Diverticulitis occurs when small pouches called diverticula, which develop in the gastrointestinal tract, become inflamed or infected. Dr. Albert Chung, a colorectal surgery specialist in Santa Margarita, CA, provides expert diagnosis and personalized treatment for diverticulitis, helping patients throughout Orange County regain comfort and digestive health. To schedule your consultation, call our clinic today at (714) 988-8690.
Diverticula are small, bulging pouches that can form in the wall of the colon, most often in the lower-left portion (the sigmoid colon). They're remarkably common, especially with age, and usually cause no problems at all. When these pouches become inflamed or infected, the condition becomes diverticulitis, which requires prompt medical care.
These terms sound similar and are often confused, but they mean different things. Understanding which one you have shapes everything that follows.
Diverticulitis occurs when weakened areas of the colon wall give way under increased pressure, which can lead to the development of diverticula. Why some of these pouches become inflamed or infected isn't fully understood. Several factors raise risk.
Symptoms of diverticulitis can vary from mild to severe. Typical signs include:
Because these symptoms can mimic other conditions, an accurate diagnosis matters. Persistent abdominal pain with fever deserves prompt evaluation.
These can indicate complications like perforation, abscess, or peritonitis, which require urgent evaluation. Go to an emergency room or call emergency services.
During your initial consultation, Dr. Chung will thoroughly evaluate your medical history and current symptoms. Diagnostic testing typically includes:
Avoid nuts, seeds, and popcorn because they might lodge in diverticula and trigger inflammation.
No restriction needed. Large studies have not shown increased risk of diverticulitis from consuming nuts, seeds, or popcorn. In fact, a high-fiber diet that includes whole foods like these may help reduce risk.
You can't eliminate the risk of diverticulitis entirely, but you can meaningfully lower it.
Untreated or severe diverticulitis can lead to complications including intestinal blockages, abscesses (pockets of infection), fistulas (abnormal connections between the colon and other organs), and perforation of the colon wall. Perforation can cause peritonitis, a serious infection of the abdominal cavity that requires emergency surgery.
The good news is that most cases of diverticulitis are caught and treated before complications develop. Prompt evaluation when symptoms appear is the best way to keep a flare-up simple.
Diet does two different jobs in diverticular disease: resting the colon during an attack, and reducing pressure in the colon between attacks. They call for opposite approaches.
| Phase | What to eat | How long |
|---|---|---|
| Acute flare | Clear liquids: water, broth, clear juice, tea, gelatin. Gives the inflamed colon a rest while antibiotics or the body's own response bring the infection under control. | Two to three days, or until pain eases |
| Recovery | Low-fiber foods: white rice, white bread, eggs, poultry, fish, well-cooked vegetables without skins, canned fruit. Gentle on the colon while it heals. | A few days to a week, advancing as tolerated |
| Between flares | High-fiber diet with 25 to 30 grams a day from fruits, vegetables, legumes, and whole grains, plus plenty of water. Nuts, seeds, and popcorn are fine. This is the phase that prevents the next attack. | Permanently |
Patients often stay on the low-fiber diet far too long out of fear. Once pain has resolved, fiber should be brought back gradually over one to two weeks. A psyllium supplement is a reliable way to reach the target. Read about practical high-fiber eating and choosing a fiber supplement.
The old rule of operating after a second attack is gone. The American Society of Colon and Rectal Surgeons now recommends that the decision be individualized, based on how attacks affect your life rather than on a count. Dr. Chung recommends elective surgery when attacks are frequent or severe enough to disrupt work and daily life, when a complicated episode (abscess, fistula, or stricture) has occurred, when symptoms smolder between attacks without fully resolving, or when the patient is immunosuppressed and a future attack would be dangerous. Emergency surgery is needed for perforation with peritonitis, an abscess that cannot be drained, or a blockage.
The operation is a sigmoid colectomy: the diseased segment is removed and the healthy colon is joined to the upper rectum. In an elective setting, Dr. Chung performs this robotically through small incisions, with a two to four day hospital stay, and the bowel is reconnected in the same operation in almost all cases. Emergency surgery for a perforation sometimes requires a temporary colostomy, which is one of the strongest arguments for treating the disease electively once it has become a recurring problem. Read about robotic colorectal surgery.
Diverticula can bleed as well as become infected, and the two rarely happen together. Diverticular bleeding is sudden, painless, and often alarming in volume: a toilet bowl full of dark red or maroon blood, usually in an older adult. It stops on its own in most cases but needs prompt evaluation, because the volume can be significant and other causes must be excluded. A colonoscopy is performed once bleeding settles, and surgery is reserved for the uncommon bleed that continues or recurs repeatedly. See the rectal bleeding page.
Guidelines recommend a colonoscopy six to eight weeks after a first episode of diverticulitis confirmed on CT, unless one has been done recently. The reason is that a small proportion of what looks like diverticulitis on imaging is actually a colon cancer, and the inflammation can hide it. Dr. Chung performs this colonoscopy himself, which means the same physician who treated the attack also confirms the diagnosis and rules out anything else.
Most Orange County patients with diverticulitis are first treated in an emergency room or by a primary care physician, and never see a specialist. Seeing a colorectal surgeon after an attack gets you a follow-up colonoscopy, a prevention plan, and an honest assessment of whether surgery is worth considering, from the surgeon who would perform it.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
Mild, uncomplicated diverticulitis often does, and current guidelines allow selected healthy patients to be treated without antibiotics under supervision. It should still be diagnosed properly, because the symptoms overlap with appendicitis, colitis, and colon cancer, and because a complicated attack with an abscess or perforation needs different treatment.
Not always. Antibiotics are recommended for patients with fever, high inflammatory markers, immunosuppression, significant other illness, or complicated disease on CT. Otherwise-healthy patients with mild, uncomplicated diverticulitis can often be managed with a liquid diet and close follow-up. Dr. Chung makes that call based on your CT and exam.
A high-fiber diet with adequate water, regular physical activity, a healthy weight, not smoking, and limiting red meat and NSAID use all reduce the chance of recurrence. About one in five patients has a second attack; most do not.
Yes. The advice to avoid them was based on theory rather than evidence. A large study of more than 47,000 men found no increase in diverticulitis among those who ate nuts, corn, and popcorn regularly. High-fiber whole foods, including these, are part of prevention.
For severe or rapidly worsening abdominal pain, a high fever with shaking chills, vomiting that prevents you from keeping fluids down, a rigid or extremely tender abdomen, or significant rectal bleeding. These can signal perforation, abscess, or peritonitis.
Yes. Regular vigorous activity is associated with a lower risk of both diverticulitis and diverticular bleeding. Walking and normal activity are fine as soon as a flare has settled; strenuous exercise can resume once pain is gone.
Most patients never do. Surgery is recommended when attacks are frequent or severe enough to affect your life, after a complicated episode such as an abscess, fistula, or stricture, for persistent smoldering symptoms, or in emergencies. When it is needed, Dr. Chung performs a robotic sigmoid colectomy with the bowel reconnected in the same operation.
Whether you're managing recurrent diverticulitis, recovering from a flare, or trying to prevent another episode, Dr. Chung can help you build a plan that fits your situation.
Book a consultation Call (714) 988-8690Mild diverticulitis can resolve with proper rest and diet adjustments; however, evaluation by a healthcare provider ensures accurate diagnosis and appropriate care to avoid complications.
Regular exercise, maintaining a fiber-rich diet, staying hydrated, and avoiding smoking significantly decrease the risk and frequency of diverticulitis episodes.
Yes, regular physical activity, including walking and running, helps reduce symptoms and prevent flare-ups by improving bowel function and overall gut health.
Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
