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
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this makes seance.i have been suffering from this condishion all the way back from 18yrs old when i hade my frist colonoscopy.im 45 now and for years thay could not tell me what was wrong with me now thay dinose me with diverticuliltis
i have been sufering off and on for a long time now we are starting to get some answers.
My father recently had second colonoscopy last year and six months later was rushed to hospital with a perforated bowel caused from untreated diverticulitis.
My husband is 56 years old and had his first routine colonscopy approx 3 months ago. He had one polyp removed and at the time there was no sign of any inflammation. He has just been hospitilised with diverticulitis and will be in for 3 days. He has not previously had any intestinal issues.
Very coincidental that both men ended up with this less than 6 months after their procedures and yet both of them were told by their doctors that the diverticulitis was not related to their colonoscopies. I am convinced that it is related.
Had my second colonoscopy mid-August, 2 weeks before my daughter’s wedding and had one polyp removed. Started noticing symptoms of lower abdominal pain and generally not feeling well within a week, but thought at first it was the stress of wedding planning, then being exhausted once it was over. Remember walking through the house rubbing my belly like I was pregnant and saying “I just don’t feel right”. At the 5 week mark, I was admitted through the ER for 3 days with diverticulitis. Afterward, I started wondering if the polyp removal could be responsible, as I had never had an episode of diverticulitis before. This forum give credence to my thoughts. Thinking it’s NOT a coincidence!
I am 69. 2 years ago I had moderate cramping then slight pain in lower left abdomen with some nausea. I went to the ER and they did a catscan that showed diverticulitis. Usual treatment with Flagyl and Cipro. Did the liquid diet then moved on to the fiber. At my annual checkup my md of 14 years told me I should get a colonoscopy. I had a bladder infection about 2 weeks before my checkup. I had pain with it and another cat scan. Results said resolved diverticulitis? Urine showed bladder infection. Antibiotic was prescribed. Im not having the colonoscopy and my md has me on a great probiotic because I was so tired from the antibiotics and stress and just didn’t feel well. He did a stool sample for bood and it was negative. I will do that again for my annuals. No colonoscopy. Too dangerous and they cannot sterilize the camera the same way they do surgical instuments and that is probably why people have problems even months after this test. Feel great. Probiotics are wonderful.
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.
I just underwent my first colonoscopy at age 44 for family history / preventative check. Mild to moderate diverticulitis was identified, but I already it was there from a CT back in 2009. Within 24 hours I developed diverticulitis. symptoms cleared with homeopathic remedies in 4 days. Then, 2 weeks later full blown attack, and CT revealed diverticulitis.
prescribed Levofloxacin (anti-anthrax drug) and Metronixdazole.
I have never presented symptoms prior. I also had a CT performed in 2009 for a cardiology preventive check, and radiologist identified the Diverticulitis back then. My G-Ent doctor was aware of this.
Question: if you already knew this would you still perform the scope and risk exacerbating the condition? I think the Surgery Prep alone probably exposed the tissue and caused the irritation all by itself let alone the scope compounding matters. Look forward to your feedback.
Diverticulitis runs in all of my family. For 53 years I ate as much as I wanted of whatever I wanted, could eat half a jar of nuts with no problem. When I had my first and only colonoscopy at 53, the doc said I had lots of diverticula and he had to work hard to clean it out. The diverticula were caked full and smooth and did not clean out during prep. Since the colonoscopy, I get bouts of Diverticulitis ever 2 weeks to 2 months. I can’t even look at a bun with sesame seeds. If I had it to do over, I would never have the colonoscopy.
Three years ago, I had a routine colonoscopy. It was my third screening in 15 years, no polyps nor other abnormalities were cited. However, the day after that last screening, I had a sharp pain in my lower left abdomen. I dismissed it, thinking it was just some left over air from the procedure. I had never even heard of diverticulitis prior to that, but since then, I’ve had three excruciating attacks. I’m just recovering from the most recent attack, and am convinced that the last screening caused my condition. I doubt I have recourse, as proof wouldn’t be conclusive, but I have certainly lost confidence in this procedure and will never have it performed again.
