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
What is the treatment for diverticulitis and diverticulosis?
Treatment for diverticulitis and diverticulosis include medications to treat abdominal pain due to muscle spasms, oral antibiotics for infection, and liquid or low fiber foods when having a acute attacks of diverticulitis.
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.
Surgical treatment for diverticulitis
Diverticulitis that does not respond to medical treatment requires surgical intervention. Surgery usually involves drainage of any collections of pus and resection (surgical removal) of the segment of the colon containing the diverticula, usually the sigmoid colon. Surgical removal of the bleeding diverticulum also is necessary for those with persistent bleeding. In patients needing surgery to stop persistent bleeding, it is important to determine exactly where the bleeding is coming from in order to guide the surgeon.
Sometimes, diverticula can erode into the adjacent urinary bladder, causing severe recurrent urine infection and passage of gas during urination. This situation also requires surgery.
Sometimes, surgery may be suggested for patients with frequent, recurrent attacks of diverticulitis leading to multiple courses of antibiotics, hospitalizations, and days lost from work. During surgery, the goal is to remove all, or almost all, of the colon containing diverticula in order to prevent future episodes of diverticulitis. There are few long-term consequences of resection of the sigmoid colon for diverticulitis, and the surgery often can be done laparoscopically, which limits post-operative pain and time for recovery.
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