Diverticulitis is the inflammation or infection of small pouches, known as diverticula, that form in the lining of the colon. The presence of these pouches is called diverticulosis, a common condition that often causes no issues. When one or more pouches become inflamed, it leads to an acute episode of diverticulitis, causing symptoms like abdominal pain, fever, and nausea. The duration of the illness varies significantly depending on the severity, treatment, and whether complications occur.
Duration of Acute Symptoms
The time it takes for the most intense symptoms to subside depends heavily on whether the case is uncomplicated or complicated. Uncomplicated diverticulitis, the most frequent form, often resolves quickly with outpatient management. Patients with mild cases typically begin to improve within two to three days after starting antibiotics and following a modified diet.
Diagnosis is often confirmed through imaging, such as a CT scan, to assess the inflammation and rule out complex issues. This initial period focuses on resting the colon, usually by limiting food intake to a clear liquid diet for a few days. If symptoms do not lessen after three days, or if they worsen, reassessment and possibly a change in treatment are needed.
For more severe or complicated cases, such as those involving an abscess or perforation, the acute symptomatic phase lasts longer. These situations often require hospitalization for close monitoring, intravenous (IV) antibiotics, and bowel rest. Acute symptoms may persist for five to seven days or even longer before the pain and fever consistently recede. The duration of acute symptoms signifies the point at which the infection and inflammation are controlled, not the time until the colon tissue is completely healed.
Full Recovery Timeline
Full physical healing and returning to normal function extend beyond the resolution of acute symptoms. The inflamed colon tissue requires time to fully repair and recover its strength. This recovery phase typically takes approximately four to six weeks following the initial attack.
During this time, patients must follow a careful and gradual diet progression to prevent irritating the healing colon. The transition begins with low-fiber foods, often called a low-residue diet, which are easier to digest. This phase can last for several days to a few weeks, depending on symptom stabilization.
The next step is to slowly reintroduce high-fiber foods incrementally over several weeks. This slow reintroduction helps prevent discomfort and bloating, allowing the digestive system to adjust smoothly. Most individuals can return to light physical activities within one to two weeks after acute symptoms disappear. However, strenuous activities should be postponed until the colon is fully healed, usually closer to the four-to-six-week mark.
Managing the Condition Long-Term
While an acute episode has a defined timeline, the underlying diverticulosis is lifelong, meaning there is a risk of future attacks. Approximately 20 to 30 percent of individuals who experience one episode will have a recurrence, with the risk highest immediately following the first attack.
Long-term management focuses on preventative lifestyle changes to minimize the chance of another flare-up. A sustained high-fiber diet is the foundation of this strategy, aiming for a daily intake of 25 to 35 grams of fiber. Adequate hydration is necessary for fiber to work effectively, helping to maintain soft stool and reduce pressure within the colon.
Regular physical activity and maintaining a healthy weight are also components of long-term management. In some cases, inflammation may not resolve completely or may cause lasting damage, such as a stricture or a fistula. These chronic complications may necessitate ongoing medical treatment or surgery, requiring continuous attention.