Diverticulitis vs. Crohn's Disease: A Gut Inflammation Review

Knowing the signs, causes, diagnostic options, treatments, and latest research make conversations with your doctor more productive. 

By Tommy Douglas, Amateur Health Researcher and Blogger

Diverticulitis and Crohn’s disease are distinct conditions, so recognizing their different symptoms is essential for getting the right care. Understanding what triggers each condition helps guide management and treatment choices. 

Because diagnostic methods vary, consult a healthcare professional for accurate testing and interpretation. A range of therapies—medical, dietary, microbiome-based, and surgical—can ease symptoms and improve quality of life. 

Being informed empowers you to discuss the best, personalized options with your care team.

 A healthy gut lining with visible villi (finger-like projections) for nutrient absorption.

Part 1 Diverticulitis Understanding the Pouches

What is diverticulitis

Diverticulitis occurs when small pouches called diverticula form in the colon wall and become inflamed or infected. These pouches often develop from increased pressure inside the colon, commonly linked to chronic straining or a low-fiber diet.

Common symptoms

• Abdominal pain, usually lower left side.
• Fever and chills.
• Constipation or diarrhea.
• Nausea and loss of appetite.
• Tenderness in the abdomen.

Typical causes and risk factors

• Low-fiber diet and chronic constipation.
• Age-related weakening of the colon wall.
• Obesity, smoking, and lack of exercise.
• Certain medications that affect bowel function.

Diagnosis options

• Physical exam and medical history.
• Blood tests to check for infection.
• CT scan to confirm inflammation or complications.
• Colonoscopy after acute inflammation resolves to rule out other conditions.

Treatment and management

• Mild cases: antibiotics, clear-liquid or low-residue diet, and rest.
• Severe or complicated cases: hospitalization, IV antibiotics, drainage of abscesses, or surgery.
• Prevention: high-fiber diet, regular exercise, adequate hydration, and avoiding straining.

How This Differs from Crohn’s Disease

• Key distinction: Diverticulitis is a localized infection/inflammation of colon pouches, while Crohn’s disease is a chronic, immune-mediated inflammatory bowel disease that can affect any part of the digestive tract and often requires long-term medical management.
• Why recognition matters: Accurate symptom recognition ensures the right tests and treatments—diverticulitis may need short-term antibiotics or surgery, whereas Crohn’s typically requires anti-inflammatory drugs, immunomodulators, biologics, or other long-term strategies.

Quick Patient Guide

1. Signs to watch for: abdominal pain, fever, changes in bowel habits, bleeding, weight loss, or persistent fatigue.
2. Common causes: diverticulitis often follows diverticula and local inflammation; Crohn’s involves immune-driven inflammation with genetic and microbiome factors.
3. Diagnosis options: physical exam, blood tests, stool tests, colonoscopy, imaging (CT or MRI), and specialized microbiome or biomarker tests.
4. Therapies: antibiotics and dietary changes for diverticulitis; anti-inflammatory drugs, biologics, microbiome therapies, and surgery for Crohn’s—treatment depends on severity and location.
5. Research directions: pediatric-specific trials, microbiome modulation, targeted biologics, gene-editing approaches, stem cell therapy, and AI-assisted diagnostics.

If you suspect diverticulitis or have ongoing gut inflammation, schedule an appointment with your healthcare provider. Bring this guide and your symptom notes to make the visit more productive.

Practical Tips for Talking with Your Doctor

• Bring a symptom log noting pain location, bowel changes, fever, and triggers.
• Share medical history including prior colon issues, surgeries, and family history of IBD.
• Ask about tests: which imaging or endoscopy is recommended and why.
• Discuss treatment goals: symptom control, preventing complications, and long-term management.
• Inquire about lifestyle changes: fiber intake, exercise, smoking cessation, and medication side effects.

A Quick Guide to Help Prevent Diverticulitis:  

Diverticulitis can be uncomfortable and interfere with daily life, but there are simple ways to lower your risk. 

