Causes of diverticulitis?

Dear Alice,

Can stress bring on a diverticulitis attack?

Dear Reader,

While asymptomatic diverticulosis is common in Americans, diverticulitis has a number of recognized risk factors that can increase the likelihood of bouts occurring more or less frequently — however, stress is not among them. That said, just because there isn’t a direct relationship, it doesn’t mean that it doesn’t play a role for some folks. For those unfamiliar with the conditions and the relationship between the two: diverticulosis occurs when a person develops diverticula, or small protrusions, in the walls of their large and small intestines, stomach, or esophagus. Diverticula are usually benign, but they can sometimes become infected or inflamed, leading to a condition called diverticulitis. Symptoms that can occur when the diverticula become inflamed include constipation or diarrhea, nausea, vomiting, fever, and chills. Some folks (but not all) may also experience some bleeding associated with a bout of diverticulitis, which becomes evident when passing stool. Read on for more on the factors associated with diverticulitis, how stress may play a role for those who experience the condition, and some prevention strategies.

Risk factors for diverticulitis do include:

  • Getting older: The exact reason for this is not known, but people over 40 years old have a higher incidence of diverticulitis
  • Eating a low-fiber diet: Relatedly, those who had low-fiber diets that were also high in total fat and red meat had an increased risk.
  • Genes: Though more research is needed, some experts believe that some folks are genetically predisposed to the condition.
  • Having low levels of physical activity: In some studies, people found to have the highest risk of the condition had low physical activity levels. People who engaged in vigorous physical activity (e.g., running or jogging) had the least amount of risk.
  • Obesity and smoking: While the mechanisms for these risk factors aren’t understood, obesity and cigarette smoking is associated with a higher risk for diverticulitis.
  • Use of certain medications: There is some evidence to suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and opiates may increase the risk of the condition as well.

Although stress isn’t among these factors, that doesn’t mean it’s not contributing to bouts of diverticulitis that some people experience. Many people struggle with self-care when stressed, and that may mean they are less likely to practice healthy lifestyle behaviors (e.g., opting for less nutritious foods, not moving as much, or using tobacco as coping strategies). This means that your question is a critical one — because awareness of the established risk factors can help inform decisions that limit the impact diverticulitis has on people’s lives.

On that note, eating more dietary fiber, being physically active, and drinking enough fluids (to help move fiber through the system!) are recommended strategies to stave off diverticulitis. Being that these all contribute to overall health, adding healthy stress coping to the list is a great idea — take a look at Number one cause of stress for some suggestions. Lastly, working with a health care provider can help inform any specific actions to take to prevent and manage bouts of diverticulitis as well.


Last updated Dec 16, 2016
Originally published Oct 25, 2013