Diverticulitis During Pregnancy: Symptoms, Causes, Diagnosis, Treatment

What Causes Diverticulitis During Pregnancy?

Diverticula are small, bulging sacs that can form when naturally weak places in the colon give way under pressure. This pressure builds when you strain during bowel movements. The pouches formed can trap stool and bacteria leading to inflammation or infection known as diverticulitis.

Several factors make developing diverticulitis more likely during pregnancy:

• Constipation from pregnancy hormones slowing digestion
• Extra weight and pressure from the growing uterus
• A diet low in fiber
• Increased progesterone causing muscles to relax, including those in the colon

Genetics and aging are also risk factors. Diverticulitis is rare before age 40 but becomes more common as we get older. Some women have their first bout while pregnant in their 30s or 40s.

Signs and Symptoms of Diverticulitis in Pregnancy

Common signs and symptoms of diverticulitis in pregnant women include:

• Left lower abdominal pain
• Cramps and tenderness around the left side of the lower abdomen
• Bloating
• Constipation and diarrhea
• Nausea and vomiting
• Fever
• Chills
• Cramps and pain after eating

Symptoms range from mild to severe depending on how much inflammation and infection is present. Pain typically starts gradually and persists or grows worse over time. Some women mistake early diverticulitis pain as normal pregnancy discomfort or round ligament pain.

When to See a Doctor

Call your doctor right away if you develop any symptoms of diverticulitis while pregnant. Left untreated, diverticulitis can lead to an abscess or perforation (hole) in the colon requiring hospitalization or emergency surgery.

Never ignore abdominal pain during pregnancy as it may indicate a serious condition. Other concerning causes include:

• Ectopic pregnancy
• Miscarriage
• Placental abruption
• Preterm labor
• Kidney stones or infection
• Appendicitis

Your doctor will examine your abdomen and ask about your symptoms. Be prepared to describe the pain, when it started, and any other accompanying symptoms. Mention any personal or family history of colon conditions.

Diagnosing Diverticulitis During Pregnancy

If diverticulitis is suspected, your doctor may order some of the following tests:

• Blood tests: A complete blood count can detect infection or inflammation. Blood tests can also rule out other concerns like kidney problems.
• Urinalysis: A UTI can cause similar abdominal pain so a urine sample is tested.
• Ultrasound: An abdominal ultrasound creates images of the colon and can detect thickening, abscesses, and other abnormalities.
• CT scan: This detailed cross-section view of the abdomen confirms diverticulitis. However, CT scans expose the fetus to radiation and are avoided unless absolutely necessary.

Colonoscopy

A colonoscopy is the gold standard for evaluating colon problems. A narrow, flexible tube with a camera is inserted to directly visualize the entire colon. Suspected tissues can be biopsied.

However, colonoscopies require extensive bowel prep and sedation so are typically avoided in pregnancy. There is a small risk of inducing labor. This test may be recommended after delivery to verify diverticulitis and check for related complications like strictures.

Treating Diverticulitis During Pregnancy

Treatment focuses on clearing any infection while supporting mother and baby. Uncomplicated diverticulitis often responds well to:

• Antibiotics: Oral or intravenous antibiotics treat infection. Those safe in pregnancy are preferred.
• Bowel rest: For acute episodes, you may be told to avoid solid foods for a few days to give your colon a rest.
• Clear liquids: Drinking clear broths, herbal teas, juice and water keeps you hydrated.
• Pain medicine: Acetaminophen is considered safe during pregnancy. Opioids may be prescribed short-term for severe pain.

With your doctors approval, over-the-counter cramping and gas remedies may also provide relief. As symptoms improve, bland low-fiber foods are gradually reintroduced.

Severe Diverticulitis

Hospitalization for IV antibiotics, fluids and pain control may be needed if diverticulitis is severe. Surgery is considered for uncontrolled infections or complications like:

• Abscesses in a diverticula
• Fistula connecting colon to other organs
• Perforation and peritonitis
• Intestinal obstruction
• Uncontrolled bleeding

Emergency surgery may be required but can usually be delayed until after delivery. The benefits must be weighed against surgical risks for mom and baby.

Recovering from Diverticulitis

After an acute bout of diverticulitis, focus on rest and self-care. Recovery tips include:

• Gradually ease back to your normal diet starting with low fiber, low-residue foods
• Drink plenty of fluids
• Avoid alcohol, caffeine and carbonated drinks as they can irritate the digestive tract
• Take prenatal vitamins and follow obstetrician's guidance
• Use castor oil packs or hot packs to soothe lingering cramps and pain
• Try natural remedies like probiotics and chilled chamomile tea
• Rest as much as possible between normal activities

Be alert to any fever, increased pain or other concerning symptoms and call your doctor promptly. Relapses happen in about a quarter of cases so follow-up closely after an acute episode.

Preventing Recurrent Diverticulitis During Pregnancy

Making certain lifestyle changes can help prevent repeat occurrences of diverticulitis while pregnant:

• Increase your daily fiber intake slowly to 25-35 grams
• Drink more water to soften stools
• Exercise regularly to prevent constipation
• Limit consumption of red meat, fatty foods, refined grains and sugar
• Consider taking a daily probiotic supplement
• Use stool softeners judiciously if recommended by your doctor

Left untreated, diverticulitis has a high chance of returning. Follow your treatment plan and take preventive measures to help reduce flare-ups during pregnancy.

What's the Impact of Diverticulitis on Pregnancy?

Mild to moderate diverticulitis often responds well to conservative treatment and does not appear to raise complications during pregnancy or delivery. But prompt treatment is key to prevent the infection from spreading.

Severe or recurrent diverticulitis increases the risk of early contractions and preterm labor. Abscesses may require surgical drainage. In rare cases, a hysterectomy along with colon surgery may be required with loss of the baby.

Talk to your doctor about any concerns regarding diverticulitis and your pregnancy. With prompt diagnosis and proactive treatment, most women go on to deliver healthy babies.

Caring for Your Health After Pregnancy

Diverticulitis may continue to plague you after giving birth. Up to 30% of people have another attack within a year. Staying alert to recurrent symptoms and flares is important, especially if diverticulitis first appeared while you were pregnant.

Eat a high-fiber diet, exercise regularly, manage constipation and take any prescribed medications. Some doctors recommend surgery after delivery to remove the diseased part of the colon and prevent future attacks.

The challenges of diverticulitis can be difficult in any life stage but try not to be discouraged. With proper treatment and preventive lifestyle habits, you can keep this uncomfortable colon condition from flaring and enjoy a happy, healthy pregnancy.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.