Diverticulitis and PSA: Can Colonic Inflammation Elevate Prostate-Specific Antigen?

Diverticulitis does not directly raise PSA, but pelvic inflammation can cause transient PSA elevation.

Mechanism

• Inflamed diverticula (sigmoid colon) adjacent to prostate → inflammatory cytokines (IL-6, TNF-α) diffuse locally.
• Prostatic inflammation → increased PSA leakage into circulation.
• Typically modest rise (e.g., 4–10 ng/mL); normalizes after diverticulitis resolves (4–6 weeks).

Clinical Approach

1. Treat diverticulitis first (antibiotics, bowel rest).
2. Recheck PSA 6–8 weeks post-resolution.
3. If PSA remains elevated → proceed with prostate evaluation (MRI, biopsy per guidelines).
4. Do not biopsy during active diverticulitis (infection risk, false-positive).

Key Point

A single elevated PSA during diverticulitis is not diagnostic of prostate cancer. Context and timing are critical.