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Person holding stomach: Does diverticulitis go away?
Health Education

Does diverticulitis go away?

Here’s what you should know about recurring symptoms from a diverticulitis flare
Sarah Bradley writer headshot
By | Jun. 20, 2023 Medically reviewed by Jesse P. Houghton, MD, FACG

If you have diverticulosis, a.k.a. small pockets inside the lining of your colon, there’s a chance you’ve experienced diverticulitis, or the inflammation and infection of one of those pockets. Diverticulosis is relatively common, affecting around 50% of people over 60, though it often doesn’t cause symptoms, and people may not know they have it. Diverticulitis, on the other hand, is less common but more problematic. Symptoms of diverticulitis include pain, bloating, change in bowel habits, and gastrointestinal distress.

Considering how uncomfortable diverticulitis is, anyone who’s suffered through a bout of it likely has one question on their mind: Will it happen again? Here’s what you need to know about diverticulitis, including why it happens and how it’s treated and prevented. 

What is a diverticulitis flare?

When the small pouches or sacs, called diverticula, in the lining of the large intestine become inflamed, you have diverticulitis. This is usually called a “flare” or “attack,” and the inflammation should resolve in a few days with proper treatment. A non-complicated diverticulitis flare should last only a few days, but it can last for as long as two weeks, says Arturo Bravo, MD, a gastroenterologist at Houston Methodist Willowbrook Hospital.

Symptoms of a flare include:

  • Persistent or constant abdominal pain, often on the lower left side
  • Fever 
  • Nausea, vomiting, and constipation
  • Abdominal tenderness

Many things can cause a diverticulitis flare, but Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, says the common risk factors are aging and obesity, smoking, eating a low-fiber diet, and certain medications, including opiates and steroids.

Does diverticulitis go away?

Uncomplicated diverticulitis usually goes away with at-home treatment. But there’s a chance you could have repeated episodes of acute diverticulitis. According to Dr. Bravo, diverticulosis is a lifetime condition, and not only does the risk of diverticular disease increase with age, but diverticulitis can get progressively worse if not treated. 

If you know you have diverticulitis—or suspect you might—it’s essential to see a healthcare provider to determine the best treatment approach whenever you have a flare. Your healthcare provider will generally schedule a colonoscopy (typically at least four weeks after the flare has resolved) to ensure any potential complications are prevented. There are several ways to treat a diverticulitis flare, including antibiotics, lifestyle changes, and home remedies.

Antibiotics

According to Dr. Bravo, if your disease is mild and you are otherwise healthy, you’ll likely be treated at home with oral antibiotics, which might include a combination of ciprofloxacin and metronidazole. However, if you develop a temperature greater than 100.1°F, worsening or severe abdominal pain, or an inability to tolerate fluids, you may require a hospital stay to receive treatment with antibiotics given through a vein, he says. This may also be a sign of an abscess in one of the diverticula that would require medical attention.

That said, oral antibiotics are often not necessary in mild cases. Even in some more complicated diverticulitis, their use is increasingly questioned as evidence suggests they are typically not more helpful than other treatments unless a confirmed bacterial infection exists. 

Lifestyle changes  

If you’re experiencing a diverticulitis flare, Dr. Bedford says the usual course of treatment is to adopt a low-fiber, liquid diet until your symptoms improve. This allows your bowels to heal. 

For people who’ve had a previous flare and are hoping to prevent a recurrence, Dr. Bedford says it’s important to do three things: exercise regularly, eat a high-fiber diet (think lots of fruits and vegetables) and prevent constipation. All of these will improve your gut motility, or food movement through your digestive system. 

“Anything that constipates you can trigger an attack,” he explains, “because constipation increases pressure in the colon that can stimulate an attack.”

Common causes of constipation include not staying hydrated enough, ignoring the urge to use the bathroom, taking medications like narcotics and iron supplements, and having certain health conditions, like celiac disease or irritable bowel disease. If medication or another condition are not the cause, then you may be able to prevent constipation by drinking more water, going on daily walks, and adding a fiber supplement to your diet.  

Home remedies

When you’re in the middle of a diverticulitis attack, the most important thing to do is to allow your colon to heal from the inflammation or infection. You can do this by:

When does diverticulitis not go away?

If you don’t treat your diverticulitis and allow it to heal or make the necessary dietary changes to prevent recurrence, Dr. Bedford says, it can worsen; your symptoms may linger for a long time or even become chronic. Chronic diverticulitis occurs when flares don’t fully heal or when other conditions cause frequent flares or inflammation.

Chronic diverticulitis often requires more intensive treatment than a liquid diet, rest, and antibiotics. Some people with severe cases need surgery to avoid more serious complications, like fistulas or intestinal perforation. According to Dr. Bravo, surgery involves removing the diseased part of the colon and reconnecting the two ends together, or partial resection. This may be done in two procedures, requiring a colostomy in between, or in a planned, more extended surgery.

How to prevent recurrent diverticulitis

Diverticulitis recurrence happens in about 20% of people who have had a prior flare. Remember, the pouches in the colon are there permanently; you can’t get rid of them, so there’s always a chance that whatever caused your first flare could cause more of them.

That’s why adjusting your diet and lifestyle after a flare is important. It helps reduce the risk of future diverticulitis attacks. Other things that will reduce your risk:

  • Exercising regularly to reduce colon pressure and increase gut motility
  • Not smoking 
  • Eating a high-fiber diet to keep bowel movements regular, including whole grains, raw fruits and vegetables, beans, legumes, and brown rice
  • Drinking at least 8 cups of water daily
  • Limiting the amount of animal fat in your diet
  • Not taking opioids, steroids, and NSAIDs

One thing you don’t have to do to prevent diverticulitis? Avoid whole pieces of fiber like seeds, corn, and nuts. Experts used to make this recommendation, says Dr. Bravo, but many healthcare providers no longer think eating these foods increases diverticulitis risk.

There doesn’t seem to be one singular food or food group most likely to cause inflammation in the diverticula. It’s more likely that everyone with a history of diverticulitis has a unique set of triggers, so tracking your eating habits can help. If you have a flare-up every time you eat a lot of strawberries, for example, you can identify and avoid them in the future.

Diverticulitis is painful, and unfortunately, once you’ve had an attack, you’re more likely to experience another at some point. But in most cases, individual flares can be treated at home with rest and liquids, and future attacks may be prevented with regular exercise, a high-fiber diet, and daily practices to reduce constipation.