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3 Causes of Diverticulitis You Need to Know

ByHuman Health Co.

Millions of people worldwide suffer from diverticulitis, a condition in which small pouches in the colon become inflamed and infected. This can lead to severe abdominal pain, constipation, diarrhea, bloating, and fever. Unfortunately, the cause of this condition is not fully understood and currently, there is no cure. In this article, we explore the 3 main causes of diverticulitis and provide practical strategies for managing the condition effectively.

Diverticulitis Flare Up

Diverticulitis

Diverticulosis refers to the formation of small pouches (diverticula) in the colon wall, typically in the sigmoid or lower colon. In most cases, diverticulosis doesn’t cause any symptoms. However, when one or more of these diverticula become inflamed or infected, the condition is known as diverticulitis.

Symptoms of diverticulitis include sharp or persistent abdominal pain (usually in the lower abdomen), fever, chills, nausea, vomiting, diarrhea or constipation, bloating, and gas. Flare-ups can occur unexpectedly, and some individuals may go long periods without symptoms.

The exact cause of diverticulitis remains unclear, and triggers for flare-ups often vary from person to person. Unfortunately, there is currently no cure for diverticulitis, which can make managing the condition particularly frustrating.

Major Risk Factors of Diverticulitis

The exact cause of diverticulitis is unknown. However, several well-studied risk factors have been identified. Reducing or eliminating these risk factors can significantly lower the chances of developing diverticulitis or experiencing a flare-up.

1. Obesity

Diverticulitis and Obesity: Understanding the Link

Obesity is one of the strongest and most consistent risk factors for developing diverticulosis and diverticulitis, as well as experiencing frequent flare-ups. It is uncommon for individuals at a healthy weight to develop these conditions.

A large 18-year prospective cohort study1 involving 47,228 health professionals (aged 40–75) found that BMI, waist circumference, and waist-to-hip ratio were all independently linked to the development of diverticulitis and diverticular disease.

The study tracked participants’ health habits, including diet (high-fat intake, fiber consumption, and red meat intake), use of non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, and smoking. Among all the variables studied, obesity was the only factor consistently associated with a new diagnosis of diverticulitis, regardless of diet, smoking, or medication use.

slimming, scales, health, lifestyle, exercises, obesity, fat, diet, belly, weigh, measure, obesity, obesity, obesity, fat, fat, fat, fat, fat

Additional research supports this connection. Several retrospective case studies2,3,4,5,6 found that over 75% of patients with diverticulitis were overweight or obese. These findings were based on BMI, waist circumference, and waist-to-hip ratio. A case-control study7 comparing 18 controls with uncomplicated diverticulosis and 43 patients with diverticulitis found that BMI was significantly higher in those with recurrent or perforated diverticulitis. Similarly, a study involving 112 cases8 from a cardiovascular prevention trial confirmed that higher BMI was strongly linked to symptomatic diverticular disease.

The evidence is clear. Diverticulitis is rare in individuals with a healthy weight. Obesity significantly increases the risk of developing the condition and experiencing more severe symptoms over time.

2. Sedentary Lifestyle

The Impact of a Sedentary Lifestyle on Diverticulitis

A sedentary lifestyle is a significant risk factor for diverticulitis for several reasons—some more obvious than others. The most direct link is that inactivity often leads to obesity, which is one of the strongest risk factors for developing diverticulitis.

Another key factor is that physical activity directly supports digestive health. Regular movement stimulates bowel activity, promoting efficient digestion and waste elimination. This helps improve gut motility and reduces issues like constipation and bloating. When the body is active, the intestines function more effectively, which supports a healthier, less inflamed digestive system.

Man Holding Remote Control

Exercise also plays a crucial role in maintaining a balanced gut microbiome9, which is essential for overall digestive health. Research shows that physically active individuals tend to have a more diverse and balanced gut microbiome compared to those who are inactive10. A healthy microbiome improves digestion, enhances nutrient absorption, and strengthens the immune system. Regular exercise has been shown to improve the balance of Bacteroidetes and Firmicutes, two key groups of gut bacteria. This may help reduce obesity-related issues and gastrointestinal conditions like diverticulitis.