• Start by boosting your fiber intake—aim for 20 to 35 grams a day from fruits, veggies, and whole grains to keep things moving smoothly in your colon. 
• Stay hydrated by drinking at least eight large glasses of water daily to help prevent constipation. 
• Keep active with regular exercise to support healthy bowel function, and if you’re adding more fiber, do it gradually to avoid gas and bloating. 
• Try to limit red meat and opt for lean or plant-based proteins instead. 
• Avoid long-term use of certain laxatives unless advised by a doctor and choose natural options like prunes or psyllium. If you can’t get enough fiber from food, supplements can help. 
• Maintain a healthy weight—especially around your midsection—to further reduce your risk.
• Quit Smoking: Smoking is linked to diverticulitis in several ways. It can dehydrate your organs and weaken the muscle tone in your colon, which may lead to the formation and inflammation of pouches in the colon wall. It also increases the risk of developing diverticulitis.
• Diet During a Flare-Up: During a diverticulitis flare-up, healthcare providers may recommend a clear liquid diet, gradually transitioning to solid foods as symptoms improve. It is also advised to avoid foods that may increase the risk of flare-ups, such as red meat, and instead emphasize a diet abundant in vegetables, fruits, and whole grains.

By following these lifestyle changes, individuals can significantly reduce their risk of developing diverticulitis and maintain a healthy digestive system. For more detailed guidance and personalized advice, consulting with a healthcare provider is always recommended.

Part 2: Crohn's Disease - Understanding Chronic Inflammation  

Crohn's disease is an autoimmune type of inflammatory bowel disease (IBD) that can impact any part of the digestive tract, from the mouth all the way to the anus. Unlike diverticulitis, which only affects the inner lining of the colon, Crohn's can involve the full thickness of the bowel wall. This long-term condition triggers inflammation that interferes with digestion, causing a range of symptoms.

Symptoms of Crohn's Disease:

• Persistent diarrhea: This is often bloody or mucoid.

• Abdominal pain and cramping: Especially in the lower right abdomen.

• Urgent need to have a bowel movement (urgency): Even if there's little stool passed.

• Fever: May be a sign of infection or inflammation.

• Fatigue: Chronic inflammation can lead to tiredness.

• Weight loss: Due to difficulty absorbing nutrients from food.

• Nutritional deficiencies: Can occur due to malabsorption.

• Mouth sores: May develop inside the mouth.

• Perianal disease: Inflammation around the anus, including fistulas (abnormal connections) and abscesses (collections of pus).

Causes of Crohn's Disease:  

The exact cause of Crohn's Disease isn’t fully known, but it’s thought to be triggered by a mix of factors. Genetics can play a role, as it sometimes runs in families, and the immune system may overreact to harmless bacteria, viruses, or certain foods in the gut. Environmental factors like smoking or pollution might also contribute. It’s not contagious and can’t be passed from person person.  

Diagnosing Crohn's Disease:  

To diagnose this chronic inflammatory condition of the digestive tract, healthcare providers start with a physical exam to check for common signs like tenderness or inflammation. 

• Stool tests help rule out other issues, like bacterial infections. 
• Blood tests, such as a Complete Blood Count (CBC), can spot signs of anemia or inflammation.
• Imaging scans like CTs, MRIs, and X-rays help detect inflammation, strictures, or complications like abscesses. 
• Endoscopy is a key tool for getting a close look at the intestinal lining, while a barium swallow test can show which parts of the digestive tract are affected. 
• Colonoscopies allow doctors to see the inner lining directly and take tissue samples for further analysis.  

Treatment Options for Crohn's Disease:  

Treatment options for Crohn's disease are diverse and continually evolving, aiming to manage symptoms, reduce inflammation, and improve the patient's quality of life. Current clinical guidelines recommend a range of therapies, including various classes of medications and, in some cases, surgical interventions.

Medical Treatments

• Biologic Therapies: These are a significant part of modern Crohn's disease treatment and often target specific inflammatory pathways.
• Tumor Necrosis Factor alpha (TNFα) antagonists: These drugs block TNFα, a protein that promotes inflammation. They are commonly used for both inducing and maintaining remission in Crohn's disease. 

While effective for many, approximately 30% of children with Crohn's disease may find these drugs stop working within two years.

• Anti-integrins: These medications work by preventing inflammatory cells from entering the inflamed tissues in the gut 
• Interleukin-12/23 (IL12/23) inhibitors: These therapies target specific interleukins involved in the inflammatory response.
• Janus kinase (JAK) inhibitors: These are a newer class of oral medications that block signals within immune cells that contribute to inflammation
• Corticosteroid: These powerful anti-inflammatory drugs are often used for short-term induction of remission during flare-ups but are generally not recommended for long-term maintenance due to potential side effects.
• Other Medications: Beyond biologics and steroids, other medications may be used to manage symptoms or modulate the immune system. Research is ongoing for novel treatments, including those for immune-mediated diseases like Crohn's disease.

