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.
80 Responses to “Can colonoscopy cause diverticulitis?”
M. Brian Fennerty, MD
Editor-in-Chief
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I had a colonoscopy which was the most painful experience. Shortly after developed diverticulitis. The GI said he had never seen such a mess of intestines .. going all over the place. Question to GI’s would this mess not show up b4 the procedure? Could the pain been avoided by the GI putting me out since he must have seen the mess. He described the procedure as Treacherous.. sure was.
I am in the hospital right now. The first thing I thought when the doctor said I had diverticulitis, was, I just had a colonoscopy, what went wrong? The doctor who performed the colonoscopy removed 1 polyp, and said I have diverticulosis, he recommend that I add fiber to my diet, and come back in 3 years,(since he removed the polyp),
I didn’t have to get a colonoscopy, I’m 52 years old, my doctors mentioned that I should because of my age. I compared it to getting a mammogram, to catch problems at an early stage.
5 weeks later, my lower abdomen hurt really bad, I thought it could be my appendix, the pain became so severe, I went to the ER and after a CT scan, was told it was diverticulitis. I’ve been laying in the hospital, in pain, IV anti-biotics (Flagyl and Leviquin), no food, water, nothing by mouth, thinking what the heck happened, something is not right. I found this website and I don’t really want to read too many stories, just wanted to add my comment since I have this question on my mind while I’m laying in the hospital, hoping I have a speedy recovery.
4 wks ago I had a colonoscopy and a sessile polyp removed. I was back in hospital within 36 hours of the colonoscopy, given anti-biotics intravenously. This was a query perforated bowel. I had had an earlier colonoscopy which detected diverticulitis. This was news to me though I had had IBS for many years. I think a lot of research needs to be done on this topic as people’s lives are being put at risk. As yet I am still recovering.
I just experienced a case of a Crohn’s patient, with a follow-up colonoscopy for longstanding disease, in remission on Methotrexate. I performed a right-sided polypectomy and chromoendoscopy-targetted biopsies. She had mild sigmoid diverticulosis. Tow days later she was admitted in a local hospital with acute abdominal pain, to rule out colonoscopy-related perf. It turned out she had a typical diverticulitis image on the CT-scan. Evolved favorably within 48 hours on iv antibitoics.
This is the first case I am aware of this kind in my service. It could be related to microperf induced by distension due to the endoscope or the air, or through inflammation induced by the passage of the scope.
I am wondering if the age of the patient enters into the mix here. My mother had a colonoscopy in her late 70s. They found no polyps but she has been complaining of stomach problems and loose stools ever since. Now at age 87, after being hospitalized for congestive heart failure, she presented with upper and lower GI issues. She has been readmitted to the hospital because she stopped eating, has been suffering terrible diarrhea, and is generally lethargic. A scan revealed blockage in the colon. So, today, she is scheduled to undergo yet another colonoscopy! I am trying to weigh all factors in this matter. Why was a woman close to 80 years old made to undergo her first colonoscopy, if this was to be the result? So much for HER quality of life. “First do no harm” indeed.
I am 69 female. Had diverticulitis Sept.2012 and Jan. 2013 dx via CAT-Scan.
Rx antibiotic regimen both times. GI scheduled colonoscopy next week. I asked him to look at the CAT-Scans, he refused to look. I am very apprehensive and not sure if I should have this Colonoscopy done. Stool was not checked for occult blood. Please, I need advice. Thank you.
I had a colonoscopy about 5 months ago and had a polyp removed, everything else was fine, never had any issues prior to my colonoscopy. Two weeks ago I end up in the emergency room with severe pain, diarrhea, bloody stools. They said I had an infection in my colon, gave me antibiotics, felt better. Went to the Dr. for a follow-up and they tell me I have diverticulitis. I believe it was definately caused from the colonoscopy.
I had abdominal surgery to repair colon/intestinal adhesions and blockage a couple of years ago. The only symptoms I had had before sugery was loose stools and pelvic floor pain. After surgery I developed typical symptoms of diverticulitis that I’ve had ever since. I finally reached a point where it seemed to calm down . Then, after getting a CT scan for a tailbone issue my doctor told me I was constipated. I took a mild laxative (epsom salts) which worked great (no pain) and within days the diverticulitis symptoms came back with a vengeance and have stayed. I believe that the sudden cleaning out of the bowel irritated it severely. Since then I have started drinking raw milk, taking probiotics and drinking slippery elm bark tea. It seems to be really helping. One other thing. No doctor tells you that when you take antibiotics, the good bacteria necessary for healthy bowels are killed off along with the bad bacteria and that you really need to take probiotics to get the balance back. Why not?
I am a 57 year old male who had one polyp removed during my first colonoscopy about 6 years ago. As a result I was scheduled for another colonoscopy 3 years ago & the diagnosis was that I had diverticulitis. My Bm’s were normal before the second colonoscapy but were certainly not after my second colonoscopy. I am glad I do not have colon cancer but diverticulitis is no laughing matter.
