthcare provider before making significant changes to diet or lifestyle, especially for individuals with existing health conditions.

Emerging Research and Future Directions in Diverticulitis Management

The field of diverticulitis research continues to evolve, with new studies shedding light on potential risk factors, treatment approaches, and preventive strategies. What are some of the emerging areas of research in diverticulitis?

• Role of gut microbiome in diverticular disease development and progression
• Genetic factors influencing susceptibility to diverticulitis
• Novel therapeutic approaches, including probiotics and anti-inflammatory agents
• Minimally invasive surgical techniques for complicated cases
• Long-term outcomes and quality of life in patients with chronic diverticular disease

As research progresses, it is anticipated that new insights will lead to improved prevention strategies and more targeted treatment options for individuals affected by diverticulitis.

Living with Diverticular Disease: Coping Strategies and Support

For individuals diagnosed with diverticular disease or recovering from diverticulitis, coping with the condition can be challenging. What strategies can help patients manage their condition and improve quality of life?

• Educate yourself about the condition and its management
• Maintain open communication with healthcare providers
• Join support groups or online communities for shared experiences and advice
• Develop a personalized diet plan with the help of a registered dietitian
• Practice stress-reduction techniques, such as meditation or yoga
• Keep a symptom diary to identify potential triggers
• Plan ahead for travel and social situations to manage dietary needs

By adopting these strategies and working closely with healthcare professionals, many individuals with diverticular disease can effectively manage their symptoms and maintain a good quality of life.

The Economic Impact of Diverticulitis on Healthcare Systems

Diverticulitis not only affects individuals but also has significant implications for healthcare systems and society at large. What is the economic burden associated with diverticulitis?

• Increased healthcare utilization and hospital admissions
• High costs associated with diagnostic procedures and treatments
• Lost productivity due to work absences and disability
• Long-term healthcare needs for chronic cases

Understanding the economic impact of diverticulitis highlights the importance of effective prevention strategies and optimal management approaches to reduce the overall burden on healthcare systems.

Special Considerations: Diverticulitis in Younger Populations

While diverticulitis is more common in older adults, there has been an increasing trend of diagnoses in younger individuals. How does diverticulitis manifest in younger populations, and what special considerations should be taken into account?

• Potentially more aggressive disease course
• Higher risk of recurrence
• Greater impact on quality of life and work productivity
• Need for long-term management strategies
• Consideration of genetic factors and family history

Healthcare providers must be aware of the unique challenges faced by younger patients with diverticulitis and tailor their approach accordingly to ensure optimal outcomes and minimize long-term complications.

The Role of Nutrition in Diverticulitis Prevention and Management

Nutrition plays a crucial role in both the prevention and management of diverticulitis. How can dietary choices influence diverticular health, and what nutritional strategies are recommended?

Preventive Nutritional Strategies

• High-fiber diet (25-30 grams per day for adults)
• Adequate hydration
• Balanced intake of fruits, vegetables, and whole grains
• Limiting processed foods and red meat

Dietary Management During Acute Episodes

• Clear liquid diet during initial stages
• Gradual introduction of low-fiber foods
• Avoidance of seeds, nuts, and high-fiber foods until healing occurs

Long-term Nutritional Management

• Gradually increasing fiber intake
• Identifying and avoiding personal trigger foods
• Maintaining a diverse and balanced diet

Working with a registered dietitian can help individuals develop personalized nutrition plans that support diverticular health while meeting their overall nutritional needs.

Technological Advancements in Diverticulitis Diagnosis and Treatment

As medical technology continues to advance, new tools and techniques are emerging for the diagnosis and treatment of diverticulitis. What are some of the latest technological advancements in this field?

• High-resolution CT imaging for more accurate diagnosis
• Artificial intelligence-assisted image analysis for early detection
• Minimally invasive laparoscopic and robotic surgical techniques
• Advanced endoscopic procedures for complicated cases
• Wearable devices for monitoring symptoms and disease progression

These technological innovations have the potential to improve diagnostic accuracy, enhance treatment outcomes, and reduce the overall burden of diverticulitis on patients and healthcare systems.

Global Perspectives on Diverticulitis: Geographic and Cultural Variations

The prevalence and manifestation of diverticulitis can vary significantly across different geographic regions and cultural groups. What factors contribute to these variations, and how do they impact global health strategies?

• Dietary patterns and fiber consumption in different cultures
• Genetic predisposition among various ethnic groups
• Access to healthcare and diagnostic resources in different regions
• Cultural attitudes towards digestive health and medical interventions
• Environmental factors influencing gut microbiome composition

Understanding these global perspectives is crucial for developing culturally sensitive and effective strategies for diverticulitis prevention and management on a worldwide scale.

The Psychological Impact of Living with Chronic Diverticular Disease

Chronic diverticular disease can have significant psychological effects on individuals, impacting their overall well-being and quality of life. How does living with this condition affect mental health, and what strategies can help address these challenges?

• Anxiety related to potential flare-ups and complications
• Depression associated with chronic pain and dietary restrictions
• Social isolation due to symptoms and dietary needs
• Body image concerns related to abdominal discomfort and bloating
• Stress from managing a chronic health condition

Addressing the psychological aspects of diverticular disease is essential for comprehensive patient care. Mental health support, counseling, and stress management techniques can play a crucial role in helping individuals cope with the challenges of living with this condition.

Future Directions: Personalized Medicine in Diverticulitis Care

The field of personalized medicine holds promise for improving the management of diverticulitis by tailoring prevention and treatment strategies to individual patients. What are some potential applications of personalized medicine in diverticulitis care?

• Genetic testing to identify individuals at higher risk for complications
• Microbiome analysis to guide probiotic and dietary interventions
• Biomarker-based prediction of disease progression and treatment response
• Pharmacogenomic approaches to optimize medication selection and dosing
• Personalized dietary plans based on individual gut microbiota profiles

As research in this area progresses, personalized medicine approaches may lead to more effective prevention strategies, targeted treatments, and improved outcomes for individuals with diverticulitis.

