Is diverticulitis treatment 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 diverticulitis 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 diverticulitis 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.
Surgical diverticulitis treatment
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.