Today is wed and on monday I started the prep for a colonoscopy. My son ended up getting sick so I had to reachedule my colonoscopy. Tonight I ended up with a diverticulitis flare up. Oh the cramping!! I havent ate anything bad and just lowered my fiber for the procedure so the only thing I can think of is the prep had to irritate it. Any info would be great.
I never had any issues at all before having my colonoscopy. This colonscopy was done as my first screening. By the following morning I had severe, lower left quadrant pain. I ended up in the ER, 2 days later. Testing found nothing. It has been 8 yrs. and I am still dealing with the pain, it comes and goes. I have seen 5 different doctors and had many tests….no reason can be found for the pain. This was the worse thing I have agreed to do. I will never have another colonoscopy unless I am hemorraging.
I am a patient. I had a colonoscopy on May 21. The doctor removed 1 polyp and said everything was fine. This was my second colonoscopy, my first being 10 years ago. Two weeks later I was in the ER and diagnosed with diverticulitis. Me and my body feel pretty sure there is a connection. What I know is that unlike the first time, my bowels have not worked normally since this colonoscopy. I feel like my colon is just sluggish. Moderate constipation, irregularity. My diet always includes fruits and vegetables. I just cannot seem to get back to my normal. Now, I am back on a liquid diet and antibiotics. I am more concerned that even when the infection is cleared up that my bowels are still not going to get back to normal.
Had severe diverticulitis about 16 years ago and was hospitalized. I/V antibiotics resolved the situation. Still had frequent (generalized) abdominal pain and diarrhea. GI doc performed colonoscopy and noted numerous diverticlu, and colitis. After undergoing numerous courses of different drugs to no avail, colon resection was discussed. I quickly fled to do my own research, and with the help of tests offered by Dr. Kenneth Fine (finerhealth.com)I very shortly thereafter went on a gluten-free diet, which resolved my condition completely. A much later colonoscopy/biopsy performed by the same GI doc confirmed I was now asymptomatic of the colitis.
Fast forward to Feb. 2013: New healthcare provider. Positive fecal occult blood test led to colonoscopy w/biopsy of an “inverted diverticulum”, which the GI doc was guessing the subject of the biopsy to be. Also noted were internal hemmorhoids, very likely the source of the blood. Two weeks later, eruption of divertiulitus that ebbed and flowed for 2 more months and 3 courses (one extended course) of cipro and flagyl. Wound up in the hospital for 6 days and again I/V antibiotics. CT scan noted 2 cm. abscess and likely perforation. Been home now for 3 weeks w/mild llq pain still present on a low fiber, darn near liquid diet. Surgeons want to resect/remove my Sigmoid Colon in July, which I’m not keen on having done, but I’m living in fear of non-elective emergency surgery (colostomy, etc) if this goes acute again. Nice choice, eh? IMHO: Either one or all of the steps involved in the colonoscopy (bowel cleansing, insufflation, biopsy, possible dirty scope)CAUSED this situation; and yes indeed, there is a distinct link between colonoscopy and diverticulitis, and much, much worse. Any feedback by knowledgeable people or doctors to help me avert the looming surgery would be very much appreciated.
I, too, developed diverticulitis within 2 days after colonoscopy and again 6 months later; both times, Rx was antibiotics with diet restrictions. Although most reports, above, fail to connect diverticulitis with colonoscopy, annecdotal evidence may indicate a degree of correlation, especially in those patients with diverticulosis prior to the procedure. Perhaps Dr.s should perform some preliminary examination to ascertain potential for diverticulitis prior to procedure.
Hello i am currently a patient with diverticulitis. My first attack was perforated, i was treated in the hospital for about a week with antibiotics, sent home on antibiotics for one more week, the following week i had another infection and went back to the hospital for 5 days. Again treated with antbiotics, this time sent home with a pic line and a tpn bag for 2 weeks no solid food or water. Everythings been fine for about 2 months since then until i got a colonoscopy done this past wednesday. Immediately following the procedure I am back to having harsh pains in my abdomen and developed a fever last night, to which i had another scrip for antibiotics phoned in and am currently taking. Dont know why im writing this in here its just the first time ive come across something that sounds like what is happening to me. By the way i should also mention I am a 32 yr old male, have been 100% healthy up until this happened, never been to a hospital or have any other history of illnessess other then common colds and occasional flu like everyone else.
