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Treatment of Diverticulitis

Diverticulitis occurs when pouches that have developed in the weak spots of the intestinal walls, which are called diverticula, become infected or inflamed.  These infected or inflamed pouches will cause one or more of the following symptoms: cramping, severe abdominal pain, bleeding of the rectum, vomiting, diarrhea, constipation, chills, or urinary tract infections. 

Once the doctor has diagnosed diverticulitis as the culprit, the treatment will vary according to the severity of the infection and/or inflammation and whether this is a first time or recurrent attack. 

  • Level 1 Treatment
    If the symptoms are mild then in addition to antibiotics a liquid or low fiber diet will be all you need.

  • Level 2 Treatment
    If the symptoms are a bit more than mild your doctor will usually recommend you stay home and keep it mellow and quite for a few days, give your colon a rest and heal time.  You will be more than likely put on an antibiotic to rid the infection, take the full course of antibiotic medications to insure the infection is completely gone.  For pain the doctor may prescribe a pain medication or suggest an over the counter pain reliever, keep in mind these can cause constipation and could aggravate the problem so take them only if necessary.

    Keep away from all fruits, vegetables, and whole grains (basically stick to a low fiber diet).  Generally within 3-4 days you should begin to show improvement and can slowly add high fiber foods back in to your diet.  You may also want to consider taking a daily psyllium seed supplement (stool softener) for about 30 days to get your body back into its regular routine.
  • Level 3 Treatment
    Should your attack be severe with a fever above 100F, vomiting, severe abdominal pains, or a high white blood cell count there is a higher risk of complications and a hospital stay will be necessary.  Don’t go into a panic just about ½ of diagnosed cases of diverticulitis require hospitalization and quite a few require aggressive treatments that include intravenous antibiotics.  Just think a few days off your feet and some great meal choices!

  • Level 4 Treatment
    About 20% of people with diverticulitis will require surgery because either the symptoms do not improve, there may be a rupture, fistula, severe bleeding, or your case of diverticulitis recurs often.  The doctor will recommend removing the diseased section of the colon and reattach the two healthy sections back together.  If there is a rupture or larger diseased section the surgeon will need to perform two surgeries, the first to remove and repair the intestine and create a temporary colostomy.  Once the area has healed, generally 12 weeks later they will go back in for the second surgery to reattach the two healthy ends of the intestine back together and close the colostomy.  For a few this surgery may not work and the colostomy may become permanent, if this is the case it’s not the end of the world, colostomy has come a long way.

    Sometimes an abscess can be drained by inserting a needle and using a CT scan first, if this is successful then surgery will not be necessary.

When you are diagnosed, follow the treatment recommendations that your doctor has given you.  If you are questionable get a second opinion.  This is your body we are talking about and a pro active stand is important.  Research all you can about your condition, write down any questions you have and ask your doctor for the answers.  Check out support groups in your area or online and see what others have experienced and seek their advice.  Take it all in so you can better understand your condition and how to manage it.

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