Surgical Interventions

Surgery can be a necessary treatment option for some Crohn's disease patients, particularly when medication fails to control symptoms, or complications arise, such as strictures, fistulas, or abscesses.

Personalized and Multidisciplinary Approaches

Determining the optimal treatment for an individual patient can be challenging due to the complexity of available options and the need to consider numerous factors, including the patient's specific symptoms, disease location, and severity. 

Many institutions, such as the Inflammatory Bowel Disease Center at OHSU, emphasize a patient-centered, multidisciplinary approach to treatment, involving various specialists to provide comprehensive care. 

Similarly, the Inflammatory Bowel Disease Clinic at Duke Department of Medicine offers state-of-the-art diagnostic and therapeutic options.

Part 3: Emerging Research and Future Treatments for Crohn’s Disease and Gut Inflammation

Research into Crohn’s disease and gut inflammation is rapidly expanding, focusing on personalized medicine, pediatric-specific therapies, and technology-driven diagnostics. Current efforts aim to improve long-term outcomes by combining advanced biologic drugs, targeted small molecules, microbiome modulation, and regenerative approaches such as stem cell therapy.

Key Research Areas and Future Directions

Pediatric IBD Research

• Need: More safety and efficacy data for children, since many IBD drugs are approved for adults.
• Progress: Ongoing trials compare alternatives to anti-TNF agents in pediatric patients to identify safer, age-appropriate regimens.

Racial Disparities in Treatment

• Focus: Studies are examining differences in medication selection and outcomes across racial and ethnic groups.
• Goal: Improve equity by tailoring therapies and addressing barriers to access and response variability.

AI Integration and Diagnostics

• Application: Deep learning and AI models are being developed to enhance diagnosis and management of complex Crohn’s manifestations, including perianal fistulizing disease.
• Benefit: Faster, more accurate detection and personalized treatment planning.

Precision Tools for Intestinal Barrier Assessment

• Breakthrough: New assays and imaging tools measure intestinal barrier function, helping predict disease course and therapy response.
• Impact: Better risk stratification and targeted interventions for IBD and colitis-associated colorectal cancer.

Gene Editing and Repurposed Oncology Drugs

• Discovery: Identification of DNA segments and inflammatory pathways that can be targeted to reduce IBD inflammation.
• Opportunity: Repurposing drugs used in melanoma and non-small cell lung cancer and exploring gene-editing strategies for targeted therapy.

Gut Microbiome and Metabolite Therapies

• Findings: Dysbiosis—reduced microbial diversity and increased Proteobacteria—is linked to Crohn’s progression, intestinal permeability, and fibrosis.
• Therapeutic avenues: Modulating microbiota with diet, probiotics, bacteriophage therapy, metabolites (tryptophan, bile acids, SCFAs), and fecal microbiota transplant (FMT).
• Caveat: Promising but requires larger clinical trials to confirm efficacy and safety.

Fecal Microbiota Transplant Research

• Use case: FMT is established for recurrent C. difficile and is under investigation for Crohn’s and diverticulitis.
• Evidence: Pilot studies suggest donor microbiota colonization may help maintain remission, but results are inconsistent and more research is needed.

Targeted Molecular Therapies

• Approach: New drugs aim at specific inflammatory molecules and pathways to reduce side effects and increase effectiveness.
• Goal: Deliver precision medicine that matches therapy to a patient’s molecular profile.

Stem Cell Therapy

• Types: Hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs) are being studied for immune reset and tissue repair.
• Potential: Reduce inflammation, repair intestinal lining, and possibly reset immune responses that drive Crohn’s.
• Status: Largely experimental with encouraging early results; larger trials are ongoing.

Practical Implications for Patients and Clinicians

• Combination care: Biologics, targeted drugs, microbiome strategies, and surgery remain core options; emerging therapies may reduce reliance on surgery.
• Personalization: Molecular profiling and microbiome analysis will increasingly guide individualized treatment plans.
• Pediatrics and equity: Prioritizing pediatric trials and addressing racial disparities will improve outcomes across populations.

