If you have diverticulitis, pouches in your large bowel have become inflamed and infected. Diverticulitis treatment may be necessary if you experience pain, bloating, wind, constipation and diarrhoea. Pouches can occur on any part of the bowel, but diverticulitis usually affects the lower part of the large bowel, which is also known as the large intestine or colon. It is also common for pouches in the part of the colon leading to the rectum to become inflamed and to bleed profusely; these often need emergency diverticulitis treatment.
Lifestyle changes and antibiotics are the primary diverticulitis treatments and these work by preventing more bowel pouches from forming and by clearing any infection that has developed. Surgical diverticulitis treatment deals with bleeding and other emergency situations such as bowel blockages and bleeding and removes the worst affected parts of the bowel.
This article on diverticulitis treatment is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
Is it always needed?
Diverticula, the bowel pouches that can lead to diverticulitis are extremely common and occur most frequently in older people. More than one bowel pouch can occur at one time, and some people may develop many pouches in different parts of the bowel. Around three-quarters of people with them experience no symptoms and their condition is described by the term diverticulosis.
The pouches often go undetected but can be discovered during investigations such as colonoscopy or barium enema for an unrelated complaint. If they are not inflamed and appear to pose no threat, diverticulitis treatment is not necessary. If you have many bowel pouches your doctor will probably recommend that you eat more fibre in your diet to stop you being constipated and to prevent more pouches forming. If you do this carefully, avoiding nuts and seeds (which can penetrate the diverticula and lead to diverticulitis), this may be the only treatment you need.
Signs that treatment is required
In about three-quarters of people with bowel pouches some of diverticula become infected or inflamed causing discomfort and illness. Diverticulitis treatment becomes necessary when symptoms start to make an impact on daily life. These can include constant, severe pain beginning beneath the navel and moving to the lower left side of the abdomen, changes in bowel habits, more frequent urination, fever, nausea and vomiting. You may experience blood in your stools due to weakness of the blood vessel in the bowel and diverticulitis treatment can prevent further stress on the bowel tissues and avoid serious complications.
Before deciding what diverticulitis treatment is best for you, your doctor or specialist will want to confirm the suspected diagnosis using specific tests. These commonly involve having a barium X-ray after a barium enema, having an endoscopy examination of the inside of the large bowel, or by ultrasound or CT scanning images.
How medical treatments work
Once the bowel pouches have become infected, antibiotics form the first-line diverticulitis treatment. For mild cases, you can take antibiotics as tablets that you swallow and these will clear the bacteria that are infecting the pouches, allowing the bowel wall to heal. During the acute phase, when you are experiencing a lot of pain and cramping, you will also need to rest and take only liquids so that no hard material passes through the large bowel. This prevents damage to the inflamed diverticula that could result in a more serious bowel abscess, or a completely blocked bowel.
In more serious cases, when there is severe pain and also a high fever, some people need to be taken into hospital where their condition can be monitored more closely. Diverticulitis treatment again includes antibiotics, but these are given as injections so that they tackle the infection more quickly. You may also have tests to find out which types of bacteria are causing the infection, so that your diverticulitis treatment can be targeted more effectively.
In some cases, there are so many bowel pouches that have become infected and inflamed that it is not possible to limit diverticulitis treatment to antibiotics. Indications for surgery include:
- Repeated doses of antibiotics do not clear up the infection and symptoms get worse.
- Antibiotics may work temporarily, but diverticulitis symptoms keep coming back with several severe attacks.
- Having a segment of large bowel with many pouches; some may have ruptured and are bleeding, causing heavy blood loss.
- Some of the pouches penetrate through the bowel into the bladder, causing severe bladder infection.
- You have so many pouches that your bowel is almost blocked.
Surgical diverticulitis treatment aims to remove the part of the large bowel that is the source of the problem. Often, diverticula are concentrated in the sigmoid bowel and this can be removed, and the bowel rejoined without any long term problems. Surgery is done using a keyhole technique so that the incision and scar is minimal.
Life after treatment
Whatever type of diverticulitis treatment you have, it is important to consider lifestyle changes after treatment to try to prevent more bowel pouches forming. Your doctor or consultant can advise you on the best ways to change your diet to increase your intake of fibre without risking damage to any diverticula that you still have. Using a combination of careful eating, drinking plenty of fluids to avoid constipation, and seeking medical advice as soon as symptoms re-appear, emergency diverticulitis treatment can be avoided in the future.