Diverticular disease and diverticulitis: Overview – InformedHealth.org

Created: May 17, 2018; Next update: 2021.

Introduction

Diverticula are pouches in the lining of the intestine. They arise when the wall of the intestine bulges out through weak areas of intestinal muscle. The pouches are usually small and balloon-like, and the contents of the bowel (stool, or “poop”) might get into them. Although diverticula are often harmless, they may lead to bowel problems and cause pain. Simply put, there are three different conditions:

• Diverticulosis: The lining of the intestine bulges out in a number of places, but this doesn’t cause any symptoms or problems.

• Diverticular disease: The bulging pouches cause symptoms or lead to problems (complications).

• Diverticulitis: The pouches are inflamed or infected.

Diverticula can cause recurring or permanent symptoms. This is referred to as chronic diverticular disease. Diverticulitis can usually be treated effectively, but may have serious consequences if the inflammation spreads.

Diverticula and diverticulitis

Symptoms

Most diverticula don’t cause any symptoms. Diverticular disease is typically associated with pain in the lower left side of the abdomen (tummy) or – less commonly – the right side. It can also lead to bloating, constipation or diarrhea. The symptoms often go away for a while, but may be constant. They commonly get worse after meals, and then better again after going to the toilet and having a bowel movement. Sometimes diverticula lead to bleeding too.

If they become inflamed (diverticulitis), they cause sudden dull pain in the abdomen, accompanied by a mild fever. Other symptoms include constipation, diarrhea, bloating, nausea and sometimes cramping too. Diverticulitis rarely leads to vomiting. If a doctor applies pressure to the abdomen, the tummy muscles automatically tense up (a reflex known as muscular defense). If they suddenly let go, the pain gets worse.

Causes and risk factors

Diverticula form in weak areas of the intestinal muscles. They usually arise in the sigmoid colon. This s-shaped section of the large intestine is roughly 40 to 45 centimeter long and found just in front of the rectum. The contents of the intestine put the most pressure on the muscular wall here.

Some people are more likely to develop diverticula because of their genes. Further risk factors include weak connective tissue and problems with the wave-like movements of the intestinal wall. Older and very overweight people are at greater risk, too.

The influence of lifestyle factors hasn’t yet been properly determined. A diet that is low in fiber can lead to constipation and hard stools, so it seems logical that too little fiber should increase the risk of diverticular disease. Eating a lot of red meat, smoking and not getting enough movement are also believed to be risk factors.

It’s still not clear how diverticula become inflamed and what increases the risk of this happening. But inflammation is believed to be more likely in areas of reduced blood supply and if hard lumps of stool form in the diverticula.

Complications are more common in people who have a weakened immune system (for instance, after an organ transplant) or severe kidney disease. The long-term use of particular medications probably increases the risk of more serious complications. These medications include non-steroidal anti-inflammatory drugs (NSAIDs), steroids, acetylsalicylic acid (the drug in medicines like Aspirin) and opiates.

Prevalence

Many people have diverticula without knowing it. They are more common in older age: About 10% of people under the age of 50 have diverticula, and about 50% of people over the age of 70 have them. They are equally common in men and women.

About 1% of all people who have diverticula develop diverticulitis within ten years. This inflammation can occur at any age.

Effects

Diverticula often remain unnoticed if they don’t cause any symptoms. But they sometimes lead to chronic digestive problems and pain, or may even become inflamed or infected.

Diverticulitis can usually be treated effectively and then goes away after a few weeks. But about 20% of those affected get diverticulitis again within a few years.

Diverticulitis can lead to complications if the inflammation spreads to the wall of the intestine, surrounding tissue or nearby organs. Abscesses (collections of pus) or fistulas may develop. A fistula is an unnatural tunnel-like passageway between two organs, for instance between the intestine and the bladder.

One rare but serious complication may arise if the wall of the intestine tears (intestinal perforation). If the contents of the intestine then leak out into the abdominal cavity, the inner lining of the tummy (peritoneum) may become inflamed, leading to a life-threatening condition known as peritonitis. This typically causes severe tummy pain, a hard abdominal wall, fever, nausea, a rapid heartbeat and general weakness. It is important to recognize these peritonitis symptoms and quickly seek medical help.

In some people, diverticula keep becoming inflamed despite having been treated successfully in the past. This can lead to scarring that causes the intestine to become narrow (stenosis), making it difficult for stool to pass through it. In extreme cases, the intestine becomes blocked (ileus). Some people have constant diverticula symptoms although their intestine isn’t inflamed. The risk of complications is greatest when someone has diverticulitis for the first time. After that, recurring inflammations are a lot less likely to lead to complications. The main consequences of recurring diverticulitis are chronic symptoms such as irregular bowel movements, bloating and abdominal pain.

It’s good to know that diverticula do not develop into bowel cancer. This kind of cancer develops from polyps in the bowel.

Diagnosis

If you go to see a doctor about your symptoms, they will ask you about various things, such as your medical history and whether you are taking medication. This is followed by a physical examination where they listen to your tummy, and also feel your tummy and rectum. Depending on the symptoms, you may have blood and urine tests, and your temperature might be measured.  You will usually have an ultrasound scan as well. If there is still no clear diagnosis, you may need to have a CT (computed tomography) scan and perhaps a colonoscopy too (inspection of the inside of the intestine using a camera).

This can help to rule out other illnesses – the symptoms of diverticular disease are similar to the symptoms of conditions like appendicitis or irritable bowel syndrome (IBS).

Colonoscopies are too risky during acute diverticulitis. But people are often advised to have a colonoscopy about 4 to 6 weeks after the symptoms have cleared up. This is to make sure that they weren’t caused by polyps, bowel cancer or another illness.

Prevention

Eating enough fiber helps to make sure that your stool doesn’t get too hard. So it would seem logical that fiber should prevent pain and inflammation in people with diverticula. There’s a lot of fiber in whole-grain foods, vegetables, legumes (e. g. beans, lentils) and fruits. Physical exercise stimulates digestion too, but it isn’t clear whether it can prevent the symptoms.

