Crohn’s disease vs. diverticulitis: How do they differ?

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The main difference between Crohn’s disease and diverticulitis is the cause of symptoms.

It is unclear exactly why these conditions develop. However, Crohn’s disease symptoms occur due to inflammation of the small intestine. It can also affect the large intestine and other parts of the digestive tract. Crohn’s disease is a chronic condition that can begin gradually and worsen over time. People may experience times of remission when their symptoms lessen.

Diverticulitis refers to a physical tear in sacs that develop along the gut. The development of these sacs, or diverticula, is known as diverticulosis, and around half of all people in the United States over 60 years of age experience this. However, diverticulitis only occurs in about 5% of all people with diverticulosis.

In the United States, around 200,000 people go to hospital with diverticulitis every year. However, Crohn’s disease is slightly more common. Crohn’s disease affects roughly 500,000 people in the United States.

The main similarities between Crohn’s disease and diverticulitis involve their symptoms. However, some distinct differences can provide clues even before a doctor identifies the cause of these symptoms.

The following table demonstrates the differences between Crohn’s symptoms and diverticulitis symptoms.

The age of onset also makes a difference. Diverticulitis occurs more often in older adults, whereas Crohn’s disease symptoms more commonly start between 20 and 29 years of age.

Diverticulitis has several life threatening complications that can develop quickly without treatment. Crohn’s disease complications can also be severe, but they generally take longer to present.

According to a 2019 study, people with diverticulitis and a different form of IBD called ulcerative colitis typically require more in-hospital treatment than those with diverticulitis and Crohn’s disease. Those with Crohn’s disease and diverticulitis generally required similar levels of treatment to those who had diverticulitis without Crohn’s disease.

Crohn’s disease complications

Untreated Crohn’s disease can thicken the gut walls, causing dangerous blockages. It might also cause abnormal tunnels between organs called fistulas that may develop an infection and abscesses. Crohn’s disease may also form painful, itchy tears in the anus and ulcers along the gut.

This form of IBD can also increase a person’s risk of nutrient deficiencies, osteoporosis, and colon cancer without treatment. Crohn’s disease also typically causes inflammation in other parts of the body, such as the joints and eyes.

Diverticulitis complications

Diverticulitis can also lead to gut fistulas, abscesses, and tears, similar to Crohn’s disease. However, people with diverticula also have a higher risk of intestinal bleeding — known as diverticular bleeding — which can be life threatening.

This gut condition can also lead to tears in the gut and an infection of the inner stomach lining, known as peritonitis, which can also be life threatening. A hard stomach wall, severe belly pain, and general weakness can point to peritonitis in those with diverticulitis.

Crohn’s disease and diverticulitis are separate conditions, but they may have links and can occur at the same time.

An older review of research suggested that Crohn’s disease may develop as a reaction to diverticulitis. Additionally, people with diverticulosis and Crohn’s disease may have a higher risk of diverticulitis. However, many people with diverticulosis do not know they have it.

Treatment can reduce the risk of serious complications in Crohn’s disease and diverticulitis.

Treating Crohn’s disease

Crohn’s disease is a lifelong condition. Treatment to reduce and manage the inflammation in the intestines can help prevent flare-ups and keep a person in remission for longer.

Treatment typically includes medications to help manage symptoms. This may include:

• aminosalicylates to control inflammation
• corticosteroids to help reduce immune system activity and reduce inflammation
• immunomodulators to reduce immune system activity
• biologic therapies to target certain proteins made by the immune system, which can decrease inflammation

Doctors may also recommend over-the-counter (OTC) pain medication, such as acetaminophen, or antibiotics.

In severe cases, surgery may be necessary. Individuals should also speak with their healthcare professionals about nutrition and diet for Crohn’s disease.

Treating diverticulitis

People with acute or mild diverticulitis may be able to treat the condition using a mixture of antibiotics and a clear liquid diet to give the colon a break. Gradually, they can build back up to solid foods.

Some pain medications may help relieve symptoms, although nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of complications.

Diverticulitis treatment may not prevent future infections and symptoms in all people, and symptoms may flare up in those who do not have inflammation. However, the highest risk of complications usually presents when a person first develops diverticulitis.

If diverticulitis symptoms do not improve, a surgeon may need to remove part of the colon.

Learn more about treating diverticulitis.

The following are some questions people frequently ask about Crohn’s disease and diverticulitis.

Can diverticulitis be mistaken for Crohn’s disease?

It is easy to confuse Crohn’s disease and diverticulitis, as they can both cause belly pain, bloody stools, nausea, and fever. It is also possible for them to occur at the same time. However, a doctor can give a proper diagnosis using a colonoscopy.

Can diverticulitis be mistaken for IBD?

Crohn’s disease is a type of IBD, as is ulcerative colitis, which can cause similar symptoms. Diverticulitis has similar symptoms to both types of IBD but has different causes and looks different through a colonoscope.

Crohn’s disease and diverticulitis have similar symptoms but different causes. Crohn’s disease involves inflammation of the small intestine, while diverticulitis refers to complications involving common bulges in the walls of the gut.

Both Crohn’s disease and diverticulitis can lead to serious, ongoing symptoms and other health issues, including bone issues and colon cancer. However, diverticulitis presents a high risk of life threatening complications such as intestinal bleeding and peritonitis. People with Crohn’s disease and diverticulosis have a higher risk of diverticulitis.

Effective management through diet, medications, and surgery can help reduce the risk of complications.