Treating Diverticulitis

Medically Reviewed By William C. Lloyd III, MD, FACS
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Diverticulitis is a condition that occurs when tiny pouches—diverticula—along your colon wall become inflamed, infected or perforated. Diverticulitis symptoms can range from mild to severe. Symptoms can include pain in the lower left side of the abdomen, cramping, blood in the stool or rectal bleeding, nausea, diarrhea, and fever. Diverticulitis treatment focuses on preventing symptoms from occurring or managing symptoms once they start. The type of treatment your doctor suggests will depend on the severity of your diverticular disease.

Managing Mild, or Uncomplicated Diverticulitis

People who have diverticula, a condition known as diverticulosis, can develop uncomplicated diverticulitis. They generally have mild symptoms and may not need any treatment. However, if the symptoms are causing pain or discomfort, your doctor may suggest:

  • Rest at home to allow your body to relax and work on healing itself

  • Liquid diet to allow the colon wall to rest, not pushing contents towards the rectum. Ask your doctor which liquids are best and how long you should continue the diet.

  • Fiber-rich diet after the episode has ended and you no longer experience diverticulitis symptoms

  • Antibiotics if infection is present

If necessary, your doctor can prescribe medications to help relax the bowel and decrease spasms along the colon wall.

Treating Severe, or Complicated Diverticulitis

Treatment for severe or complicated diverticulitis ranges from medications to surgery. It is important to treat severe diverticulitis because untreated diverticulitis can lead to serious complications, including formation of abscesses, peritonitis, bowel obstruction, and even death. Hospital care may be necessary to stabilize patients with complicated diverticulitis.

First-line treatments may include:

  • Intravenous (IV) antibiotics

  • Medications to decrease spasms in the bowel

  • No food or drink by mouth for a set period, to reduce the workload on the colon

If these steps cannot control diverticulitis, your doctor may suggest:

  • Draining the abscess in the colon wall. Using a CT scan to see the area, a gastroenterologist or surgeon inserts a needle in your abdomen (through your skin) to remove the contents from the abscess.

  • Surgery to remove part of the bowel. After removing the affected part of the colon (colon resection), the surgeon joins the two ends.

  • Colon resection with temporary colostomy. If there is severe infection or inflammation, your surgeon may choose to make a temporary colostomy before rejoining the ends. A colostomy is an opening in the abdomen where the surgeon attaches the end of colon, allowing the contents to empty into a bag rather than be evacuated through your rectum. This gives the rest of the colon time to rest and heal until a second surgery to reattach the ends of the colon and close the opening in the abdomen. This can take about three months or longer.

Diverticulitis surgery may be performed as an emergency if your colon perforates (develops a hole) or ruptures. This can lead to life-threatening infections. If infection has spread because of the perforation or rupture, you may be on IV antibiotics for an extended period to ensure complete clearance of the infection.

Preventing Diverticulitis

You are at risk of developing diverticulitis if you’ve been diagnosed with diverticulosis. The risk is low, however. Less than 5% of people with diverticulosis develop diverticulitis. And while doctors don’t know exactly why some people develop diverticulitis and others don’t, they do believe there are some steps you can take to lower your risk.

These steps include:

  • Maintaining a healthy body weight

  • Eating a well-balanced diet, high in fiber

  • Drinking the recommended amount of fluids (usually eight 8-ounce glasses of water a day)

  • Exercising regularly

  • Avoiding constipation with your diet or supplements if necessary

Diverticulitis treatment has evolved over the years and continues to progress as doctors learn more about the condition and how to manage it. If you have diverticulitis, speak with your doctor about your treatment options and what steps you may take if your current treatments no longer seem to offer relief

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 2
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