Sometimes people are advised to avoid certain foods – particularly nuts, grains, sweetcorn and popcorn. For a long time it was thought that fragments of these foods could get stuck in the diverticula and cause diverticulitis. But studies have shown that not to be true. So you don’t have to avoid eating nuts, for example.

Treatment

Diverticula that don’t cause any symptoms don’t have to be treated. The treatment options for diverticulitis depend on how severe it is.

The aim of treatment is to

• avoid potential complications and relieve acute symptoms,

• prevent it from coming back, and

• relieve chronic symptoms.

Diverticulitis inflammations are caused by a bacterial infection, so they can be treated with antibiotics. But people usually only need to use antibiotics if complications arise or if there’s an increased risk of them arising. Complications may have to be treated in hospital.

If acute diverticulitis doesn’t improve or someone has constant symptoms, the affected part of the large intestine can be surgically removed. Because of the associated risks, it’s important to carefully consider the pros and cons of surgery first. Serious complications such as peritonitis require immediate surgery, though.

For people who have chronic symptoms, it might be worth trying to eat more fiber. There’s not yet enough good research to be able to say whether probiotic food products can help.

Nowadays there’s good reason to believe that antibiotics and surgery often aren’t as necessary as previously thought.

Sources

• Andeweg CS, Berg R, Staal JB, ten Broek RP, van Goor H. Patient-reported Outcomes After Conservative or Surgical Management of Recurrent and Chronic Complaints of Diverticulitis: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2016; 14(2): 183-190. [PubMed: 26305068]

• Carabotti M, Annibale B, Severi C, Lahner E. Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review. Nutrients 2017; 9(2): pii: E161. [PMC free article: PMC5331592] [PubMed: 28230737]

• Lahner E, Bellisario C, Hassan C, Zullo A, Esposito G, Annibale B. Probiotics in the Treatment of Diverticular Disease. A Systematic Review. J Gastrointestin Liver Dis 2016; 25(1): 79-86. [PubMed: 27014757]

• Leifeld L, Germer CT, Böhm S, Dumoulin FL, Häuser W, Kreis M et al. S2k-Leitlinie Divertikelkrankheit/Divertikulitis. Z Gastroenterol 2014; 52(7): 663-710. [PubMed: 25026009]

• Morris AM, Regenbogen SE, Hardiman KM, Hendren S. Sigmoid diverticulitis: a systematic review. JAMA 2014; 311(3): 287-297. [PubMed: 24430321]

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Diverticular disease and diverticulitis: Overview – InformedHealth.org

Created: May 17, 2018; Next update: 2021.

Introduction

Diverticula are pouches in the lining of the intestine. They arise when the wall of the intestine bulges out through weak areas of intestinal muscle. The pouches are usually small and balloon-like, and the contents of the bowel (stool, or “poop”) might get into them. Although diverticula are often harmless, they may lead to bowel problems and cause pain. Simply put, there are three different conditions:

• Diverticulosis: The lining of the intestine bulges out in a number of places, but this doesn’t cause any symptoms or problems.

• Diverticular disease: The bulging pouches cause symptoms or lead to problems (complications).

• Diverticulitis: The pouches are inflamed or infected.

Diverticula can cause recurring or permanent symptoms. This is referred to as chronic diverticular disease. Diverticulitis can usually be treated effectively, but may have serious consequences if the inflammation spreads.

Diverticula and diverticulitis

Symptoms

Most diverticula don’t cause any symptoms. Diverticular disease is typically associated with pain in the lower left side of the abdomen (tummy) or – less commonly – the right side. It can also lead to bloating, constipation or diarrhea. The symptoms often go away for a while, but may be constant. They commonly get worse after meals, and then better again after going to the toilet and having a bowel movement. Sometimes diverticula lead to bleeding too.

If they become inflamed (diverticulitis), they cause sudden dull pain in the abdomen, accompanied by a mild fever. Other symptoms include constipation, diarrhea, bloating, nausea and sometimes cramping too. Diverticulitis rarely leads to vomiting. If a doctor applies pressure to the abdomen, the tummy muscles automatically tense up (a reflex known as muscular defense). If they suddenly let go, the pain gets worse.

Causes and risk factors

Diverticula form in weak areas of the intestinal muscles. They usually arise in the sigmoid colon. This s-shaped section of the large intestine is roughly 40 to 45 centimeter long and found just in front of the rectum. The contents of the intestine put the most pressure on the muscular wall here.

Some people are more likely to develop diverticula because of their genes. Further risk factors include weak connective tissue and problems with the wave-like movements of the intestinal wall. Older and very overweight people are at greater risk, too.

The influence of lifestyle factors hasn’t yet been properly determined. A diet that is low in fiber can lead to constipation and hard stools, so it seems logical that too little fiber should increase the risk of diverticular disease. Eating a lot of red meat, smoking and not getting enough movement are also believed to be risk factors.

It’s still not clear how diverticula become inflamed and what increases the risk of this happening. But inflammation is believed to be more likely in areas of reduced blood supply and if hard lumps of stool form in the diverticula.

Complications are more common in people who have a weakened immune system (for instance, after an organ transplant) or severe kidney disease. The long-term use of particular medications probably increases the risk of more serious complications. These medications include non-steroidal anti-inflammatory drugs (NSAIDs), steroids, acetylsalicylic acid (the drug in medicines like Aspirin) and opiates.

Prevalence

Many people have diverticula without knowing it. They are more common in older age: About 10% of people under the age of 50 have diverticula, and about 50% of people over the age of 70 have them. They are equally common in men and women.

About 1% of all people who have diverticula develop diverticulitis within ten years. This inflammation can occur at any age.

Effects

Diverticula often remain unnoticed if they don’t cause any symptoms. But they sometimes lead to chronic digestive problems and pain, or may even become inflamed or infected.

Diverticulitis can usually be treated effectively and then goes away after a few weeks. But about 20% of those affected get diverticulitis again within a few years.

