Diverticulitis

Go to hospital urgently if you have

• Severe abdominal pain, or a hard, rigid tummy that hurts to touch
• High fever with shivering, or vomiting that stops you keeping fluids down
• Blood or large clots passed from the back passage
• Inability to pass stool or wind with a swollen abdomen

These can mean an abscess, a perforation (a hole in the bowel) or a blockage, all of which need emergency care.

What is diverticulitis?

Diverticulosis means having small pouches (diverticula) that bulge outwards through weak spots in the colon wall, most often in the lower left part (the sigmoid colon). It is very common after 50 and usually causes no symptoms. Diverticulitis is when one or more of these pouches becomes inflamed or infected. Most attacks are mild and settle with simple treatment; a minority lead to complications.

Causes & risk factors

• A low-fibre diet with refined flour, little fruit and vegetables, leading to hard stools and straining
• Increasing age, which weakens the bowel wall
• Obesity, lack of physical activity and smoking
• Regular use of painkillers such as ibuprofen or diclofenac, and steroids
• A high intake of red and processed meat

Symptoms

• Constant pain, usually in the lower left abdomen, that may last several days
• Tenderness in that area
• Fever, nausea or vomiting
• Constipation, or sometimes diarrhoea; bloating

Diverticulosis without inflammation can also cause occasional painless bleeding from the back passage, which always needs checking.

Tests & treatment

A doctor may arrange blood tests and a CT scan to confirm diverticulitis and look for complications. Mild attacks are treated at home with rest, a temporary low-residue or liquid diet and paracetamol for pain; antibiotics are given when needed. Severe attacks need hospital care, and repeated or complicated attacks may need surgery. Once recovered, people over 40 are often advised to have a colonoscopy to rule out other causes such as bowel cancer.

Ayurvedic view

There is no single classical term for diverticulitis. Ayurveda understands it as Vata disturbed in its main seat, the colon (pakvashaya): dry, rough, irregular eating and suppressing the urge to pass stool lead to hard stools and straining (vibandha, anaha), which push the bowel wall outwards. When Pitta joins in, inflammation and fever follow. Management emphasises warm, moist, fibre-rich food, adequate ghee or oil, regular meal times, buttermilk (takra) for colon health, and never ignoring the urge to go — with medical treatment for acute attacks.

Eating during a flare

• For the first few days, follow your doctor's advice — often clear fluids, then soft, low-fibre food.
• Good choices: rice kanji, clear soups, coconut water, thin moong dal water, well-cooked rice, curd rice, stewed apple.
• Reintroduce fibre gradually over 1–2 weeks as pain settles.
• Avoid laxatives and purgatives during an attack unless prescribed.

Preventing flares

• Aim for 25–30 g of fibre a day: whole grains, millets, dal, vegetables, fruit with the skin, and seeds.
• Drink 8–10 glasses of water a day — fibre without fluid can worsen constipation.
• Nuts, seeds, popcorn and tomato seeds do not need to be avoided; newer research shows they don't trigger attacks.
• Walk or exercise daily; keep a healthy weight; stop smoking.
• Limit refined flour, fried food, red and processed meat.
• Keep regular toilet times and don't strain.

Herbs used in Ayurveda

Strong purgatives such as trivrit, senna (sanaya) or castor oil should not be used during diverticulitis. Take any herbal medicine on a qualified practitioner's advice.

Find an Ayurvedic practitioner

Clinical sources & further reading

Reviewed against NHS: Diverticular disease and diverticulitis, NCCIH: Ayurvedic Medicine, and Ministry of Ayush pharmacovigilance. These links support education and do not replace individual medical advice.