Diverticulosis is a common condition characterized by the presence of small, bulging pouches, known as diverticula, that form along the lining of the large intestine. These protrusions develop in weakened spots of the colon wall and are often harmless, causing no noticeable symptoms. A diverticulitis flare occurs when one or more of these pouches become inflamed or infected, transitioning the condition to active diverticulitis. This acute episode is marked by a sudden onset of symptoms as the body reacts to the localized infection.
The Characteristic Pain of a Flare
The most telling sign of an active flare is focused and persistent abdominal discomfort that can be intense. This pain often presents in the lower left quadrant of the abdomen, corresponding to the sigmoid colon where diverticula most commonly form. For people of Asian descent, the pain may instead localize to the lower right side of the abdomen.
The sensation is typically described as a steady ache that can last for several days, rather than a fleeting, generalized cramp. Patients often report the pain as sharp, penetrating, or sometimes a burning feeling concentrated in a specific spot. This localized tenderness is exacerbated by movement or when pressure is applied to the area. Unlike common digestive upset, this pain remains constant because it stems from inflammation in the colon wall.
Accompanying Physical Symptoms
The inflammation and potential infection within the colon trigger a systemic response, leading to symptoms beyond the immediate abdominal pain. A low-grade fever often develops, accompanied by chills, indicating that the diverticula have become infected.
Digestive changes are also frequent, including nausea and sometimes vomiting, as the inflamed colon disrupts normal digestive function. The flare can also cause a noticeable loss of appetite. Bowel habits typically shift, with constipation being common as inflammation may slow the passage of contents. Less commonly, some individuals may experience diarrhea. Additionally, the inflamed colon can irritate the nearby bladder, sometimes causing urinary symptoms like frequency or urgency.
Recognizing Signs of a Severe Flare
While many flares can be managed, certain signs indicate the condition is advancing to a dangerous stage requiring immediate medical intervention. Unrelenting, sudden, or rapidly worsening abdominal pain that is intense and disabling is a serious warning sign. This severity suggests a complication such as a contained abscess or a potential perforation of the diverticulum.
A persistent fever exceeding 100.4 degrees Fahrenheit, especially when combined with chills or extreme weakness, can point toward a worsening infection or sepsis. Excessive nausea and vomiting that prevent the patient from keeping fluids down are concerning, as they can quickly lead to severe dehydration.
Any sign of a rigid or board-like abdomen upon touch suggests that the infection has spread into the abdominal cavity, a life-threatening condition called peritonitis. Furthermore, the inability to pass gas or stool, or the presence of fresh blood in the stool, are signs of a possible bowel obstruction or significant bleeding. These conditions require immediate emergency care to prevent widespread infection and organ failure.