Diverticulitis can lead to complications if the inflammation spreads to the wall of the intestine, surrounding tissue or nearby organs. Abscesses (collections of pus) or fistulas may develop. A fistula is an unnatural tunnel-like passageway between two organs, for instance between the intestine and the bladder.

One rare but serious complication may arise if the wall of the intestine tears (intestinal perforation). If the contents of the intestine then leak out into the abdominal cavity, the inner lining of the tummy (peritoneum) may become inflamed, leading to a life-threatening condition known as peritonitis. This typically causes severe tummy pain, a hard abdominal wall, fever, nausea, a rapid heartbeat and general weakness. It is important to recognize these peritonitis symptoms and quickly seek medical help.

In some people, diverticula keep becoming inflamed despite having been treated successfully in the past. This can lead to scarring that causes the intestine to become narrow (stenosis), making it difficult for stool to pass through it. In extreme cases, the intestine becomes blocked (ileus). Some people have constant diverticula symptoms although their intestine isn’t inflamed. The risk of complications is greatest when someone has diverticulitis for the first time. After that, recurring inflammations are a lot less likely to lead to complications. The main consequences of recurring diverticulitis are chronic symptoms such as irregular bowel movements, bloating and abdominal pain.

It’s good to know that diverticula do not develop into bowel cancer. This kind of cancer develops from polyps in the bowel.

Diagnosis

If you go to see a doctor about your symptoms, they will ask you about various things, such as your medical history and whether you are taking medication. This is followed by a physical examination where they listen to your tummy, and also feel your tummy and rectum. Depending on the symptoms, you may have blood and urine tests, and your temperature might be measured.  You will usually have an ultrasound scan as well. If there is still no clear diagnosis, you may need to have a CT (computed tomography) scan and perhaps a colonoscopy too (inspection of the inside of the intestine using a camera).

This can help to rule out other illnesses – the symptoms of diverticular disease are similar to the symptoms of conditions like appendicitis or irritable bowel syndrome (IBS).

Colonoscopies are too risky during acute diverticulitis. But people are often advised to have a colonoscopy about 4 to 6 weeks after the symptoms have cleared up. This is to make sure that they weren’t caused by polyps, bowel cancer or another illness.

Prevention

Eating enough fiber helps to make sure that your stool doesn’t get too hard. So it would seem logical that fiber should prevent pain and inflammation in people with diverticula. There’s a lot of fiber in whole-grain foods, vegetables, legumes (e.g. beans, lentils) and fruits. Physical exercise stimulates digestion too, but it isn’t clear whether it can prevent the symptoms.

Sometimes people are advised to avoid certain foods – particularly nuts, grains, sweetcorn and popcorn. For a long time it was thought that fragments of these foods could get stuck in the diverticula and cause diverticulitis. But studies have shown that not to be true. So you don’t have to avoid eating nuts, for example.

Treatment

Diverticula that don’t cause any symptoms don’t have to be treated. The treatment options for diverticulitis depend on how severe it is.

The aim of treatment is to

• avoid potential complications and relieve acute symptoms,

• prevent it from coming back, and

• relieve chronic symptoms.

Diverticulitis inflammations are caused by a bacterial infection, so they can be treated with antibiotics. But people usually only need to use antibiotics if complications arise or if there’s an increased risk of them arising. Complications may have to be treated in hospital.

If acute diverticulitis doesn’t improve or someone has constant symptoms, the affected part of the large intestine can be surgically removed. Because of the associated risks, it’s important to carefully consider the pros and cons of surgery first. Serious complications such as peritonitis require immediate surgery, though.

For people who have chronic symptoms, it might be worth trying to eat more fiber. There’s not yet enough good research to be able to say whether probiotic food products can help.

Nowadays there’s good reason to believe that antibiotics and surgery often aren’t as necessary as previously thought.

Sources

• Andeweg CS, Berg R, Staal JB, ten Broek RP, van Goor H. Patient-reported Outcomes After Conservative or Surgical Management of Recurrent and Chronic Complaints of Diverticulitis: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2016; 14(2): 183-190. [PubMed: 26305068]

• Carabotti M, Annibale B, Severi C, Lahner E. Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review. Nutrients 2017; 9(2): pii: E161. [PMC free article: PMC5331592] [PubMed: 28230737]

• Lahner E, Bellisario C, Hassan C, Zullo A, Esposito G, Annibale B. Probiotics in the Treatment of Diverticular Disease. A Systematic Review. J Gastrointestin Liver Dis 2016; 25(1): 79-86. [PubMed: 27014757]

• Leifeld L, Germer CT, Böhm S, Dumoulin FL, Häuser W, Kreis M et al. S2k-Leitlinie Divertikelkrankheit/Divertikulitis. Z Gastroenterol 2014; 52(7): 663-710. [PubMed: 25026009]

• Morris AM, Regenbogen SE, Hardiman KM, Hendren S. Sigmoid diverticulitis: a systematic review. JAMA 2014; 311(3): 287-297. [PubMed: 24430321]

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Possible causes and treatment of pain in the lower abdomen on the left

Content

• 1 Pain in the lower abdomen on the left
  • 1.1 Characteristics of pain in the lower abdomen on the left
  • 1. 2 Leading symptoms of pain in the lower abdomen on the left
  • 1.3 Possible causes pain in the lower abdomen on the left
  • 1.4 Diseases organs causing pain in the lower abdomen on the left
  • 1.5 Injuries and damage causing pain in the lower abdomen on the left
  • 1.6 Inflammatory processes causing pain in the lower abdomen on the left
  • 1.7 Diseases of the urinary tract that cause pain in the lower abdomen on the left
  • 1.8 Gynecological causes of pain in the lower abdomen on the left
  • 1.9 What to do with pain in the lower abdomen on the left
  • 1.10 Diagnosis of pain in the lower abdomen on the left
  • 1. 11 How to prevent pain in the lower abdomen on the left
  • 1.12 How long does the treatment of pain in the lower abdomen on the left
  • 1.13 Prevention of pain in the lower abdomen on the left
  • 1.14 Traditional methods of treating pain in the lower abdomen on the left
  • 1.15 Medicines for left lower abdominal pain
  • 1. 16 Surgery for left lower abdominal pain
  • 1.17 Sequelae of untreated left lower abdominal pain
  • 1.18 Related videos:
  • 1.19 Question-answer:
    • • 1.19. 0.1 What are the possible causes of pain in the lower abdomen on the left?
      • 1.19.0.2 How to determine that pain in the lower abdomen on the left is associated with bowel problems?
      • 1.19.0.3 What are the causes of intestinal obstruction?
      • 1.19.0.4 How is left lower abdominal pain diagnosed?
      • 1.19.0.5 How to treat pain in the lower abdomen on the left?