In short, staying active not only helps prevent obesity but also promotes better gut health, reducing the risk and severity of diverticulitis.

3. Smoking and Alcohol Use

The Role of Smoking and Alcohol in Diverticulitis

Smoking and alcohol consumption are believed to increase the risk and severity of diverticulitis, though the exact mechanisms are not fully understood. Studies have shown that individuals who smoke or consume excessive alcohol tend to have a higher risk of developing diverticulitis. However, this association may be influenced by other unhealthy lifestyle factors commonly linked to smoking and drinking, such as poor diet, obesity, and physical inactivity. This raises the possibility that the connection may be due to confounding factors rather than a direct cause.

Nicotine may play a more direct role. It is known to relax smooth muscle in the gastrointestinal tract by stimulating the release of nitric oxide11. Research has found that nicotine reduces the tone and activity of smooth muscle in the sigmoid colon, weakening colonic contractions and slowing down digestive movement. This reduced activity may increase the risk of developing diverticulosis, which can progress to diverticulitis.

Person Smoking Cigarette

The link between alcohol and diverticulitis is less clear. However, alcohol consumption has been shown to disrupt the gut microbiome by reducing beneficial bacteria and increasing the presence of harmful bacteria that promote endotoxin production12. This imbalance can trigger gut inflammation, which may increase susceptibility to diverticulitis.

While more research is needed to confirm a direct link, the evidence suggests that smoking and excessive alcohol consumption may contribute to digestive health issues, increasing the likelihood of developing or worsening diverticulitis.

Managing Diverticulitis

Many people living with this condition have the mindset that they have been served a life sentence of pain, uncomfortable bowel movements, and frustrating gas and bloating. However, this doesn’t have to be the case. Like many other inflammatory conditions, diverticulitis can be managed effectively with healthy lifestyle changes and the right information to help you take control of your health.

Natural Methods to Help Put Diverticulitis into Remission

  1. Weight loss
  2. Increase physical activity13
  3. Reduce inflammation by eliminating inflammatory foods and drinks
    • Ultra-processed foods
    • Sugary beverages
    • Dairy – if you are intolerant
  4. Consume gut-healthy foods such as chlorophyll, fermented veggies, cabbage, and other prebiotic and probiotic foods
  5. Reduce or eliminate smoking
  6. Reduce or eliminate alcohol consumption

Diverticulitis Remission

Taking Charge of Diverticulitis: A Path to Relief

Diverticulitis can be challenging, but you don’t have to feel stuck. The unpredictability of how your gut will behave each day can be frustrating and stressful, but there’s good news—diverticulitis isn’t a life sentence. With the right approach, you can manage it effectively and even put it into remission naturally.

One of the biggest factors is obesity, which can feel daunting to address. But the best way to tackle weight loss—and improve your gut health—is through your diet. The saying “you can’t outwork a bad diet” holds true. Start by cutting out processed foods and focusing on whole, nutrient-rich options like meat, vegetables, fruits, nuts, and dairy (if you tolerate it). This shift will help reduce inflammation, shed water weight, and eventually lower stored fat.

As you improve your diet, try adding regular walks to your routine. Movement helps keep your digestive system working smoothly, improving gut motility and reducing bloating and constipation. If you smoke or drink excessively, consider taking small steps to cut back—your gut (and overall health) will thank you.

The goal is to create a balanced, healthy lifestyle filled with movement, whole foods, and fewer gut-harming habits. Remember, change takes time—Rome wasn’t built in a day, and neither is lasting health. Take it one step at a time, and you’ll soon find yourself feeling stronger, healthier, and more in control of your gut health.

