Does Exercise Aggravate Diverticulitis?

Diverticulosis and diverticulitis are conditions that affect the lining of the digestive system. Because constipation appears to be a diverticulosis risk factor, you might wonder if muscle contractions during exercise could cause similar gastrointestinal problems.

Good news for exercise enthusiasts: Exercise has no causal relationship with diverticulosis. And in fact, research shows it is likely protective against painful diverticulitis attacks. While you may need to rest during a flare-up, exercise, even weightlifting, is OK when you're feeling well.

​Read more:​ Here's How Your Workouts May Be Affecting Your Gut Health

To understand the relationship between exercise and these conditions, it's important to first understand what they are.

"The distinction between diverticulosis and diverticulitis is an important one," says Danielle Kim Turgeon, MD, a double-board certified gastroenterologist and internist at the University of Michigan. "Lots of people have diverticulosis but will never get diverticulitis."

Diverticulosis is the presence of diverticula, small bulges or pockets, in the colon. They are fairly common with age, are usually asymptomatic and do not cause any problems on their own, according to the Cleveland Clinic. Diverticulitis, on the other hand, occurs when there is inflammation or infection of one or more of the diverticula.

While researchers don't know what exactly causes diverticulosis, there are many known risk factors, per the Cleveland Clinic. Risk factors that increase a person's likelihood of developing diverticulosis include:

• Being 40 or older
• Having overweight or obesity
• Being assigned male at birth
• Eating diets low in fiber
• Not exercising
• Smoking

Not eating enough fiber specifically can lead to constipation and strain on the walls of the colon, causing diverticula to form in weak areas of the muscle wall, according to the Cleveland Clinic.

Diverticulitis, per the Cleveland Clinic, is a condition that happens to a very small percentage of people who already have diverticulosis. "It's like having an appendix, but not everyone gets appendicitis," Dr. Turgeon says.

Symptoms, according to the Cleveland Clinic, can include:

• Pain
• Fever
• Nausea
• Rectal bleeding

Experts say no. "Physical activity has no known association with the development of diverticulosis," says Richard Joseph Saad, MD, a board-certified gastroenterologist and internist at the University of Michigan.

But what about weightlifting — can you lift heavy things? Dr. Saad says no repetitive activities such as weightlifting have been associated with developing diverticulosis.

While no relationship has been found between physical activity and diverticula formation, frequent exercise and physical activity can actually be a protective factor when it comes to the development of diverticulitis attacks of pain and inflammation.

In a February 2012 study in the ​American Journal of Gastroenterology​, researchers in Sweden studied the effects of lifestyle factors like exercise on diverticulitis rates by examining almost 40,000 women over a span of 12 years, focusing on 626 incidents of diverticular disease requiring hospitalization.

The results were clear: Women who had overweight and exercised less than 30 minutes a day were more likely to develop diverticular disease than women who did not have overweight and exercised more frequently. These lifestyle factors seem to indicate exercise as a protective factor.

Treatment during an acute episode of diverticulitis depends on the severity of symptoms. During a mild attack you may need to rest, take antibiotics and go on a liquid diet for a short time, according to the National Institute of Diabetes and Digestive and Kidney Diseases. More severe symptoms may require hospitalization, IV antibiotics and fasting for a period to give your colon a rest.

And while nothing can ensure full diverticulitis prevention, Dr. Saad says, exercise can't hurt — and it looks as though it could help.

For those who want to prevent diverticulosis formation in the first place, Dr. Saad recommends:

• Eating a high-fiber diet
• Quitting smoking
• Losing weight if you have obesity

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