The article will tell about the possible causes of pain in the lower abdomen on the left, as well as methods for diagnosing and treating this symptom. Find out which organs are on the left side of the abdomen and what diseases can cause similar symptoms. Find answers to your questions about left lower abdominal pain and know when to see a doctor.

Pain in the lower abdomen on the left is a fairly common symptom that can be caused by various reasons. It can be acute, paroxysmal or chronic, gradually increasing. All this may indicate the presence of a disease or pathological process in the body.

Diverticulitis can be one of the possible causes of left lower abdominal pain. This is an inflammation of one or more diverticula – outgrowths on the walls of the intestines, which can appear with age. Symptoms of diverticulitis may include pain in the lower abdomen on the left side, changes in stool, discomfort when urinating.

Another possible cause of pain in this area is an ovarian cyst. An ovarian cyst is a cavity containing fluid that forms on the ovary. The cyst can cause pain in the lower left abdomen, as well as irregular menstrual cycles, frequent urination, and discomfort during intercourse.

It is important to see a doctor if you have pain in your left lower abdomen, especially if it lasts or gets worse.

Treatment of pain in the left lower abdomen will depend on its cause. If you have diverticulitis, your doctor may recommend antibiotics, anti-spasmodic medications, a special diet, and lifestyle changes. If an ovarian cyst causes pain, the doctor may prescribe hormonal medications or even surgery if the cyst becomes large or causes complications.

Characteristics of pain in the lower abdomen on the left

Pain in the lower abdomen on the left is one of the most common complaints that people go to doctors with. It can have different characteristics and occur for different reasons. Pain can be sharp or paroxysmal, dull or cutting, constant or intermittent.

The most common cause of pain in the left lower abdomen is inflammation or irritation of the organs in this area. For example, diverticulitis, an inflammatory disease of the colon, can cause acute pain in the lower left abdomen, accompanied by gas, constipation, or diarrhea. Also, pain in the lower abdomen on the left can be associated with problems in the urinary system, such as a urinary tract infection or kidney stones.

It is important to see a doctor if you experience pain in the left lower abdomen, especially if it is accompanied by other symptoms such as vomiting, fever or loss of appetite. Only a professional diagnosis can determine the exact cause of the pain and prescribe the appropriate treatment.

Leading symptoms of pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various reasons. It can be acute or chronic, accompanied by other symptoms, or self-limiting. The leading symptoms of this condition can provide information about possible causes and help the doctor make the correct diagnosis.

One of the leading symptoms of pain in the lower abdomen on the left is a feeling of heaviness or pressure in this area. The patient may feel discomfort or pressure, which may increase with certain movements or when the abdomen is touched. This symptom may be characteristic of various conditions such as diverticulitis, inflammation of the ovary or colon.

Another leading symptom of pain in the lower abdomen on the left can be gas and bloating. The patient may complain of a feeling of fullness in the stomach, frequent belching, bloating and increased gas formation. This symptom may be a sign of conditions such as irritable bowel syndrome or intestinal obstruction.

Also, pain in the lower abdomen on the left can be accompanied by a change in stool. The patient may experience constipation or diarrhea, as well as a change in the consistency and color of the stool. This symptom may indicate a bowel problem such as an ulcer, ulcerative colitis, or colon cancer.

Possible causes of pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various reasons. One of the most common causes is a problem with the digestive system. For example, inflammation of the colon, known as diverticulitis, can cause pain and discomfort in the left lower abdomen.

Pain in the lower abdomen on the left can also be associated with urinary system problems. For example, a bladder or urinary tract infection can cause pain and discomfort in that area.

Another possible cause of lower left abdominal pain is a problem with the reproductive system. For example, inflammation of the ovaries or ovarian tubes can cause pain in the left lower abdomen in women.

In some cases, left lower abdominal pain may be caused by a painful anomaly such as intestinal lactose intolerance or irritable bowel.

Diseases of the organs that cause pain in the lower abdomen on the left

1. Diverticulitis

Diverticulitis is an inflammation and infection in small growths on the walls of the large intestine, called diverticula. This disease can cause severe pain in the lower abdomen on the left, which can be aggravated by eating or passing feces.

2. Sigmoiditis

Sigmoiditis is an inflammation of the sigmoid colon, which is part of the large intestine. This disease can also cause sharp pain in the left lower abdomen, often accompanied by diarrhea, bloody or mucous stools, and a feeling of need to continually relieve nausea.

3. Torsion of the ovary

Rotation of the ovary around its own axis is called torsion of the ovary. This condition can lead to infringement of blood flow and intense pain in the lower abdomen on the left. Torsion of the ovary is a serious medical condition and requires immediate treatment.

4. Salpingitis

Salpingitis is an inflammation of the fallopian tubes that is usually caused by an infection such as chlamydia or gonococcal infection. This disease can cause pain in the left lower abdomen, which can be sharp and worse with movement.

Injuries and injuries causing pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various injuries and injuries that can affect the organs and tissues of this area. This is a serious condition and requires medical attention.

Another possible injury that causes pain in the left lower abdomen is a bladder injury. When the bladder is damaged, acute pain occurs, which may be accompanied by bleeding from the urine. In such cases, immediate medical attention is required.

