Sigmoid Colon 1) Diverticulitis Flareup vs 2)Smoldering vs 3)Narrowed?

Posted by bc321 @bc321, Dec 14 10:25pm

What I currently have going on is different and a mystery, so I'm interested if anyone has similar experiences. Seems it could be:

1) A Diverticulitis Flareup
2) Smoldering Diverticulitis (still not sure officially what that is) or
3) A narrowed sigmoid colon caused by repeated flareups (10-11 in 10 years).

My surgeon has decided it’s #3. It started 24Nov2025, 24 days before my now canceled sigmoid colectomy scheduled for 17Dec2025; Since 24Nov2025, 21 days, I’ve had:

A) 4 to 48 hour periods of low to medium diverticulitis-like aches in my usual lower-left-quadrant spot; mostly just when food or gas is or has recently processed through that spot.
B) No fever, chills or sensitivity to pressing on the area
C) No high white blood cell or other infection identifying lab results (blood draws last 3 days).
D) No inflammation showing on 2 CT scans (3Dec and 12Dec2025)
E) Bowel movements 10 of the last 14 and the last 6 days straight. (On Mirilax+softeners most days).
F) Similar 4 to 48 hour periods of feeling almost normal to completely normal.
G) An antibiotic shot then 10 days of Augmentin ending 8Dec2025 based solely on symptoms at the time.
H) IV antibiotics the last 2 days while hospitalized and monitoring diet and results (no change)
I) Low-Residue diet most of the 21 days, clear liquid for 2, IV for 1, full liquid for 1, and low-residue tonight as I transition home tomorrow.

The decision is that it isn't infected based on A through D above so it isn’t 1) or 2) above because if it’s diverticulitis it is infected by definition (IF “Smoldering” is defined as diverticulitis/infection). We’re moving forward with surgery on 7Jan2025, 23 days and a wakeup from tonight. I’ll be on low-residue diet and mirilax until surgery. She normally wants 6 weeks symptom free if possible, but it is what it is.

Anyone had this type of issue? I’ve only had flareups that feel like this for a couple days but then fever and pain spike, a CT scan confirms it, I get on antibiotics, and 10-14 days I’m back to normal. This one is weird for me.

Interested in more discussions like this? Go to the Digestive Health Support Group.

Janell, Volunteer Mentor | @jlharsh | 6 days ago

@bc321
You mention preparing for a January 6 sigmoid colectomy.

You no doubt have discussed detail with your surgeon. As you wait for others to comment it may help to review an overview of the procedure. I particularly like the section about what to expect following.
- Mayo Clinic Colectomy: https://www.mayoclinic.org/tests-procedures/colectomy/about/pac-20384631

How are you feeling about having your sigmoid colon removed?

bc321 | @bc321 | 5 days ago

In reply to @jlharsh "@bc321 You mention preparing for a January 6 sigmoid colectomy. You no doubt have discussed detail..." + (show)

@jlharsh Ready for it ASAP now that I have these symptoms from a prognosis of a narrowed colon. The goal is to make it 3 weeks to surgery without infection. The last 3 nights indicate even small low-residue meals of any substance cause pain/pressure 23-27 hours later. I'm testing clear liquid + protein shakes in small portions through the day to rest the colon and test if the nightly pains go away from dinner the day before. If that works I'll see if a morning low-residue meal to see if it comes back, but in the morning of the next day. I can do protein shakes and clear liquids for 3 weeks if necessary. Some have described this as what "smoldering diverticulitis" is, but there are no facts that support that it is infection-based. It seems my colon somehow somewhat suddenly narrowed enough to cause all of this and I'm guessing it will not reverse itself. I did have a full flareup 2 months prior to this starting and completely healed and was back to normal in 7-10 days, but I guess the scarring from that recovery could have continued developing and it was just enough to be the straw that broke the camel's back, so to speak. Thanks.