The Book of Rare Diseasesfrom the Vermont Synergy Initiative
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Diverticulitis

Common, and the standard story is thinner than it looks.

Two long-standing rules about diverticulitis have shifted, and many people are still told the old ones.

This chapter is still a draft — we are still writing it, and your thoughts and comments are very welcome while we do.
Diverticulitisleft-lower, feverAppendicitisshifts right-lowerBowel cancerblood, weight losslooks the same
They open the same way — belly pain and a change in bowel habit. IBS mimics the pattern too, but without fever, blood or weight loss — which is exactly why a persistent change is checked, not assumed.

Is it simply a disease of the bowel? Build the picture up:

Go deeper

1 layer below. Open any one.

For uncomplicated diverticulitis, large trials have questioned whether antibiotics are needed in every case. Guidelines have moved toward selective use, though practice varies. And the old advice to avoid nuts, seeds and popcorn has been contradicted by the evidence. It does not raise the risk. Good evidence

Which case counts as “uncomplicated” is a clinical judgement. The point is to ask, not to assume the old rule.

Same system, different clothes: the gut as one connected system · the constipation–diarrhoea continuum. It is also misread as appendicitis, and the reverse.

Questions to bring

Copy these, or read them out. They fit in a short visit.

  1. Is mine uncomplicated — and do I actually need antibiotics, or is watchful management reasonable?
  2. Do I really need to avoid nuts and seeds?

The short version

Getting ahead of it
Fibre and hydration between episodes; nuts and seeds are fine (the avoidance is a myth).
Your testing regime
CT imaging to confirm and grade an attack; a colonoscopy after recovery to exclude cancer.
What they don’t tell you
Uncomplicated cases may not need antibiotics, and the nuts-and-seeds rule is debunked.
What it can spawn
Abscess, perforation, fistula, stricture, and recurrent attacks.
What it’s confused with
Appendicitis (and the reverse), IBS, and colorectal cancer.

From general clinical literature; not a diagnosis; nothing here comes from any individual’s medical record.

Also asked as: pain low on the left side, and meals that seem to set it off · “pain low on my left side” · “is diverticulitis serious” · “what can I eat with diverticulitis” (diverticulitis and diverticulosis)