Rectal bleeding is distinctly uncommon in diverticulitis and should make one consider a different diagnosis. This is the most common form of diverticulitis. Patients present with acute, steady, left lower abdominal discomfort. This may be associated with alteration in bowel habits with either constipation or diarrhea. There may be a low-grade fever but the patient is not tachycardic.
Examination reveals mild left lower quadrant tenderness without an appreciable mass.
Solid foods may be started as symptoms subside and a high fiber diet instituted after resolution of the inflammation. The patient with this stage of inflammation will complain of moderate to severe left lower abdominal pain and anorexia. Alteration in normal bowel habits with constipation or diarrhea will occur. Abdominal exam reveals a tender mass and voluntary guarding in the lower abdomen. Rebound tenderness or referred rebound tenderness may be present.