From the Guidelines
Yes, a diverticulitis flare can potentially trigger a complicated Urinary Tract Infection (UTI). This connection occurs because diverticulitis involves inflammation of small pouches (diverticula) in the digestive tract, most commonly in the colon. When these pouches become inflamed or infected, the proximity to the urinary system can allow bacteria to spread from the intestines to the urinary tract, especially in women due to their shorter urethra. The inflammation from diverticulitis can also put pressure on the bladder or urinary tract, potentially impeding normal urine flow and creating conditions favorable for bacterial growth.
According to the study by 1, prior diverticulitis is considered a risk factor for complicated UTIs, and patients with a history of diverticulitis may be more prone to recurrent UTIs. The study also highlights that women who have three or more symptomatic infections over a 12-month period may benefit from prophylysis.
Common symptoms that might indicate both conditions are present include:
- Abdominal pain (typically lower left quadrant for diverticulitis)
- Fever
- Changes in bowel habits
- Painful urination
- Increased urinary frequency
- Cloudy or bloody urine
If you're experiencing a diverticulitis flare and develop urinary symptoms, contact your healthcare provider promptly as you may need separate treatments for both conditions - typically antibiotics like ciprofloxacin or trimethoprim-sulfamethoxazole for the UTI and possibly different antibiotics such as metronidazole combined with a fluoroquinolone for the diverticulitis, depending on severity. The American Gastroenterological Association (AGA) Clinical Practice Update 1 and 1 provide guidance on the management of diverticulitis, including the use of antibiotics and the importance of considering underlying risk factors for complicated disease. Additionally, the study by 1 emphasizes the need for a low threshold for cross-sectional imaging, antibiotic treatment, and consultation with a colorectal surgeon in immunocompromised patients with diverticulitis.
From the Research
Diverticulitis and Urinary Tract Infections (UTIs)
- Diverticulitis is a condition characterized by inflammation of the outpouchings of the bowel wall, which can lead to various complications, including abscesses, perforations, and fistulas 2.
- The symptoms of diverticulitis may include left lower quadrant pain, tenderness, abdominal distention, fever, anorexia, constipation, nausea, diarrhea, and dysuria 3.
- Dysuria, a symptom of diverticulitis, is also a common symptom of Urinary Tract Infections (UTIs), suggesting a possible connection between the two conditions.
- However, there is no direct evidence in the provided studies to suggest that a diverticulitis flare can trigger a complicated UTI.
Complications of Diverticulitis
- Complicated diverticulitis can lead to life-threatening conditions, such as perforation, phlegmon, abscess, ascending septic thrombophlebitis (phylephlebitis), bleeding, intestinal obstruction, and fistula 2.
- The management of diverticulitis is undergoing a paradigm shift, with treatment moving to the outpatient setting and physicians forgoing antibiotics for uncomplicated disease 4.
- The decision for elective surgery for diverticulitis has become preference sensitive, and the most current data guiding surgical management of diverticulitis include the adoption of new minimally invasive and robot-assisted techniques 4.
Diagnosis and Management of Diverticulitis
- The diagnosis of diverticulitis is typically made using computed tomography (CT) scans, which can help identify the extent and severity of the disease 3, 2.
- The management of diverticulitis depends on the severity of the disease, with uncomplicated diverticulitis often being treated conservatively and complicated diverticulitis requiring more aggressive treatment, including surgery 3, 5.
- Immunocompromised patients with diverticulitis may require more careful management, as they are at higher risk of developing complications 5.