Diverticulitis is the inflammation of pouches, or diverticulum, that form in the intestinal wall, usually in the colon. In acute cases involving bacterial infection, patients are primarily given antibiotics along with other prescription drugs, and in severe cases surgery may be required. For prevention, doctors recommend a high-fiber diet and supplements.
Intestinal pouches common
As people age, many develop diverticula, or pouches in intestinal walls. Thought to be caused by pressure, these pouches can be found in about 50 percent of people over age 60. In most cases, they don't cause a problem, but diverticulitis, or inflammation and infection, develops in a small percentage of people. Symptoms may include painful cramps in the lower abdomen, blood in stool, chills, fever, nausea, vomiting and weight loss.
Treatment depends on severity
Abdominal palpation, CT scans, colonoscopy and white blood cell counts are used to diagnose diverticulitis. Patients are usually treated first with antibiotics, according to the Merck Manual of Diagnosis and Therapy. Typical treatment includes broad-spectrum antibiotics such as ciprofloxacin, plus metronidazole or amoxicillin/clavulanate plus metronidazole. In older patients, a lower dose of metronidazole is often used. When using ciprofloxacin and amoxicillin/clavulanate, doctors often base adult dosing on kidney function. If the infection is more serious, patients are sometimes hospitalized and given antibiotics intravenously.
Antibiotics usually work
Antibiotics are often effective in treating diverticulitis, but between 15 and 30 percent of patients need surgery to deal with complications such as abscesses, narrowing or blockage of the colon and a perforation of the colon, which can lead to life-threatening peritonitis, according to the British Medical Journal. In those cases, surgeons may have to remove a diseased part of a patient's colon.
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Other approaches
Doctors sometimes recommend laxatives to relieve constipation and alleviate symptoms of diverticulitis. Typically, these laxatives are based upon bran and fiber. Mesalazine, sometimes called mesalamine, is an anti-inflammatory drug that doctors also may use to treat diverticulitis. Also, antispasmodic drugs such as drudicycloverine hydrochloride, or Merbentyl, or mebeverine hydrochloride, or Colofac, may used to relax bowel muscles. Those are prescription drugs, but another antispasmotic, peppermint oil, may be purchased over the counter. However, it may cause heartburn.
Chances of recurrence
People who experience a bout of diverticulitis face higher than normal odds of a recurrence--about a one-in-three chance. After a second bout, the odds go up to a one-in-two chance of having a third recurrence. If this occurs, surgery may be required. To minimize the chances of recurrences, doctors recommend a high-fiber diet and supplements. That means lots of fruits, vegetables and whole grains.
Some doctors tell patients to avoid nuts and seeds, but there is no scientific evidence to support that recommendation.
