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.

56 Responses to “Can colonoscopy cause diverticulitis?”

  1. Tom says:

    Am a family doc with a history of diverticulitis 18 years ago. Find since, developed diverticulitis two weeks after colonoscopy. As there is a reasonable mechanism for a causal association, this is probably a reasonably rare but significant complication of the procedure and should be studied.

  2. Janet Saluk says:

    I am a nurse practitioner who developed diverticulitis last week– and had a routine colonoscopy in mid August that showed diverticula
    I have never had this before–and had been eating the healthiest I have ever eaten and exercising regularly-and was feeling best I had in a long time
    In hindsight, I have had some mild discomfort after BM’s for a week or so–so was probably smoldering for a while. Also, while undergoing my Miralax prep, I noticed small “plugs” near end while rest was clear…could these have been materials released from diverticula??? z
    This def merits further retrospectives study!

  3. Randy says:

    Thank goodness I found this blog. I had a routine (50yo) colonoscopy with two polyps clipped. Within 48hours I developed flu-like symptoms which lasted 36hours and then an extreme lethargy/exhaustion with left lower quadrant pain for the next 4 days. I have never felt more “out of it”, dazed, faint, lightheaded, one simple task required 3-4 hours of recovery/rest. All with profuse sweating, constantly. One week after the procedure with this “exhausted/daze/haze” I was living in, I saw my regular MD and the GI doc. I thought I was anemic and/or septic or both or crazy. They both said it sounded like a “virus”. Cipro and Flagyl cleared it up almost instantly. Neither MD would admit nor link it to the colonoscopy. However now that I see this blog I am sure it was Diverticulitis secondary to the procedure. The GI doc did say I had pretty bad Diverticulosis. Whether it was the prep or the scope or the air, I guess I will never know but clearly the direct correlation just can not lie. The earlier posts on this link started with older docs stating they have never saw these complications post colonoscopy. Now that the “American diet” is making us unhealthier inside and out, I wonder if complications from colonoscopies are going to be much more common than the older generation MDs experienced. I agree this is a phenomena which should be studied, reported and presented to patients as part of the risks. Due to my family history with colon cancer I will have to do this every 5 years. Next time I will do some homework and see what diet I can do to avoid this situation from happening again. This was truly not a fun week.

  4. Rose says:

    One year agim I had my first colonoscopy which came back with a normal result outside of a very tiny polyp removed from the rectal area. Eight weeks later, I had full blown diverticulitis. It was in my lower left abdomen area (nowhere near the area where they removed the polyp. Ten months later, I started having dull pain all across my belly and ended up in the hospital with collapsed colon, fecal impaction, and small intestine dialation. I never had problems before. I am so regular that I “go” every day within a two hour period. I don’t smoke, don’t take pain medications, and I’m not diabetic. I eat a balanced diet, don’t like cheeses or dairy products, and rarely get constipation. I am completely convinced that my intestinal issues were caused by that colonoscopy. I must point out that if most people are like me, they ended up in the ER or at their doctor’s office with these issues and probably never report them to the person who performed the colonoscopy. To really find out whether or not there is a link, you may have to survey patients a year after the procedure and ask if they have experienced an onset of intestinal issues in that time period. I really do think that colonoscopy is to blame for the issues I battle now. Sadly, I’d have to get another colonoscopy to find out what kind of damage is present today, just one year later. It is what I intend to do because I’d like some answers.

  5. Debbie Smith says:

    My father was diognosed with diverticulitis several yrs. ago. Had a colonoscopy with polyp removal which was biopsied and found to be benign. Within two weeks of the procedure had severe abdominal pain, gas diahrea , I believe prophylactic antibiotic therapy would have been of great benefit if not preventing this ‘flare up’ altogether. Yes , absolutely there is a connection, especially when the pt. is known to have history of diverticulae and diverticulosis. Of course no one wanted to be responsible or admit the corelation so even after begging for antibiotics for my Dad, none were given until formation of fistula, introducing colon contents into his stomach, proven after nausea became overwhelming and NG tube placement revealed what had been causing it. It was too late for my Dad….for God’s sake someone get a Grant and a study group together for proof, or at the very least give antibiotics prophylactically for ANY surgical procedure, aren’t Dr.s aware that 70-90% of good and ‘bad’ bacteria live in the colon!?

  6. micharl kahler says:

    I had a colonoscopy and it was noted that I had Diverticulitis, but no issues. The Sunday following my colonoscopy on Monday I had to go to the ER for severe pains on my left side. Thought it was kidney stones but it was Diverticulitis. I think the procedure caused the issue.

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