A diverticulitis flare-up is the acute inflammation or infection of small, bulging pouches, called diverticula, that form along the lining of the large intestine. While diverticulosis (the presence of these pouches) often causes no symptoms, a flare-up of diverticulitis causes sudden, intense distress in the abdomen. Understanding the specific physical sensations associated with this flare is important for knowing when to seek appropriate medical care.
The Defining Nature of Abdominal Pain
The primary and most recognizable sensation of a diverticulitis flare is a persistent pain in the abdomen, often described as a steady ache or cramping ranging from moderate to severe. The pain is typically localized in the lower left quadrant of the abdomen, where the majority of diverticula form. However, in some cases, the pain may be felt in the lower right quadrant instead.
The pain remains constant for several days unless treated, unlike a typical stomach ache that comes and goes. This localized tenderness often worsens with movement or when the area is pressed, indicating inflammation in the intestinal wall.
The pain of a flare is focused and specific to the area of the inflamed pouch, unlike generalized abdominal discomfort. The onset can be sudden and sharp, or it can build up gradually over a few days, becoming progressively more severe. This focal, unrelenting pain is a strong indicator of a diverticulitis episode.
Accompanying Systemic Symptoms
Beyond the localized abdominal pain, a diverticulitis flare often triggers a systemic response as the body attempts to fight the infection. One common sign is a low-grade fever, which frequently comes with chills, indicating the body’s reaction to the infection.
Digestive changes also frequently accompany the flare, often manifesting as nausea, sometimes severe enough to cause vomiting. Inflammation near the colon disrupts normal bowel function, leading to changes in stool consistency, such as constipation or, less commonly, diarrhea.
The inflammation in the large intestine can also cause a feeling of fullness or swelling, perceived as bloating or abdominal distention. Tenderness, cramping, and a loss of appetite are further indicators of this inflammatory event.
Recognizing Emergency Indicators
While many flares can be managed outside of a hospital setting, certain symptoms signal a complicated flare requiring immediate medical attention. A high or rapidly worsening fever, typically above 101°F (38.3°C), suggests a more extensive infection or the development of an abscess.
A sudden and severe increase in abdominal pain that spreads across the entire abdomen can indicate a rupture or perforation of the inflamed pouch. This perforation can lead to peritonitis, a life-threatening infection of the abdominal cavity lining, which may be felt as a rigid, board-like stiffness in the abdominal muscles.
Other indicators of a complicated episode include excessive vomiting leading to severe dehydration, or signs of shock. Signs of shock include dizziness, light-headedness, a rapid heart rate, or significant rectal bleeding. These severe signs necessitate immediate emergency care, which may include intravenous antibiotics or surgery.
Immediate Steps When a Flare Begins
When initial symptoms of a flare, such as persistent lower abdominal pain and fever, begin, contact a healthcare provider promptly. Early communication allows for rapid assessment and guidance on whether at-home management is appropriate or if imaging, like a CT scan, is necessary to rule out complications.
Initial self-management focuses on resting the bowel to reduce inflammation, typically involving a clear liquid diet for a few days. This temporary dietary modification includes items like clear broth, gelatin, and clear fruit juices without pulp, allowing the colon to heal. As symptoms improve, a low-fiber diet is introduced before gradually returning to normal eating habits.
For pain management, it is recommended to use acetaminophen. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided as they can increase the risk of bleeding or further complications. Applying a heating pad to the tender area can also help soothe mild cramping and discomfort. Do not wait for symptoms to resolve on their own, as untreated inflammation can progress.