When someone living with lupus also has other health conditions, it can be hard to tell which condition is causing certain symptoms.

“I’m having diarrhea and stomach pain/cramping right now,” one MyLupusTeam member wrote. “Could this be pancreatitis or diverticulitis?”

Lupus can affect many organs in the body, including the organs in the gastrointestinal (GI) tract. When lupus affects the GI tract, it can lead to conditions like pancreatitis and diverticulitis, along with others like liver diseases and mesenteric vasculitis (a disorder of the blood vessels in the gastrointestinal tract).

In this article, we will discuss the connection between lupus, diverticulitis, and pancreatitis, including the differences between these conditions.

Are People With Lupus More Likely To Get Diverticulitis?

Many people with lupus experience a common digestive problem called diverticulitis.

In diverticulitis, weak spots in the intestines, called diverticula, become infected and inflamed. This inflammation can cause pain, bloody stools (poop), and other complications. Lupus itself doesn’t directly cause diverticulitis. However, your risk of diverticulitis or related complications may increase if you take some lupus medications, including

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroids
• Immunosuppressants (medications that weaken the immune system to help reduce inflammation)

Complications from untreated diverticulitis may include bowel perforations or sepsis, a severe infection that can lead to organ failure and serious health consequences.

Are Diverticulitis and Pancreatitis Related?

Pancreatitis, a rare complication of lupus, is unrelated to diverticulitis. Like lupus, pancreatitis causes inflammation, but the inflammation is located in the pancreas. Pancreatitis can be caused not only by lupus itself but also by the treatments used for managing the condition. Certain medications used in lupus treatment, such as azathioprine (Imuran) and steroids, can also cause pancreatitis as a side effect.

Healthcare providers diagnose pancreatitis when blood tests show a spike in pancreatic enzymes. Some studies suggest that up to 30.5 percent of people with lupus have elevated pancreatic enzymes at any given time.

What Are the Differences Between Diverticulitis and Pancreatitis?

There are some similarities between these gastroenterology-related conditions — for instance, they all involve inflammation and may affect the gastrointestinal system.

However, diverticulitis and pancreatitis aren’t the same and don’t require the same form of treatment. Here are some factors that may help you identify the potential causes of your stomach issues.

1. Where You Feel Pain

Diverticulitis affects the intestines, whereas pancreatitis affects the pancreas. These organs are in similar areas of the body. However, diverticulitis usually causes pain in the lower left side of the abdomen. Pancreatitis pain affects the upper abdomen and sometimes spreads to the back.

One MyLupusTeam member shared their experience with pancreatitis. “I’ve had pancreatitis, and it’s very painful,” they said. “My stomach and back were hurting so badly that I had to go to the emergency room. I didn’t have diarrhea.”

2. When You Feel Pain

In diverticulitis, the pain is abrupt and intense. It may last several days until the issue resolves itself or until you seek treatment.

One MyLupusTeam member shared a scary experience they had with the sudden onset of diverticulitis: “I was at work and got incredible stomach pains, which I figured were from cramps or a pulled muscle because of my work. The following day, I was doubled over in sheer pain. My wife phoned our general practitioner, and he thought it was my appendix. They rushed me to the hospital, and it turned out to be a very long lifesaving surgery. They discovered I had diverticular disease, and my bowel was very badly infected, perforated, and about to burst.”

Pancreatitis pain tends to change based on what you eat and your body’s position. For example, it may get worse after eating, when pressing on your abdomen, or during activities like lying flat, coughing, or exercising.

This type of pain may improve when you sit upright, lean forward, or curl into a ball.

3. Which Other Symptoms Accompany Pain

Other symptoms of diverticulitis or pancreatitis may give clues about what’s causing your abdominal pain. Nausea, vomiting, fever, and burning sensations are common with both conditions — and also common in lupus. However, if these symptoms come on suddenly or get worse, it’s important to talk to your doctor to find out whether something else may be going on.

With diverticulitis, you may also experience:

• Constipation
• Bloating or a hard abdomen
• Bloody stools

Symptoms more specific to pancreatitis include:

• Indigestion
• Lightheadedness from low blood pressure
• Poor appetite
• Rapid heart rate
• Shallow breathing
• Stool with fat in it (an oily film after having a bowel movement)
• Unexpected weight loss

One MyLupusTeam member described their bout of pancreatitis: “When I had pancreatitis, I couldn’t eat or hold anything down. I had never been through so much pain in my life. I stayed in the hospital for about a month the first time. That was a few years ago, but I had it again recently and had to stay two weeks until I got better and could finally eat something.”

How Is Diverticulitis Diagnosed?

Your health care provider may use the following tests to help determine if diverticulitis is causing your pain:

• CT scan — Can reveal pouches or inflamed areas in the intestines
• Colonoscopy — A thin, flexible tube with a camera is inserted into the rectum to examine the inside of the large intestine for abnormalities or signs of disease
• Blood, urine, and stool tests — Help identify signs of infection or inflammation that support a diverticulitis diagnosis

How Is Pancreatitis Diagnosed?

Amylase and lipase are enzymes produced by the body that help you digest food. Pancreatitis causes a spike in amylase and lipase, and this spike shows up in a blood test. Your healthcare provider may also use a CT scan or MRI to look for swelling in the pancreas.

Getting the Right Diagnosis

A MyLupusTeam member suggested answering a few key questions to help your doctor figure out what’s going on. Bringing this list — along with your answers — to your appointment can help you get the right diagnosis sooner.

Ask yourself:

• What are your symptoms like?
• When did they start?
• How long do they last?
• What makes them feel better?
• What makes them feel worse?
• Have you noticed anything that triggers the symptoms?
• On a scale of 1 to 10, how much do these symptoms interfere with your activities of daily living, and how?

Paying attention to your symptoms gives your healthcare provider valuable insight when deciding what to do next.

There are many potential causes of similar gastrointestinal symptoms, such as:

• Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease
• Liver disease
• Peptic ulcers and heartburn
• Gallstones
• Vasculitis
• Peritonitis
• Celiac disease

While it’s helpful to hear about the experiences of others, remember that people don’t always feel pain in the same way. You should rely on your rheumatology provider for an accurate diagnosis and treatment. Remember that diverticulitis and pancreatitis can be life-threatening if you develop dangerous complications.

Stay safe by never ignoring or underestimating severe abdominal pain. If you get treatment for your condition and the symptoms continue, be sure to follow up for another evaluation.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you experienced symptoms from diverticulitis, pancreatitis, or another digestive tract problem? Let others know in the comments below.