Also, pain in the lower abdomen on the left can be caused by damage to the left kidney. This can happen as a result of injury or infection. Kidney damage usually causes severe pain in the lower abdomen, which may radiate down the back and be accompanied by blood in the urine.

Inflammatory processes that cause pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be associated with various inflammatory processes that can affect the organs located in this area. One of the most common causes of pain is inflammation of the left ovary, which may result from infection or other factors. Patients with inflammation of the ovary usually have acute pain in the lower abdomen on the left, which may increase during intercourse or urination.

Other possible causes of lower left abdominal pain are inflammations of the colon, such as diverticulitis or inflammatory bowel disease. Diverticulitis is characterized by inflammation of small growths on the walls of the colon, which can cause pain and discomfort. Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, can also cause pain in the left lower abdomen and associated symptoms such as diarrhea and anorexia.

If you have left lower abdominal pain, see your doctor for an accurate diagnosis and appropriate treatment. Do not self-medicate, as this can aggravate the problem and lead to serious consequences for your health.

Diseases of the urinary tract causing pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various diseases of the urinary tract. Given the complexity of diagnosis, a visit to the doctor is necessary to establish the exact cause of the pain and prescribe the appropriate treatment. In this article, we will consider several common causes of pain in the lower abdomen on the left.

1. Urinary tract disorders. Pain in the lower abdomen on the left can be associated with various patterns

Gynecological causes of pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various gynecological causes:

• Ovarian cyst is one of the most common causes of pain in the lower abdomen on the left in women. This is a cavity filled with fluid that forms on the ovary. The cyst can cause discomfort and pain, especially during menstruation or physical activity.
• Endometriosis is a condition in which tissue like the tissue that covers the uterus begins to grow in other parts of the body, including the ovaries. This can cause pain, including pain in the lower abdomen on the left.
• An ectopic pregnancy is a condition in which a fertilized egg begins to develop outside the uterus, most commonly in the fallopian tube. This can lead to sharp and intense pain in the lower abdomen on the left, as well as bleeding and other serious problems.
• Inflammatory diseases, such as inflammation of the uterus (adnexitis), inflammation of the ovaries or inflammation of the cervix, can cause pain in the lower abdomen on the left.

If you experience pain in your left lower abdomen, especially if it is accompanied by other symptoms such as vaginal discharge, changes in your menstrual cycle, or fever, see your gynecologist for diagnosis and appropriate treatment.

What to do with pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be a sign of various diseases and conditions. If you feel such pain, it is important to pay attention to its nature and accompanying symptoms. In some cases, pain can be avoided or relieved with simple home remedies.

1. Rest and reduce activity: If the pain in the lower abdomen on the left is not intense and is not accompanied by other serious symptoms, try to rest and reduce activity. Avoid physical activity and set up space for relaxation.

2. Apply heat: In some cases, applying heat to the painful area can help relieve pain and improve your condition. You can use a warm heating pad or a hot bath.

3. Reduce stress: Stress can be one of the causes of lower left abdominal pain. Regular stress management techniques such as meditation, yoga, or deep breathing can help reduce pain and improve your overall well-being.

4. Seek medical attention: If pain in the left lower abdomen becomes intense, prolonged, or is accompanied by other symptoms such as vomiting, blood in the stool, or high fever, seek medical attention immediately. He will be able to determine the cause of the pain and prescribe the appropriate treatment.

Do not forget that pain in the lower abdomen on the left can have various causes, and only a qualified doctor can give an accurate diagnosis and prescribe an effective treatment. Remember that self-medication can be dangerous, so it’s important to seek medical attention if needed.

Diagnosis of pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various reasons, so it is important to diagnose in order to determine the source of pain. Initially, the doctor may conduct an examination and ask a series of questions to find out the nature and intensity of pain, as well as associated symptoms.

Laboratory testing, such as blood and urine tests, may be required for a more accurate diagnosis. This will help to identify the presence or absence of inflammation, infections or other pathologies.

Additional diagnostic tests may include physical examination of the abdomen, ultrasound, bladder catheterization, computed tomography, or magnetic resonance imaging. These methods allow you to study the organs and tissues in the area of ​​pain in more detail and identify possible changes.

In some cases, endoscopic examination may be required to directly visualize internal organs and tissues. A biopsy may also be needed, in which a tissue sample is taken for further analysis and to determine the cause of the pain.

How to prevent pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be caused by various reasons, from normal muscle load to serious diseases of the organs. It is important to know how to prevent pain and keep your organs healthy.

1. Observe the correct posture and conscious movements

One of the main causes of pain in the lower abdomen on the left is incorrect posture or incorrect movements. Sitting or standing in a bad posture can put stress on the abdominal and back muscles, which can eventually lead to pain. You should try to maintain a straight posture and distribute the load evenly on all muscles.

2. Abdominal exercises

Abdominal strength exercises can help strengthen muscles and prevent pain. Regular exercises such as planks, abs, and crunches can help strengthen and stretch your muscles, improve muscle tone, and reduce the risk of pain in the lower left abdomen.

3. Proper nutrition and hygiene

Proper nutrition and regular use of the toilet are important for maintaining the health of the organs in the lower abdomen. Maintain a balanced diet, including enough fiber to help avoid constipation and other digestive problems. Also, do not forget about regular meals and enough water throughout the day.

In general, prevention of left lower abdominal pain can be achieved by reducing the risk of pain. You don’t have to wait for pain to start taking care of your health. Always consult a doctor if you have questions or medical conditions for professional advice and treatment.

How long does it take to treat pain in the lower abdomen on the left

The duration of treatment for pain in the lower abdomen on the left depends on the cause of this pain. This symptom can be associated with various conditions and diseases, so you need to see a doctor for an accurate diagnosis and prescribe the optimal treatment course.

If the pain in the left lower abdomen is caused by inflammatory processes in the abdominal organs, such as diverticulitis or stomach ulcers, treatment may take several weeks or months, depending on the severity of the disease and the individual characteristics of the patient.

