Gallstones & Diverticulitis
Although gallstone disease and diverticulitis usually start with different symptoms, they may, on rare occasion, cause a similar type of pain, resulting in a diagnostic dilemma for your physician. In most cases, the signs and symptoms are different enough to allow for straightforward and rapid diagnosis and treatment. Diverticulitis is an inflammation of small pockets of your large intestine, also known as your colon. Gallstones are pebble-like formations of hardened bile located in the gallbladder, which is beneath your right rib cage.
Gallstone disease, called acute cholecystitis, may first appear with sudden, severe pain centered under your right rib cage, often with associated back pain, nausea and vomiting and fever. Gallstone disease also can be an ongoing condition called chronic cholecystitis, which may worsen after you eat a fatty meal. A surgeon can examine you and determine if your gallbladder is the likely source of your symptoms. If so, a hospital stay is usually necessary. You may be given antibiotics, and ultimately your gallbladder may be removed during a procedure known as laparoscopic cholecystectomy. Once your diseased gallbladder has been removed and you have recovered, you should not experience further problems.
Diverticulitis, or an inflammation of colon pockets, produces pain ranging from mild to intense that usually occurs on the left side of your abdomen. A perforated, or ruptured diverticulitis may cause your abdomen to become rigid. Your colon and rectal surgeon, formerly called a proctologist, or your general surgeon evaluates you and usually begins treatment with antibiotics. Diverticulitis seldom requires hospitalization. On rare occasion, an operation may be necessary, especially if you have experienced a perforation that allows the free flow of your colon's contents into your general abdominal cavity. Diverticulitis is usually a disease of older individuals.
Education and attention to your symptoms is the wisest course and easiest way to avoid the complications of either disease. The pain associated with these conditions generally prompts you to consult your physician, who can refer you to a colon and rectal specialist for diverticulitis or to a general surgeon for gallbladder disease. Seek medical advice early, do not be afraid to call when help is needed and become educated about your disease process.
Dr. Hoffman does not endorse any products seen on this website.
Irritable Bowel vs. Gallstones
Pain in the Upper Right Back After Eating
Side Effects of Gallbladder Surgery
What Could You Do to Keep the Human Appendix Healthy?
Recommended Diet to Deal with Gallstones and Biliary Colic
Gall Bladder Symptoms in Women
The Best Pain Relief for Diverticulitis
Upper-Right Side Abdominal Pain After Eating Steak
Does Fasting Affect Your Gallbladder?
Gallstone & Gallbladder Sludge Symptoms
- Barroso AO, Quigley EM. Diverticula and Diverticulitis: Time for a Reappraisal. Gastroenterol Hepatol (N Y). 2015;11(10):680-688.
- Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Can J Gastroenterol. 2011;25(7):385-389. doi:10.1155/2011/795241
- National Institute of Diabetes and Digestive and Kidney Diseases. Diverticular Disease.
- Cao Y, Strate LL, Keeley BR, et al. Meat intake and risk of diverticulitis among men. Gut. 2018;67(3):466-472. doi:10.1136/gutjnl-2016-313082
- Hollink N, Dzabic M, Wolmer N, Boström L, Rahbar A. High prevalence of an active human cytomegalovirus infection in patients with colonic diverticulitis. J Clin Virol. 2007;40(2):116-119. doi:10.1016/j.jcv.2007.07.008
- Strate LL, Liu YL, Aldoori WH, Giovannucci EL. Physical activity decreases diverticular complications. Am J Gastroenterol. 2009;104(5):1221-1230. doi:10.1038/ajg.2009.121
- Destigter KK, Keating DP. Imaging Update: Acute Colonic Diverticulitis. Clin Colon Rectal Surg. 2009;22(3):147-155. doi:10.1055/s-0029-1236158
- National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Diverticular Disease. 2016.
- Rezapour M, Ali S, Stollman N. Diverticular Disease: An Update on Pathogenesis and Management. Gut Liver. 2018;12(2):125-132. doi:10.5009/gnl16552
- Cao Y, Strate LL, Keeley BR, et al. "Meat intake and risk of diverticulitis among men." Gut. 2018;67:466-472. doi: 10.1136/gutjnl-2016-313082.
- Hollink N, Dzabic M, Wolmer N, Boström L, Rahbar A. "High prevalence of an active human cytomegalovirus infection in patients with colonic diverticulitis.” J Clin Virol. 2007;40:116-119.
- Strate LL, Keeley BR, Cao Y, et al. Western dietary pattern increases, and prudent dietary pattern decreases, risk of incident diverticulitis in a prospective cohort study. Gastroenterology. 2017;152:1023–1030. doi: 10.1053/j.gastro.2016.12.038.
Doctor Hoffman is an experienced colon and rectal surgeon and general surgeon, with 28 years of experience. He is an attending surgeon at Cedars Sinai Medical Center and an instructor in the divisions of colon and rectal surgery and general surgery. Doctor Hoffman is widely published in peer-reviewed publications such as “Diseases of the Colon and Rectum,” “Surgical Rounds” and “American Surgeon.” He is an Editor and frequent contributor to General Surgery News. Dr. Hoffman is a pioneer in the use of the procedure for prolapse and hemorrhoids (PPH), an alternative hemorrhoidal operation which has been demonstrated to result in less postoperative pain and a faster return to work or to the activities of daily living. In his research he has confirmed the superiority of PPH when compared with traditional hemorrhoidectomy. He is actively involved in research to further streamline the procedure and improve the instrumentation. Doctor Hoffman has interests in genetics and hereditary colorectal cancer as well as anal cancer and advances techniques in colonoscopy. Dr. Hoffman is a member of The American Society of Colon and Rectal Surgeons, The Southern California Society of Colon and Rectal Surgeons, The American College of Surgeons and The American Medical Association.