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Diverticulitis occurs in people with diverticulosis. It most commonly affects the sigmoid colon, which is the last part of the large intestine just before the rectum. Diverticulitis is more common in people older than 40. It can be severe in people of any age, although it is most serious in the elderly, especially those taking corticosteroids or other drugs that suppress the immune system and thus increase the hazards of infection.


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.

About half the people with diverticulitis require hospitalization and many need intravenous antibiotics. You're more likely to be hospitalized if you have vomiting, a fever above 39 C, 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.

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.

Diverticulitis > 1 > 2 > 3 > 4

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Last Modified : 03/15/08 12:22 AM