Diverticulitis: symptoms, causes and which doctor to see

For diverticulitis you can first see: General Surgery or Internal Medicine or Gastroenterology. In large hospitals, the Gastroenterology unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: constant, tender pain in the lower left abdomen; fever and chills; nausea and vomiting; constipation or diarrhoea; bloating. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: a low-fibre diet and long-term constipation; weakening of the bowel wall with age; obesity and inactivity; smoking. Only a doctor’s examination can determine the exact cause.

Mild diverticulitis settles within a few days with the treatment and diet your doctor recommends. Abscess, perforation or frequent attacks require hospital treatment and sometimes removal of part of the bowel.

It is more common in: people over 50 (it becomes more common with age); people who eat a low-fibre, processed diet; overweight and inactive people.

Examination finds tenderness in the lower left abdomen; blood count and CRP show inflammation. Abdominal CT is used to confirm the diagnosis and look for complications such as an abscess. After recovery, the doctor may recommend a colonoscopy.

A high-fibre diet (vegetables, fruit, whole grains, pulses) and plenty of water reduce constipation and the formation of diverticula. Regular exercise and stopping smoking lower the risk.

For pain and fever, see general surgery or the emergency department; follow-up can also be done by internal medicine (gastroenterology).

No. Diverticula are small pouches in the bowel; diverticulitis is inflammation of those pouches. Most people with diverticula never get inflammation.

This used to be advised, but current evidence does not show that seeds and nuts increase attacks. Your doctor will decide on the right diet for you.

If the answer to any of these questions is yes, call 112 without delay: “Has the pain spread over the whole abdomen and is the abdomen board-hard?” “Is there vomiting together with high fever and chills?” “Is there heavy bleeding from the back passage?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: the same day if lower left abdominal pain comes with fever; for surgical assessment if attacks recur; if blood is seen in the stool.