Conclusion Living Well with Gut Inflammation

Gut inflammation underlies both diverticulitis and Crohn’s disease, but they are distinct conditions with different causes, symptoms, and treatment paths. Understanding those differences helps you and your care team choose the right tests and therapies, reduce complications, and improve daily functioning.

Early recognition and timely medical evaluation are essential. Prompt diagnosis—guided by your symptoms, imaging, and specialist assessment—lets clinicians start appropriate treatment sooner, which can reduce flare severity and preserve quality of life.

Ongoing research into microbiome therapies, targeted biologics, stem cells, and AI-driven diagnostics promises more personalized and effective options in the years ahead. Staying informed about new developments can help you discuss emerging treatments and clinical trials with your doctor.

Key takeaways

• Know the difference: Diverticulitis is localized pouch inflammation; Crohn’s is a chronic, immune-mediated condition that can affect any part of the GI tract.
• Act early: Seek medical care for persistent abdominal pain, fever, bleeding, or major bowel changes.
• Treatment varies: Options range from diet and antibiotics to biologics, surgery, microbiome therapies, and experimental approaches.
• Stay informed: Research is expanding treatment choices and diagnostic tools—ask your clinician about new options and trials.

 

Sources:

1. Diverticular Disease - NIDDK | https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis | Official patient information |
2. Crohn's & Colitis Foundation - Homepage | https://www.crohnscolitisfoundation.org/ | National patient advocacy org |
3. Diverticulitis - Symptoms & Causes (Mayo Clinic) | https://www.mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758 | Clinical overview |
4. Crohn's Disease - Symptoms & Causes (Mayo Clinic) | https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304 | Clinical overview |
5. ACG Guidelines / Clinical Guidance (American College of Gastroenterology) | https://gi.org/guidelines/ | ACG guideline hub |
6. Treatment of IBD - UNC Multidisciplinary IBD Center | https://www.med.unc.edu/medicine/gi/ibd/treatment-of-ibd-1/treatment-of-ibd/ | Clinical program page |
7. Gut Microbiota and Acute Diverticulitis: Role of Probiotics (J. Pers. Med.) | https://www.mdpi.com/2075-4426/11/4/298 | Open‑access review |
8. Gut Microbiota Metabolites: Role in IBD and Fibrosis (Pharmaceuticals) | https://www.mdpi.com/1424-8247/17/3/347 | Review on metabolites |
9. UC Davis Health - Stem cell-based therapy for Crohn's (news) | https://health.ucdavis.edu/news/headlines/uc-davis-health-leads-study-on-promising-stem-cell-based-therapy-for-crohns-disease/2024/01 | Institutional news release |
10. Efficacy & Safety of Stem Cell Therapy for Crohn's (meta‑analysis) | https://link.springer.com/article/10.1186/s13287-024-03637-z | Open‑access meta‑analysis |
11. Cervical Health Awareness Month - Jamaica Hospital Health Beat | https://jamaicahospital.org/newsletter/cervical-health-awareness-month-the-importance-of-regular-cervical-screenings/ | Health awareness post (included in original list) |
12. Jefferson Digital Commons - TMF Vol 26, Issue 1 (Racial disparities article) | https://jdc.jefferson.edu/tmf/vol26/iss1/17/ | Article: racial disparities in IBD therapy |
13. TRACS UNC - Community feedback: pediatric IBD research | https://tracs.unc.edu/index.php/news-articles/2303-community-feedback-plotting-the-future-of-pediatric-ibd-research | News on pediatric IBD planning |
14. Sorriso Pharmaceuticals SOR102 Phase 1b UC data (Magnify / CNSI) | https://magnify.cnsi.ucla.edu/2025/02/27/february-27-2025-sorriso-pharmaceuticals-presents-positive-sor102-phase-1b-ulcerative-colitis-data-at-ecco-conference/ | Industry / conference report |
15. Advancing Crohn's research - AI grant (WashU MIR) | https://www.mir.wustl.edu/advancing-crohns-disease-research-3-2-million-grant-supports-ai-integration/ | Institutional news on AI funding |
16. Additional IBD resources hub (optional) | https://www.crohnscolitisfoundation.org/research/grants-fellowships | Research funding & priorities (Crohn's & Colitis Foundation) |