Diverticulosis, the development of small pouches on the colon, most often on the left side, often occurs as people age. Around 50 percent of people between the ages of 60 and 80 have diverticulosis, which affects men and women equally, according to Aetna IntelliHealth. Infection or inflammation in diverticula, called diverticulitis, occurs in between 10 and 25 percent of people with diverticulosis at some point, the same source adds. Symptoms include pain, usually on the lower right side of the abdomen and fever. Treatment depends on the severity of the disease.
Antibiotics
Oral antibiotics to treat infection generally treat mild cases of diverticulitis, but severe cases often require intravenous antibiotic administration in the hospital. Antibiotics must be taken for the full time prescribed, MayoClinic.com warns, to avoid the infection returning or the development of resistant bacterial strains. If an abscess, a walled off area of infection, develops, drainage or surgical removal will be necessary because antibiotics can't reach the infected area. A needle is inserted into the abscess under ultrasound or CT scan guidance, followed by placement of a catheter, to drain pus from the abscess.
Rest
A liquid diet allows the bowel to rest and heal. Diet is gradually advanced, starting with soft, low-fiber foods. A high-fiber diet can be resumed after a month, the Merck Manual advises. Increased fiber in the diet decreases the chance of diverticular disease. Bed rest may be prescribed along with bowel rest.
Surgery
Around 20 percent of people with diverticulitis require surgery, according to the Merck Manual Online Medical Library. If the intestine ruptures, peritonitis, infection of the abdominal cavity, can occur. Peritonitis leads to death in up to 35 percent of cases, Aetna IntelliHealth warns. If the infection is contained in one area of the bowel, only that area may be removed, and the remaining healthy parts of the bowels are joined together. It's sometimes possible to perform surgery laparoscopically, through a few small incisions rather than through one large incision. Recovery time is shorter and pain decreased after laparoscopic surgery compared to open surgery, or laparatomy.
In widespread infection, a large portion of bowel may need to be removed. There may not be enough bowel left to connect to the rectum in this case. Creation of a permanent colostomy diverts stool from the bowel to an opening in the abdominal wall. Elimination through the rectum is no longer possible.
