What is the most common presenting complaint of diverticulitis?

Updated: Aug 06, 2019
  • Author: Elie M Ghoulam, MD, MS; Chief Editor: BS Anand, MD  more...
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The clinical presentation of diverticulitis, in which diverticula become inflamed or infected, depends on the location of the affected diverticulum, the severity of the inflammatory process, and the presence of complications. Left lower quadrant pain is the most common presenting complaint and occurs in 70% of patients. The pain is often described as crampy and may be associated with a change in the bowel habit. Right-sided diverticulitis of the cecum or ascending colon may present with right lower quadrant pain, which may be confused for acute appendicitis. Even in simple, uncomplicated cases, patients may have fever and/or leukocytosis (an elevated white blood cell count). Symptoms of mild diverticulitis may be confused with overlapping symptoms of irritable bowel syndrome.

The usual initial symptoms of diverticulitis include the following:

  • Abdominal pain (most commonly in the left lower quadrant)

  • Nausea

  • Vomiting

  • Constipation or obstipation

  • Fever

  • Flatulence

  • Bloating

Other signs and symptoms in diverticulitis may arise due to an increasing severity of inflammation and the development of complications. Feared complications of diverticulitis include, but are not limited to, abscess (infected collection of pus), perforation (full thickness tearing of the colon), and fistula (abnormal connection between two organs).

Note that immunosuppressed individuals, including those taking corticosteroids, and the elderly are more likely to have an atypical presentation, or may not be symptomatic at all.

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