If the cause of the pain is intestinal obstruction or other stress on the intestines, treatment may include drugs that help relax intestinal motility, as well as changes in diet and lifestyle. In this case, the treatment time can be from several days to several weeks.

If pain in the left lower abdomen is due to an attack of gout or a cold of the kidneys, treatment is aimed at relieving symptoms and alleviating the patient’s condition, and may last several days or weeks.

Of course, to determine the exact time of treatment, you need to contact a qualified doctor who will conduct all the necessary studies and determine the optimal treatment course in each case.

Prevention of pain in the lower abdomen on the left

Pain in the lower abdomen on the left can be a sign of various diseases and conditions. To prevent the occurrence of such pain, you must follow certain precautions and follow the recommendations of doctors.

Maintaining a healthy lifestyle is one of the most important aspects of preventing lower left abdominal pain. It is important to eat right, eat foods rich in fiber, and avoid fatty, spicy and fried foods. Regular drinking of water and lack of physical activity can also cause discomfort and pain in the abdomen, so it is recommended to devote time to training or just active walks. Avoid irregular meals, overeating and excess alcohol and coffee.

To prevent the occurrence of problems in the gastrointestinal tract and, accordingly, pain in the lower abdomen on the left, it is recommended to follow a regular stool. Constipation attacks can cause discomfort and discomfort. Regular intake of fiber-rich foods, drinking plenty of fluids, and including vegetables and fruits in your diet help maintain normal bowel movements and prevent constipation.

Also an important point in the prevention of pain in the lower abdomen on the left is the timely visit to the doctor for preventive examinations. Regular checks of the condition of the abdominal organs can identify and prevent the development of diseases that can cause discomfort. If even minor changes occur in the body, you should consult a specialist.

1. Maintain a healthy lifestyle and eat right.
2. Get regular physical activity.
3. Avoid irregular meals and overeating.
4. Maintain regular stools, avoid constipation.
5. See a doctor for a checkup.

Traditional Treatments for Left Lower Abdominal Pain

Left Lower Abdominal Pain can be caused by various causes such as intestinal inflammation, kidney stones, stomach ulcers, female diseases or other organ problems in this area. If you have pain in the lower abdomen on the left and it is not too severe, you can try some folk remedies to relieve it.

1. Warm compression. Applying a warm compress to the affected area can help relieve muscle tension and reduce pain. To do this, you can use a heating pad with hot water or warm towels.

2. Herbal remedies. Some herbs have anti-inflammatory and analgesic properties that can help manage pain. For example, you can make and drink ginger, mint, or licorice herb tea.

3. Massage. Gentle abdominal massage can help relieve muscle tension and improve blood circulation in the area. For massage, you can use oil with the addition of essential oils such as lavender or rosemary.

4. Proper nutrition. Some foods may increase inflammation and cause pain. Therefore, it is important to monitor your diet and exclude from the diet spicy, fatty and heavy foods that can adversely affect the condition of the gastrointestinal tract.

5. Drink more fluids. Drinking enough water on a regular basis can help improve the functioning of the digestive system and slow down the formation of kidney stones, which can cause pain in the lower abdomen on the left.

Before using any folk remedies, it is always recommended to consult a specialist to determine the exact cause of the pain and select the most effective treatment.

Medicines for the treatment of pain in the lower abdomen on the left

Pain in the left lower abdomen can be caused by various causes , including problems with the digestive system, gynecological disorders, constipation and inflammation. To alleviate this pain, various medications can be used to help cope with discomfort.

Anti-spasmodics: These drugs help relax the smooth muscles of the digestive system and relieve spasms, which can help relieve pain in the lower left abdomen. Some of the more common antispasmodics include Drotaverine, No-Shpa, and Mebeverine.

Non-steroidal anti-inflammatory drugs (NSAIDs): These drugs help reduce inflammation and pain in the left lower abdomen. These may include ibuprofen, diclofenac, and naproxen.

Antibiotics: If your left lower abdominal pain is caused by an infection or inflammation, your doctor may prescribe a course of antibiotics to fight the infection and reduce the inflammation. To choose the right antibiotic, you need to consult a doctor.

Anti-constipation medications: If constipation is the cause of the pain in the left lower abdomen, the doctor may prescribe medications to improve intestinal motility and eliminate constipation. These include lactulose, magnesium sulfate and senna.

Anti-gas medications: If the pain in the lower abdomen on the left is accompanied by excessive gas formation, the doctor may recommend medications to help get rid of gas and improve general condition. Espumizan and Simethicone are examples.

It is important to remember that in case of pain in the lower abdomen on the left, it is necessary to consult a specialist in order to determine the exact cause of the pain and receive the correct treatment. Self-medication can be dangerous and make things worse.

Surgery for left lower abdominal pain

Pain in the lower abdomen on the left can be a sign of various diseases requiring surgical intervention. One of the most common and serious diseases requiring surgery is appendicitis. Appendicitis is an inflammation of the appendage to the intestine, which is located in the lower right corner of the abdomen. However, in rare cases, appendicitis may be located on the left side of the abdomen. In this case, surgery is necessary to remove the inflamed appendage and prevent its breakthrough, which can lead to the development of serious complications.

In addition to appendicitis, another common condition that can cause pain in the lower left abdomen is diverticulitis. Diverticula are small protrusions on the walls of the colon that often cause no symptoms. However, if the diverticulum becomes inflamed or infected, it can lead to diverticulitis, which is accompanied by pain, including in the lower left abdomen. In some cases where diverticulitis does not respond to conservative treatment or complications occur, surgery may be needed to remove the affected part of the colon.

Other possible causes of left lower abdominal pain requiring surgical treatment are hernias and tumors. A hernia is the protrusion of organs or tissues through weak points in the muscles or abdominal wall. If the hernia is in the left abdomen and causes severe pain or interferes with the normal functioning of organs, surgery may be necessary to restore muscle integrity or remove the hernia. The tumor, in turn, can cause pain, especially if it presses on surrounding tissues or organs. Surgery may be needed to remove the tumor or relieve its pressure.

