Diverticulitis is the inflammation or infection of small, bulging pouches, known as diverticula, that form along the inner lining of the large intestine. While many acute episodes typically resolve quickly, symptoms can persist for weeks. This can lead to ongoing discomfort and may require adjustments in medical management.
Typical Duration of a Flare
An uncomplicated diverticulitis flare usually follows a predictable course. With appropriate medical attention, often including antibiotics and dietary modifications, symptoms generally begin to improve within a few days. Most acute, uncomplicated cases typically resolve within approximately a week. This rapid improvement is expected when inflammation is localized and without complications.
During this initial phase, healthcare providers might recommend a clear liquid diet to allow the digestive tract to rest. Low-fiber foods are gradually reintroduced as symptoms subside. This approach aims to minimize irritation to the inflamed pouches and promote healing.
Factors Contributing to Prolonged Symptoms
Diverticulitis symptoms can extend for weeks due to several factors. One significant reason for prolonged illness is the development of complicated diverticulitis. This occurs when inflammation leads to more serious issues such as an abscess (a pocket of pus), a fistula (an abnormal connection between organs), a stricture (a narrowing of the colon), or a perforation (a hole in the colon). These complications necessitate more intensive and prolonged treatment, often involving hospital stays and potentially surgical intervention.
Another factor contributing to persistent symptoms is lingering, low-grade inflammation. Even after an acute flare-up subsides, a subtle, “smoldering” inflammation can remain, causing ongoing discomfort, mild pain, or changes in bowel habits. Additionally, some individuals may experience recurrent episodes of diverticulitis in close succession, which can give the impression of a single, extended period of illness.
Guidance for Persistent Symptoms
If diverticulitis symptoms persist for weeks, it is important to consult a healthcare provider for re-evaluation. Continuing symptoms, worsening pain, or new concerns such as fever, severe abdominal pain, or an inability to tolerate liquids, warrant prompt medical attention. Ignoring prolonged symptoms can lead to the progression of underlying issues that might require more aggressive treatment.
A doctor might perform additional diagnostic tests, such as a computed tomography (CT) scan, to check for complications like abscesses, fistulas, or strictures. This imaging helps visualize the extent of inflammation and identify structural changes in the colon. Based on the findings, the treatment plan may be adjusted, potentially involving different medications, drainage procedures, or surgical intervention.
Managing Diverticulitis Long-Term
Managing diverticulitis beyond an acute flare involves strategies aimed at preventing future prolonged episodes and complications. A high-fiber diet is often recommended for long-term management, as it helps soften stools and promote regular bowel movements, reducing pressure within the colon. This can include a variety of fruits, vegetables, and whole grains, with a recommended intake of 25 to 38 grams of fiber per day for adults, increased gradually. While past advice suggested avoiding nuts, seeds, and popcorn, current understanding indicates these foods generally do not increase diverticulitis risk and do not need to be avoided.
Lifestyle modifications also play a role in long-term management. Regular physical activity can promote healthy bowel function and may help reduce diverticulitis risk. Adequate hydration is important to ensure fiber moves smoothly through the digestive system and prevent constipation. Ongoing medical follow-up with a gastroenterologist is advisable to monitor the condition, address lingering symptoms, and discuss personalized strategies for preventing recurrence. Managing diverticular disease is often a continuous effort to maintain gut health and minimize future issues.