Thanks
Dr. Fennerty, I do not know how this website works or how the comments left for you are processed but, I am hoping to hear from you directly. I will not mention names or locations of GI office nor after treatment facilities. I had colonoscopy May 6, 2013. The prep name I Can not remember but, was a two part series. Powdered (lemon) flavored 1 gallon jug. Mix with water and refrig. followed prep exactly. started prep at 4:pm 5-5-13.although by 11:oopm I felt like stopping due to irritation to anal area but, did continue the course. Had last bowel movement around 3:45am May 6, 2013. Check in was at 6:45am. After procedure I was told by Dr. “looks Great” except for Small grade 1 non bleeding internal hemorrhoids. His report and pictures mentioned nothing regarding Diverticulitis? Post recovery was followed! I did decide to start out slow on the 7th and 8th. My diet was back to normal by around the 11th and stools were back to normal and at normal time in the mornings. 5 weeks later on the evening of 6-11-13, I began feeling a dull pain just below and just under my left rib cage. I thought this was just and overdose of a new recipe we ate for dinner that night and consisted of Quinoa (grain), black beans, Fresh dice tomatoes, onions topped with mild cheddar cheese werved on corn tortilla. I ended up going to urgent care the next day and discussed this with urgent care Dr next day. Don’t get the wrong impression by my last comment I do not overeat. I weight 158 lbs. 5′- 10″. She confirmed WHAT I ate the night before, and agreed this was the probable cause although I still questioned both my thoughts and hers as I have always had an iron stomach. I did take it easy for the next few days with no resolve. I re-visited urgent care 6-16,2013. explained to attending Dr. and according to symtoms I was diagnosed with Diverticulitis. Was placed on Brat diet 3 days,Ciprofloxacin 500mg 2/day for 14 days, Metronidozole 500mg 2/day for 14 days and Lactinex tab 50tab bottle. 4tabs chew 4/day. I finished the Lactinex on Thursday 6-20-13. I began to feel better on 6-19-13. then on 6-21-13 the same type pain starting coming back, not as strong but is still there today 6-23-13. I mention all of this to you because I investigated the symtoms of Diverticulitis online and somehow got the impression that it could have been brought on by the Colonoscopy??? then, Somehow I ended up at your site and reviewed your requests from other GI Doctors and comments left by others so, here is my information and I TRULY hope you can at least guide me or suggest what my next step should be.
Respectfully
M. Frazier
I am 65 yo woman with a past history of ulcerative Colitis, which has be sucessfully managed with diet. Have had two colonoscopies in the past 15 years with no evidence of diverticulosis or need for a biopsy. Had screening colonoscopy on 06/27/13. Finding some mild diverticulosis and several biopsies done. Two days later developed severe pain lower left quadrant with a low grade fever. Emergency room visit and cat scan revealed Diverticulitis and put on Cipro and Flagyl for ten days plus a low fibre diet during recovery. It is good to see other reports of this kind because the emergency Doc had never heard of colonoscopy causing diverticulitis. Now, I have to say there will be NO more colonoscopies!
I had a colonoscopy 3 months ago and was in a week of having it develop symptoms of diverticulitis.and now no matter what I eat after I eat I start to get the spasms and pain. and it specially at night they grow more intense and painful so difficult to deal with I end up holding my stomach and just having to wait it out. I’ve been to my doctor and she gave me medicine for stomach pain and told me that I might have to like this from the colonoscopy. or diverticulitis. its limited my ability to be able to eat certain foods at all I have to stay away from grains and seeds I cannot eat popcorn and I can’t eat anything after a certain time or I will be in ridiculous pain. I will never get another colonoscopy again
Had a colonoscopy April 28, 2013. Found mild diverticulosis. Have had 2 cases of diverticulitis since. June 20, 2013, and July 14, 2013! Cipro & Metro both times!
I am a healthy non-obese active 58yo female – and just had my first screening colonoscopy on 5/22/13. Given a clean bill of health except for noted diverticular disease throughout. No polyps. No inflammation.
My bowels had been absolutely fine (symptom-wise) prior to this test with only some random loose stools with certain foods once in a great while.
Well immediately after resuming a normal diet post procedure my stools were diarrhea – constantly. It was horrible. Worse than with the prep. No one warned me about either.
Eating a bland diet that included daily yogurt seemed to help ease that some, and by end of June I was returning to normal. I just assumed that my natural flora had been disturbed by the test.
Then a little over a week ago I noticed bright red blood in the toilet with my stool.
Right. Great.
This has repeated itself several times since then. No pain abdominally or rectally.
I have no hemorrhoids to my knowledge.
Stool is normal. My diet includes roughage & plenty of water.
I am going to make an appointment with my PCP this week to discuss this but haven’t panicked due to knowing about the diverticular disease & not feeling ill or light headed, and also knowing my recent scope was essentially negative for anything serious.
But I am annoyed & bummed out and wish there was a less invasive way to screen for colon cancer than probing around inside places that are doing just fine.
I’m glad to see this forum and to learn that there are some actual professional and clinical concerns – in addition to what all the patients are and have been saying.
I am an RN and I have often wondered why certain areas of medicine leap forward with less invasive or painful ways to detect, while others do not.
Do not even get me started on mammograms.
It is a shame that in order to determine if my bowel had cancer or signs of per-cancer, a disease that was not bothering me before had to become ‘stirred up’ and is now something I have to deal with. GI world – lets please move into the future with our diagnostic tools and tests!