Consequences of untreated left lower abdominal pain

Untreated left lower abdominal pain can have serious health consequences.

1. Inflammatory processes: Untimely treatment of pain in the lower abdomen on the left can lead to the development of inflammatory processes in the organs located in this area. This may be appendicitis, inflammation of the left ovary or ovary in women, inflammation of the colon, etc. Inflammation can lead to complications and organ damage, and require more complex and prolonged treatment.

2. Development of tumors: Some tumors, such as colon cancer or ovarian cancer, may present with pain in the left lower abdomen. If the pain is not treated, the tumor may continue to grow and lead to the development of cancer. Therefore, it is very important to consult a doctor in time if pain occurs in this area.

3. Peritonitis: Peritonitis is an inflammation of the peritoneum that can result from infection from a swollen organ. One of the most dangerous causes of peritonitis is a ruptured appendix. Untimely access to a doctor with pain in the lower abdomen on the left can lead to the development of peritonitis, requiring urgent hospitalization and surgical intervention.

4. Deterioration of the quality of life: Unresolved pain in the lower abdomen on the left can significantly impair the quality of life of a person. Pain can limit his movement, interfere with daily tasks and play sports. In addition, constant sensations of pain can cause depression and anxiety, which negatively affects the psychological state.

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Q&A:

What are the possible causes of pain in the lower abdomen on the left?

Pain in the left lower abdomen can be caused by a variety of causes, including diverticulitis, bowel spasms, bowel irritation, ovarian rupture, ovarian inflammation, bowel obstruction, and kidney or bladder problems.

How to determine that pain in the lower abdomen on the left is associated with bowel problems?

If the pain in the lower abdomen on the left is accompanied by constipation, diarrhea, bloating, then this may indicate problems with the intestines. Also, symptoms can be a change in the consistency of stool and its color, frequent urge to defecate, the appearance of blood in the stool.

What can be the causes of intestinal obstruction?

Intestinal obstruction can be caused by bending and twisting of the intestine, tumors, infections and inflammations, scarring after surgical interventions, as well as various disorders of intestinal motility.

How is pain in the left lower abdomen diagnosed?

Diagnosis begins with an examination and review of the patient’s medical history. Further, the doctor may prescribe laboratory blood and urine tests, ultrasound of the abdominal organs, x-rays, computed tomography or magnetic resonance imaging. Sometimes a colonoscopy or laparoscopy is required.

How to treat pain in the lower abdomen on the left?

In the treatment of pain in the lower abdomen on the left, different methods are used, depending on the cause of these sensations. The doctor may prescribe drugs to relieve spasm and pain, probiotics to restore intestinal microflora, drugs to improve peristalsis, antibiotics for infections. In some cases, surgery may be required.

Not everything that hurts in the stomach is diverticulitis

Almost all people develop diverticula in the colon sooner or later. Someone at 40 years old, at 80 years old – the majority. Diverticula are protrusions-vesicles, most often found closer to the exit, in the sigmoid colon. It’s on the bottom left.

Usually they do not ask for food and do not interfere with life. But they can flare up. It turns out such a saccular protrusion with an accumulation of pus. More often this trouble is preceded by constipation or diarrhea.

At the reception, a person who has pain in the lower left for 5 years almost every day and for many hours. Colonoscopy revealed large diverticula. He is treated with antibiotics and mesalazine, but there is no improvement. And diverticulitis is not present and was not. Long-term monotonous pain is always a functional disorder, treated with drugs such as duloxetine and pregabalin.

How do we know if we have diverticulitis? By complaints. More often the patient says that there was constipation (rarely diarrhea), then cramping or constant pain appeared, usually on the left lower abdomen. Pain “reacts” to going to the toilet. Sometimes shaking of the body while walking. Often the temperature rises, the person experiences a general malaise.

Next we touch the stomach, usually we find local pain in the sigmoid colon. There may be “peritoneal” symptoms. Remember, the doctor, when palpating the abdomen, presses locally on the abdomen, and then abruptly removes his hand? If at the time of removal of the hand the pain increased sharply, the inflammation probably went beyond the intestine and affected the peritoneum. At this point, it is good to do a clinical blood test and see the C-reactive protein. In some clinics, such analyzes are available in real time.

The doctor receives signs of inflammation from tests. In principle, this is sufficient for the diagnosis of diverticulitis. We will prescribe treatment and everything will be fine soon. But one of my patients in this situation was scheduled for a colonoscopy, “to be sure.” First, preparation with a washing preparation, then the colonoscopy itself with bowel inflation. They saw an inflamed diverticulum, although they might not have seen it. The manipulations led to a perforation (hole) in the diverticulum and an emergency operation, in which the patient’s sigmoid colon was removed. It’s a shame that colonoscopy – a very useful method in many cases – for suspected diverticulitis was unnecessary and harmful.

If the clinical and laboratory picture is not enough for us, we prescribe computed tomography, sometimes ultrasound. Why? These methods “see” the inflammation (fluid or infiltrate) that has already gone beyond the intestine to the peritoneum. And perforation will also be shown – free air outside the intestines, which should not be. The methods themselves do not increase the risk of complications.

What to do next? Uncomplicated diverticulitis does not require hospitalization. But it is often offered, common sense is against it, the interests of the patient are against it, but the fear of the investigator is a strong argument for it. Fear is a bad adviser to a bad doctor.

If inflammation does not come out of the diverticulum, it can be treated with intestinal septic – an antibiotic that is not absorbed, today it is rifaximin.

If it went to the peritoneum, they used to try to operate. This is an extreme measure. A systemic antibiotic is almost always sufficient. Diverticulitis usually resolves in 1 to 3 weeks.

What’s next? It all depends on how often the diverticulitis comes back. It is important to prevent constipation by using vegetable fiber, fiber from preparations such as psyllium, synthetic fiber analogues such as macrogol.

Remember when I wrote that my patient was prescribed mesalazine? Some hopes were pinned on it at one time, but it turned out to be good in ulcerative colitis, its effect is hardly noticeable or absent in the prevention of diverticulitis.