Could Your Abdominal Pain Be Diverticulitis?

November 21, 2025

Close-up view of a woman experiencing pain or cramps in her stomach

When it comes to abdominal pain, it can be hard to know what’s really going on. “Abdominal pain is a very vague complaint, so we usually need to know more,” says Amandeep Singh, MD, a gastroenterologist at University Hospitals. One possible cause? A condition called diverticulitis.

What Is Diverticulitis?

Diverticulitis is a digestive condition that occurs when small, bulging pouches – called diverticula – develop in the colon and become inflamed or infected.

Diverticulitis is a more severe form of diverticulosis, which is very common, especially in people over 50. Many people don’t know they have it until it gets diagnosed during a colonoscopy. Only about 5 percent of people with diverticulosis will develop diverticulitis. Both conditions are a type of diverticular disease.

What Causes Diverticulitis?

Diverticulitis tends to be more common in countries like the U.S., where people eat less fiber (fruits, vegetables and whole grains), and more red meat and refined grains (white flour and white rice products). Studies suggest that a high-fiber diet reduces the risk of diverticulitis.

Age and sex are also factors. “People over 50 are at greater risk,” says Dr. Singh. “Before the age of 60, diverticulitis tends to be more prevalent in men, but after 60, women develop it at a higher rate.”

Other risk factors include:

Genetics
Constipation
Overuse of NSAIDs
Obesity
Smoking
Not getting enough exercise

Common Symptoms

Diverticulitis symptoms are typically mild, and they may go away on their own. If they don’t, a temporary liquid or low-fiber diet or a course of antibiotics is sometimes needed to treat them. If symptoms are severe, treatment is likely to involve antibiotics and may also require surgery.

Common symptoms of diverticulitis include:

Pain, usually on the lower left side of the abdomen (it can occur on the right)
Fever
Nausea
Vomiting
Chills
Cramping
Constipation (or diarrhea)
Blood in the stool

Most people – about 80 percent – have uncomplicated diverticulitis, meaning only mild inflammation in one of the small pouches in the colon. The remaining 15 to 20 percent may develop complications, which can be acute (sudden) or chronic (long-term), including infection, bleeding and structural changes to the colon.

You’re more likely to develop diverticulitis if you have diverticulosis or if you’ve had diverticulitis in the past. But generally speaking, if your lifestyle is healthy, your risk is low.

Diagnosing Diverticulitis

A medical history and physical exam can help determine if you have diverticulitis. “But these only have a 50 percent chance of identifying whether a patient has diverticulitis or another condition,” says Dr. Singh.

“We also need some kind of imaging,” he continues. “A CT scan with contrast can diagnose about 95 percent of diverticulitis cases.” It’s highly effective at detecting diverticulitis when you have it and ruling it out when you don’t.

“If complicated diverticulitis is suspected, your doctor will want to check for signs of infection or inflammation,” he says. Tests will likely include blood tests, like a CBC (complete blood count) and CRC (C-reactive protein).

“The combination of all of these helps give a clear diagnosis,” he says. “The imaging tells us when it’s diverticulitis, the blood tests indicate if it’s uncomplicated or complicated, and then we have to figure out if there might be other causes for the abdominal pain.” A stool test may also be recommended.

Additional testing may be recommended to rule out other conditions, such as:

“We don’t typically recommend a colonoscopy to diagnose diverticulitis, but it is recommended as a follow-up to make sure there is no cancer,” says Dr. Singh. “Six to eight weeks should be enough time for inflammation to calm down and the patient to get back to normal.” A colonoscopy can be performed then.

People with uncomplicated diverticulitis have a low risk of colon cancer, around 1 percent higher than the normal population, he says. “If it's complicated diverticulitis, the risk goes up to 7.9 percent, so we don't want to risk missing a cancer.”

How to Treat and Prevent Diverticulitis

Treatment is personalized, depending on the type of diverticulitis. For acute symptoms, a clear liquid diet is recommended for a few days. As symptoms improve, you can begin eating low-fiber foods. During this time, you should avoid high-fiber foods, milk and other dairy products, red meat and NSAIDs. “If you’re not progressing by day five, then you should see a doctor to find out why,” says Dr. Singh.

If you’re being treated with an antibiotic, you should be feeling mostly better within a week or so. “If it’s a complicated case, it may take a little longer, possibly up to four weeks,” says Dr. Singh. Otherwise, you’ll need to be re-examined for complications or other possible causes.

Once you’re back to normal, you can resume a high-fiber diet. This includes eating nuts, seeds and popcorn – just keep servings moderate and drink lots of fluids to stay hydrated, since it’ll help keep your stools softer, says Dr. Singh. “Your risk of recurrence decreases by 75 percent if you eat a high-fiber diet, limit red meat to less than four times a week, do two hours of moderate-intensity exercise a week and avoid smoking.”