William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Diverticulosis and diverticulitis facts
- What is diverticulosis?
- What is diverticulitis?
- What are diverticulitis symptoms?
- What causes diverticula and how do diverticula form?
- What are the more serious complications of diverticulitis?
- How are the diagnosis of diverticulitis and diverticulosis made?
- What is the treatment for diverticulitis and diverticulosis?
- Medical treatment of diverticulitis and diverticulosis
- Surgical treatment for diverticulitis
- What can be done to prevent diverticulitis and diverticulosis?
- Pictures of Diverticulitis (Diverticulosis) - Slideshow
- Find a local Gastroenterologist in your town
How are the diagnosis of diverticulitis and diverticulosis made?
If suspected, the diagnosis of diverticular disease can be confirmed by a variety of tests. Barium X-rays (barium enemas) can be performed to visualize the colon. Diverticula are seen as barium filled pouches protruding from the colon wall.
Direct visualization of the inside of the colon and the openings of the diverticula can be done with flexible tubes inserted through the rectum and advanced into the colon. Either short tubes (sigmoidoscopes) or longer tubes (colonoscopes) may be used to assist in the diagnosis and to exclude other diseases that can mimic diverticular disease.
In patients suspected of having diverticulitis causing persistent pain, tenderness, and fever; ultrasound and computerized tomography (CT) examinations of the abdomen and pelvis can be done to detect inflammation of the tissues surrounding the ruptured diverticulum or collections of pus.
What is the treatment for diverticulitis and diverticulosis?
Medical treatment of diverticulitis and diverticulosis
Most patients with diverticulosis have minimal or no symptoms, and do not require any specific treatment. A normal fiber diet is advisable to prevent constipation and perhaps prevent the formation of more diverticula.
Patients with mild symptoms of abdominal pain due to muscular spasm in the area of the diverticula may benefit from anti-spasmodic drugs such as:
- chlordiazepoxide (Librax),
- dicyclomine (Bentyl),
- atropine, scopolamine, phenobarbital (Donnatal), and
- hyoscyamine (Levsin).
When diverticulitis occurs, antibiotics usually are needed. Oral antibiotics are sufficient when symptoms are mild. Some examples of commonly prescribed antibiotics include:
- ciprofloxacin (Cipro),
- metronidazole (Flagyl),
- cephalexin (Keflex), and
- doxycycline (Vibramycin).
Liquid or low fiber foods are advised during acute attacks of diverticulitis. This is done to reduce the amount of material that passes through the colon, which at least theoretically, may aggravate the diverticulitis. In severe diverticulitis with high fever and pain, patients are hospitalized and given intravenous antibiotics. Surgery is needed for patients with persistent bowel obstruction or abscess not responding to antibiotics.
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