In general, your
treatment depends on the severity of your symptoms and whether this is your
first attack of diverticulitis. If your symptoms are mild, a liquid or
low-fiber diet and antibiotics may be all you need. But if you're at risk of
complications or have recurrent attacks of diverticulitis, you may need more
advanced care.
Home care
If your condition calls for home treatment,
expect to remain quiet for a few days. You'll also temporarily need to avoid
all whole grains, fruits and vegetables, so your colon can rest and heal. Once
your symptoms improve — often in two to four days — you can gradually start
increasing the amount of high-fiber foods in your diet.
In addition, your
doctor will likely prescribe antibiotics to help kill the bacteria causing your
infection. Even if you start feeling better, be sure to finish your entire
course of medication. Stopping too soon could cause your infection to come
back. It also helps create strains of bacteria that are resistant to
antibiotics. If you have moderate or severe pain, your doctor may recommend an
over-the-counter pain reliever such as acetaminophen (Tylenol, others) or a
prescription pain medication, although these medications tend to be
constipating and may aggravate the problem.
Hospitalisation
About half the people with diverticulitis
require hospitalisation and many need intravenous antibiotics. You're more
likely to be hospitalized if you have vomiting, a fever above 100 F, a high
white blood cell count or are at risk of complications such as a bowel
obstruction or peritonitis. You're also likely to need additional care if you
are older, have another disease or have a weakened immune system.
Surgery
If you have recurring diverticulitis, your
doctor may recommend surgery to remove the diseased part of your colon. There
are two types of surgery:
Primary bowel
resection. This is the standard surgery for people with
diverticulitis. Your surgeon will remove the diseased part of your intestine
and then reconnect the healthy segments of your colon (anastomosis). This
allows you to have normal bowel movements. Depending on the amount of
inflammation, you may have open (traditional) or laparoscopic surgery. In open
surgery, your surgeon makes one long incision in your abdomen, while
laparoscopic surgery is performed through three or four tiny incisions. You'll
heal faster and recover more quickly with laparoscopic
surgery. Unfortunately,
it may not be an option if you are very overweight or have extensive
inflammation.
Bowel resection with
colostomy. This surgery may be necessary if you have so
much inflammation in your colon that it's not possible to rejoin your colon and
rectum. During a colostomy, your surgeon makes an opening (stoma) in your
abdominal wall. The unaffected part of your colon is then connected to the
stoma, and waste passes through the opening into a bag. A colostomy may be
temporary or permanent. Several months later — once the inflammation has healed
— your surgeon may be able to perform a second operation to reconnect your
colon and rectum.