Diverticulitis - Treatment Overview

Treatment Overview

You may have a brief (acute) bout of diverticulitis that goes away with home treatment such as increasing fiber in your diet. However, in some cases the condition occurs off and on (intermittently) over the long term (chronic). Treatment is the same in both cases, unless complications develop.

Initial treatment

Treatment for diverticulitis depends on the severity of your symptoms. If the pain is mild, you are able to drink liquids, and you have no signs of complications, treatment may include:

• Medicines such as antibiotics and pain relievers.
• Changes in diet, starting with a clear-liquid or bland diet that is low in fiber until the pain goes away, then increasing the amount of fiber.

Although some people avoid nuts, seeds, berries, and popcorn, believing that these foods might get trapped in the diverticula and cause pain, there is no evidence that they cause or worsen diverticulitis.³

If the pain is severe, you are not able to drink liquids, or you have complications of diverticulitis, hospitalization is necessary. Treatment will include:

• Receiving antibiotics in a vein (intravenous, or IV).
• Receiving intravenous fluids and nutrition only (no food or drink by mouth) for up to a week to allow the bowel to rest.
• Keeping the stomach empty by sucking out the contents through a tube passed up the nose and down the throat into the stomach (nasogastric or NG tube). This may be needed if you are vomiting or have abdominal swelling.
• Performing surgery either for complications of diverticulitis or if you have had repeated attacks that are not helped by changing your diet. Overall, less than 8% of people with diverticulitis (1 in 12) need surgery.⁴

Most cases of promptly treated diverticulitis will improve in 2 to 3 days.

Ongoing treatment

Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack. Treatment may include:

• Gradually increasing the amount of fiber in the diet through fruits, vegetables, wheat bran, and possibly the regular use of a fiber supplement.
• Getting plenty of fluids daily.
• Having regular doctor visits to monitor your condition. If you have diverticulitis, the health professional may see you about 2 days after treatment begins to make sure you are improving. A colonoscopy or barium enema X-ray probably will be done about 6 weeks later, after symptoms are under control, to look for any other problems, such as inflammatory bowel disease or colon cancer.

Treatment if the condition gets worse

In some cases, complications of diverticulitis, such as an abscess, perforation, or bowel obstruction, can develop. Surgery to remove the affected part of the intestine usually is needed to treat these conditions.

Nonurgent (elective) surgery also may be done for diverticulitis if you have had two or more severe attacks, which usually indicates a greater chance of having future attacks.⁵