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Every so often, an acute resurgence of the original symptoms may appear; this is known as a "flare-up". Depending on the circumstances, it may go away on its own or require medication. The time between flare-ups may be anywhere from weeks to years, and varies wildly between patients – a few have never experienced a flare-up. [120]
The risk of complications, such as peritonitis or perforation, is greater during the first episode of diverticulitis, and the risk reduces with each recurrence. People who are immunocompromised have a 5-fold increased risk of recurrence with complications, such as bowel perforation, compared to immunocompetent people.
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Complicated acute diverticulitis is distinguished from uncomplicated diverticulitis by the presence of abscess or colonic perforation. Chronic smoldering diverticulitis is caused by recurrent acute diverticulitis that does not respond to medical treatment but does not progress to complications such as abscess, peritonitis, enteric fistula, or ...
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Update: A bit more clarity on this point. A lot of patient information in the US and UK seems not to make a clear distinction between what to do in order to manage the condition generally, and what to do if you have an acute episode of the condition - i.e. a "flare up". According to official UK guidelines, during a flare up...