Supporting Research

  1. Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology. 2009 Jan;136(1):115-122.e1. doi: 10.1053/j.gastro.2008.09.025. Epub 2008 Sep 25. PMID: 18996378; PMCID: PMC2643271. ↩︎
  2. Konvolinka CW. Acute diverticulitis under age forty. Am J Surg. 1994 Jun;167(6):562-5. doi: 10.1016/0002-9610(94)90098-1. PMID: 8209928. ↩︎
  3. Zaidi E, Daly B. CT and clinical features of acute diverticulitis in an urban U.S. population: rising frequency in young, obese adults. AJR Am J Roentgenol. 2006 Sep;187(3):689-94. doi: 10.2214/AJR.05.0033. PMID: 16928931. ↩︎
  4. Schweitzer J, Casillas RA, Collins JC. Acute diverticulitis in the young adult is not “virulent.”. Am Surg. 2002 Dec;68(12):1044-7. PMID: 12516805. ↩︎
  5. Mader TJ. Acute diverticulitis in young adults. J Emerg Med. 1994 Nov-Dec;12(6):779-82. doi: 10.1016/0736-4679(94)90483-9. PMID: 7884196. ↩︎
  6. Schauer PR, Ramos R, Ghiatas AA, Sirinek KR. Virulent diverticular disease in young obese men. Am J Surg. 1992 Nov;164(5):443-6; discussion 446-8. doi: 10.1016/s0002-9610(05)81177-8. PMID: 1443367. ↩︎
  7. Dobbins C, Defontgalland D, Duthie G, Wattchow DA. The relationship of obesity to the complications of diverticular disease. Colorectal Dis. 2006 Jan;8(1):37-40. doi: 10.1111/j.1463-1318.2005.00847.x. PMID: 16519636. ↩︎
  8. Rosemar A, Angerås U, Rosengren A. Body mass index and diverticular disease: a 28-year follow-up study in men. Dis Colon Rectum. 2008 Apr;51(4):450-5. doi: 10.1007/s10350-007-9172-5. Epub 2007 Dec 22. PMID: 18157570. ↩︎
  9. Monda V, Villano I, Messina A, Valenzano A, Esposito T, Moscatelli F, Viggiano A, Cibelli G, Chieffi S, Monda M, Messina G. Exercise Modifies the Gut Microbiota with Positive Health Effects. Oxid Med Cell Longev. 2017;2017:3831972. doi: 10.1155/2017/3831972. Epub 2017 Mar 5. PMID: 28357027; PMCID: PMC5357536. ↩︎
  10. Clarke SF, Murphy EF, O’Sullivan O, Lucey AJ, Humphreys M, Hogan A, Hayes P, O’Reilly M, Jeffery IB, Wood-Martin R, Kerins DM, Quigley E, Ross RP, O’Toole PW, Molloy MG, Falvey E, Shanahan F, Cotter PD. Exercise and associated dietary extremes impact on gut microbial diversity. Gut. 2014 Dec;63(12):1913-20. doi: 10.1136/gutjnl-2013-306541. Epub 2014 Jun 9. PMID: 25021423. ↩︎
  11. Wijarnpreecha K, Boonpheng B, Thongprayoon C, Jaruvongvanich V, Ungprasert P. Smoking and risk of colonic diverticulosis: A meta-analysis. J Postgrad Med. 2018 Jan-Mar;64(1):35-39. doi: 10.4103/jpgm.JPGM_319_17. PMID: 29067919; PMCID: PMC5820812. ↩︎
  12. Bishehsari F, Magno E, Swanson G, Desai V, Voigt RM, Forsyth CB, Keshavarzian A. Alcohol and Gut-Derived Inflammation. Alcohol Res. 2017;38(2):163-171. PMID: 28988571; PMCID: PMC5513683. ↩︎
  13. Human Health Co. (2025b, March 11). The powerful link between Muscle Mass and a healthy life. https://humanhealthco.com/the-powerful-link-between-muscle-mass-and-a-healthy-life/ ↩︎

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