I came across this discussion whilst trying to find a reason why (after having a Colonoscopy for the first time), I have pain in both my left and right side. I’ve found this discussion most informative so thought I would mention my situation from a patients point of view.
I had my Colonoscopy a little under 3 weeks ago due to bleeding. No biopsies were taken, no polyps were found but I was found to have internal Haemorrhoids that had caused the bleeding. However, they did discover I had mild Diverticulitis. I felt fine following the procedure and even the day after felt pretty good. By the third day, I had terrible nausea and pain in both my left and right sides, near my rib cage and also in my lower back directly opposite to the pain in the front. The nausea lasted exactly 7 days and I barely ate a thing in that time but never actually vomited. Although the pain is slowly dissipating and is nowhere near as bad as it was, I am still very tender in my sides and still feel quite bloated at times and my stomach can feel incredibly hard. It does still hurt a little to lay in bed on either my left of right side. In my opinion, the Colonoscopy has indeed caused a flare up of my previously undetected Diverticulitis which had never, ever given me any issues up until post Colonoscopy. I’ve been told to have another one done in 7 years when I’m 50 years of age but I must admit I won’t be too keen to do so!!
Update to my previous post – I have just obtained the reports from that last screening, which, as it turns out, does cite “scattered diverticula” and recommends a high fiber diet. At the time, the doctor’s report to me was a verbal one, and had he mentioned diverticula, I would certainly have paid attention. Further, one would think he’d have explained the seriousness of this disease in detail.
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.
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!
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.
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.
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!?
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.
I recently had my first colonoscopy and coincidentally had my first bout of diverticulitis about a week later. And while correlation does not necessarily indicate causation, I find it hard to believe that it is only a coincidence. I think it should certainly be studied, but I definitely will not have another colonoscopy for at least five years after this (I had no polyps.)
I had a colonoscopy October 28th, 2014 one small benign polyp removed. No immediate issues. then the following week I noticed a dull intermittent pain in left lower abdomen. After 4-5 days, went to Doctors. He diagnosed Diverticulitis and prescribed Cipro and flagyl and this resolved the pain.
Three weeks later, December 2, I have a blackout syncope accompanied by incontinence and bloody diarrhea. Two nights in hospital while they ran tests (Xray,Cat-scan, EKG, Heart Echo scan, numerous blood tests.) Drs did not do a new colonoscopy due to the fact that I’d had one approx. 1 month ago.
Best diagnosis was “Acute GI Bleeds, currently resolved” Causation was not clear.
No previous incidence of diverticulitis, or lower GI bleeding. I think the subsequent issues are related to Oct 28th colonoscopy.
I had a colonoscopy at age 52. Up until then I had no issues with my digestion and had never had constipation, regular bowel movements every morning. For three days after the colonoscopy it felt like water was sloshing around in my gut and I felt pressure on my bladder. Going to my regular Doctor for a follow up the next month she diagnosed diverticulitis. My digestion is still not right after 2 years. I am convinced the colonoscopy caused it.
I had a coloscopy two weeks ago on a friday Nov 30, 2014. On Sunday night at 1am, I started with extreme pain (LLQ) and diarrhea. After 24 hours I went back to my GI who had conducted the procedure.
I saw my GI on Tuesday where he tested me for C. Difficile. Tests came back negative. I went back to my family doctor on Thursday who put me on immodium to rest the bowels.
On the following Monday (day 9) I returned and saw another doctor as there was no improvement. I am now on antibiodics for what she suspects maybe diverticulitis. I have been free from diarrhea/pain for 24 hours without the benefit of immodium.
I am not aware that I had/have diverticulitis. The initial colonoscopy was ordered due to previous intermitent issues with diarrhea and vomiting which was suspected as being related to crohns (family history). I do not believe my GI saw divertculitis during the procedure or he would likely have treated me when I retunred to him on Tuesday presenting with pain in LLQ and diarrhea. I am a 57 year old female.