Diverticulitis is a condition where pouches in the large intestine, called diverticula (named such as they divert off the normative long intestine tract) become infected or inflamed. This can be due to bacterial infection, resident inflammation, rotten food stuck in the pouches inducing an immune response, or spontaneous, and typically require medical attention.
Diverticulitis can be accompanied by abdominal pain on the lower left side, usually radiating from the descending or sigmoid colon leading up to the rectum. It can also lead to the appearance of nausea, fever, swelling, and changes in bowel habits. If left untreated, complications such as bowel obstruction or rectal bleeding can occur.
What Causes Diverticulitis Flare-Ups?
Diverticulitis is a flare-up, or worsening, of the condition called diverticulosis, wherein the diverticula form. It can be triggered by several factors, including (but not limited to):
- Low fiber diet
- Physical strain
- Gut irritants such as NSAIDs or caffeine
- Resident gut bacteria overgrowth
- Stress
Diverticulitis Flare-Up Symptoms
Symptoms differ from an IBS or IBD flare-up in that they are mostly localized to the lower left quadrant of the abdomen, where patients are most at risk for food back-up leading to the rectum. However, there are some similarities, including:
- Fever
- Nausea and vomiting
- Changes in bowel habits
- Bloating and gas
- Rectal bleeding
Severe pain or pain accompanied by a fever signifies an acute episode, a serious condition that demands immediate medical attention and will likely be treated with antibiotics.
How Long Does A Diverticulitis Flare-Up Last?
The duration of diverticulitis flare-ups can vary widely among individuals, typically ranging from a few days to several weeks. The length can be influenced by several factors, including:
- The severity of the inflammation
- Your response to treatment
- Promptness of treatment
- Complications such as abscesses or perforations
- Your individual health and immune system
- Lifestyle factors, such as diet and exercise
Managing a Diverticulitis Flare-Up
Treatment options for diverticulitis symptoms generally include a combination of medical management and lifestyle modifications to alleviate symptoms and prevent future episodes. Treatment may vary depending on the severity of the flare-up.
Pain Relief
During a flare, over-the-counter pain relievers like acetaminophen may be recommended to manage pain. In addition to medication, using heating pads on parts of the body that are cramping can reduce aches and pains. Steer clear of NSAIDs like Advil, however; they can cause additional irritation to the gut lining that can extend the period the diverticula remain inflamed.
What to eat during a diverticulitis flare-up
The best way to help your gut during a Diverticulitis flare-up is through adopting a temporary liquid diet. Broths and soups convey nutrients to the body while giving your gut a well-deserved rest. Likewise, the lack of solid material means a) less gas formed in your colon, as there is less for the resident bacteria to break down, and b) there is less movement of the stomach and intestines to break down food.
During the diverticulitis flare-up, it is a good idea to refrain from consuming high fiber foods. While it aids in digestion, it works through increasing the motility of the gut—which can lead to diarrhea and bloody stool while the body fights its way through diverticulitis. Consider easy-to-digest soft vegetables, white rice, and white lean meats instead to meet your nutritional goals.
Getting Enough Sleep
Quality sleep is essential for recovery during a diverticulitis flare-up. Poor sleep can increase inflammation and weaken your immune response, making it harder for your body to fight off infection. Aim for at least 7–9 hours of rest each night, and prioritize a calming bedtime routine. Avoid heavy meals, caffeine, and screen time before bed, as these can disrupt sleep quality. If abdominal pain makes it difficult to sleep, try lying on your right side.
Hydrate
Proper hydration is key to preventing constipation and reducing irritation in the digestive tract during a flare-up. Aim to drink at least 8–10 glasses of water daily, or more if you have a fever or diarrhea. Clear broths, herbal teas, and electrolyte solutions can help maintain fluid balance and support gut healing. Avoid alcohol, caffeine, and sugary drinks, as these can dehydrate you and worsen symptoms. If you struggle with bloating, sip fluids slowly rather than drinking large amounts at once.
Ginger tea is a potent anti-inflammatory drink that is commonly used to combat nausea and improve gut motility. Consider adding caffeine-free ginger tea to your hydration rotation.
Antibiotics Treatment
In moderate to severe cases of diverticulitis, where medical intervention is necessary, doctors may prescribe antibiotics to control bacterial infection and prevent complications. Common options include metronidazole, ciprofloxacin, or amoxicillin-clavulanate, typically taken for 7–10 days. It’s crucial to complete the full course, even if symptoms improve, to prevent recurrence or antibiotic resistance. Some patients experience side effects like nausea, diarrhea, or yeast infections—taking probiotics alongside antibiotics may help maintain gut balance. Always follow your doctor’s instructions, and seek medical advice if symptoms worsen despite treatment.
What to eat when recovering from a diverticulitis flare-up
As your symptoms begin to subside, slowly increase your fiber intake. This will aid in digestion and prevent future flare-ups.
Once the flare subsides, your doctor may recommend a high-fiber diet, as this can help prevent future episodes by keeping stools soft and reducing pressure in the colon.
Probiotics
Many take probiotics to help restore healthy gut bacteria, especially after a course of antibiotics. Probiotics could hypothetically reduce the risk of future flare-ups but more research is needed to support their routine use for this purpose.
Natural Remedies for Diverticulitis:
Curcumin is a natural remedy extracted from turmeric that reduces inflammation by inhibiting TNFα (a key player in diverticulitis) and helps restore gut microbiome balance. Curcumin also boosts butyric acid-producing bacteria, essential for intestinal health and mitigating symptoms of diverticular diseases. Furthermore, it enhances beneficial gut bacteria, supporting overall gut health and potentially preventing diverticulitis flare-ups.
Berberine, found in coptis herbs, exerts antimicrobial activity and increases butyrate production, which helps maintain a healthy intestinal environment and reduces inflammation. Berberine decreases inflammation by lowering TNF-α levels and helps repair the intestinal barrier by improving tight junction expression, which can be thought of as tightening the gaps between cells in the gut wall. Coptis also contains palmatine and jatrorrhizine, which improve its antibacterial, antiviral, and anti-inflammatory properties.
Therefore, combining curcumin and berberine may be ideal for those with Symptomatic Uncomplicated Diverticular Disease (SUDD). This is a term for the ongoing, relapsing-remitting mild diverticulitis-like symptoms that start after an acute episode of diverticulitis is resolved, and linger for weeks or months afterward. These near-daily include abdominal pain, bloating, and altered bowel movements.
Preliminary research indicates the potential benefit of curcumin and berberine in combination to target these lingering digestive symptoms. However, in severe or complicated cases, hospitalization may be necessary to provide more intensive care, including antibiotics or surgery, to prevent complications like perforation or obstruction. Therefore, anyone experiencing a sudden onset of severe abdominal pain with fever during a diverticulitis flare-up should seek medical care immediately.
For patients curious about curcumin and berberine for lingering symptoms, you can find a tailored program for your specific needs through our free online assessment.
How can we help you in Evinature?
Evinature has a specific, tailored nutraceutical protocol for Diverticulitis that helps manage flare-ups and maintain long-term care. DivertX combines the active ingredients in curcumin and Coptis, as mentioned above, to help balance gut microflora while strengthening gut lining integrity.
Summer Pitocchelli-Schwartzman
