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February 14th, 2011

Can colonoscopy cause diverticulitis?

Many of you out there have done many tens of thousands of colonoscopy like I have and are well aware of the complications most known to be associated with this procedure, like bleeding or perforation. And most of us are aware of very unusual complications that have been reported, such as splenic lacerations or barotraumas.

However, I recently had a patient develop acute diverticulitis within 24 hours of colonoscopy, and I have consulted in the last year on another patient who developed diverticulitis shortly after the procedure.

Although diverticulitis precipitated by colonoscopy prep or the procedure itself (microperforation from the bowel prep, pressure from the shaft of the instrument or air infused during the procedure, etc.) is plausible, there seems to be little in the literature on this subject.

One reason for the lack of data might be that there is not really an association, that these are two unrelated events. Another might be that because diverticulitis is not immediately evident (like bleeding or perforation), the causal link has been missed, given that delayed complications are not often reported in large series of procedures.

So I am asking you endoscopists out there:
1) Have you observed diverticulitis in a patient shortly after a colonoscopy?
2) Do you think the procedure can cause diverticulitis?
3) If so, what do you think the mechanism is for this complication?

I look forward to hearing from you.

52 Responses to “Can colonoscopy cause diverticulitis?”

  1. Robin says:

    I am a 51 year old female that had a routine colonoscopy at my PCPs instance due to my age (no other reason). Spent the prep time throwing up the solution, but per the doctor got enough down to proceed with the colonoscopy. Woke up from the procedure in excruciating pain in lower left region of abdomen. Was told it is gas and cramping and that the colonoscopy showed everything looked great. Went home. Spent the evening and the next day doubled over in excrutiating pain. Woke up the 3rd day with fever and chills and even worse pain along with vomiting. Ended up at the ER. Following a CT and ultrasound was told irritation of the bowel that caused an infection. Took 3 days of IV antibiotics before I was released and another 10 days oral antibiotics. Now, a month later, I am still having pain. None of this was there prior to the colonoscopy (no mention of diveretculitis, but am certainly wondering what damage the scope caused). Needless to say I will never agree to another one and am praying that this pain resolves itself. I have another appt with my PCP to figure out why the pain albeit lessened is continuing.

  2. Karen Strand says:

    February 18 2014

    My colonoscopy showed nothing abnormal other than a few benign polyps that were removed. There were also “random colon biopsies” done of the lining.
    Two days later I began having lower abdominal cramping. This has continued every day since, for over two weeks. I’m wondering whether diverticulitis was caused by the procedure. I have an appointment set up.

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