Individuals over 70 years old commonly develop diverticulitis but people in their 30’s and 40’s can experience signs of this digestive tract condition. Abdominal pain presenting on the left side of the body or blood in the stool, though common for numerous ailments could be an indicator of diverticulitis.
Nearly 200,000 individuals in the United States are diagnosed with diverticulitis every year. If you have been diagnosed with diverticulitis, understanding your condition and how to manage your symptoms naturally, with medication, or surgically, is necessary to maintaining health and wellness.
Diverticulitis is a condition in which small pouches, called diverticula, develop in the intestines and become inflamed or infected. Diverticula, or the pouches, alone are not harmful and are referred to as diverticulosis. Undigested food can get caught in the diverticula and cause irritation and inflammation. Once the pouches become infected and diverticulitis has formed, treatment is needed.
If left untreated, diverticulitis can lead to an abscess in the lower part of the bowel called the sigmoid colon. Bowel obstruction, diverticular bleeding, or internal bleeding into the large bowel can also occur if diverticulitis symptoms are ignored.
Abdominal pain in the lower left quadrant is one of the main symptoms associated with diverticulitis. Fever, chills, diarrhea or constipation, bloating, rectal bleeding, bloody stools, nausea, and vomiting are additional symptoms of diverticulitis.
Men are more likely to develop diverticulitis than women. If you are of a certain age and are experiencing these symptoms your doctor may suspect diverticulitis. Other conditions such as irritable bowel syndrome (IBS) may have similar symptoms as an episode of diverticulitis so your doctor will need to do a systematic review of your health.
Your physician will ask you numerous lifestyle questions and perform a physical examination to further determine if you need to undergo testing for diverticulitis. Individuals who do not exercise and are overweight have an increased risk of diverticulitis. Phlegmon, or the inflammation of the soft intestinal tissue, can occur in individuals who lack dietary fiber. A diet high in fats can increase the potential for pouches to develop in the intestines and become inflamed.
The use of opioids and steroids can also lead to an episode of diverticulitis. In addition, your doctor may ask if you frequently use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The use or overuse of pain relievers is also linked to episodes of diverticulitis.
A physical exam including temperature, weight, and checking the abdomen for tenderness is part of the process of diagnosing diverticulitis. Women often undergo a pelvic exam and a pregnancy test to rule out other conditions including the possibility of pregnancy.
Generally, patients concerned about diverticulitis may need to submit urine or stool samples. Blood tests may also be required to check for an increased white blood cell count that could indicate an infection. Once the results of the blood and urine are examined (or if there is an urgent need) a CT scan, x-rays, or colonoscopy can be ordered to confirm a diagnosis of diverticulitis.
CT scan is short for computed tomography scan. An intravenous (IV) contrast solution or oral contrast solution such as barium sulfate is often used to identify conditions like diverticulitis in the large intestines or bowels. The contrast solutions used for CT scans allow better visibility of the body’s internal workings. The severity of the condition can also be determined through this process.
Similar to CT scans, x-ray technology can be used to examine the intestines. Again, a contrast solution creates a better image for the radiologist to review for diagnosis. X-rays of the lower GI tract can be assessed for complications associated with diverticular disease. An x-ray will show if the peritoneum is inflamed or if the diverticulum is blocked with stool.
Colonoscopy is an internal examination of the colon and lower bowels. A lit tube with an image transmitter (camera) is inserted in the rectum to gain visual access to the problem area. The doctor will be able to see diverticula and determine what treatment options are needed. In addition, a colonoscopy can help eliminate other conditions such as colon cancer.
Mild diverticulitis may heal with diet modifications, stool softener, rest, or oral antibiotics to fight infection. If the diverticulitis disease progresses to acute diverticulitis due to lack of treatment, intravenous antibiotics and even surgery may be necessary to properly treat the condition.
Your physician may refer you to a diagnostic radiologist or gastroenterologist, or digestion specialist to determine if surgery is necessary.
Antibiotics and anti-spasm medications are included in the possible pharmaceutical treatments recommended for the management of acute diverticulitis.
Antibiotics are utilized for treating infections that can occur in acute diverticulitis. Ciprofloxacin, levofloxacin, metronidazole, amoxicillin-clavulanic, and moxifloxacin are typically prescribed to treat infection related to diverticulitis.
Muscle relaxants may be helpful in reducing spasms in the large intestine as a result of peritonitis or irritated soft tissue. Levbid may be prescribed to aid spastic muscles related to diverticulitis.
Treating diverticulitis with prescription medication can often prevent the need for surgical intervention. Below is a list of some of the top medicines that are used in treating diverticulitis.
Best medications for diverticulitis | ||||
---|---|---|---|---|
Drug name | Drug class | Administration route | Standard dosage | Most common side effects |
Levbid (hyoscyamine sulfate ER) | Antispasmodic | Oral | 0.375 mg tablet with 12-hour release twice daily | Tightening of chest, confusion, blurred vision |
Anaspaz (hyoscyamine) | Antispasmodic | Oral | 0.125 mg dissolving tablet | Anxiety, trouble breathing, dizziness |
Augmentin (amoxicillin-clavulanate) | Antibiotic | Oral | One extended-release tablet every 12 hours | Rash, nausea, vomiting |
Flagyl (metronidazole) | Antibiotic | Oral | 500 mg tablet as directed by a doctor | Dizziness, headache, confusion |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
Prescription medicine, such as antibiotics or anti-spasm medications, is often needed to fight infection and reduce internal stress associated with diverticulitis. Every medication has a list of potential side effects. The most common side effects of diverticulitis medication are nausea, vomiting, headache, dizziness, and confusion. Additional side effects are also listed in the table above.
See your medication label or talk to your doctor or pharmacist for more information regarding the side effects associated with your prescription. Be sure you are taking your medication as prescribed and follow-up with your doctor if your medication is causing you unwanted side effects.
A variety of home remedies can naturally help relieve diverticulitis, especially mild cases. Rest is often recommended for individuals whether you have mild or acute diverticulitis. A liquid diet or a clear liquid diet is another way to allow the intestinal tract to naturally heal.
A liquid diet allows the bowels to empty and inflammation to clear up on its own. Undigested food debris can be flushed out of the bowels during a liquid diet regiment and bloating pressure can be relieved. Broth, ginger ale, tea (especially green tea) and clear sports drinks can be consumed while on a clear liquid diet. Juices, such as apple or white grape can give you energy while you are cleansing and resting the intestines. As long as the juice does not contain pulp, almost any juice can work. A less strict liquid diet or soft food diet can also be beneficial if you are suffering from diverticulitis. Gelatin and apple sauce are among many foods that can soothe an infected bowel.
If you are not able to go completely to a liquid diet, a modified diet reducing foods that aggravate the diverticula is suggested. In addition to eliminating diverticulitis triggers, individuals are recommended to increase the intake of foods that support digestive health.
Avoid red meat, fried foods, nuts, corn, and sugary foods. Some individuals are irritated by dairy while others are soothed by dairy. Take personal notes on what foods trigger or comfort your intestines.
A high fiber diet is recommended for digestive health. If you are consuming solid foods, whole-grain breads, pastas, and cereals can be incorporated into your daily meal plan. Adding almost any kind of beans, rice, many vegetables (potatoes or squash), and fruits (pears, peaches, and apples) can increase your fiber intake. Prune juice is also helpful for bowel health.
Green tea, aloe vera juice, turmeric, spinach, garlic, and ginger have healing properties that support healthy digestion. Superfoods are sometimes considered natural medicines, so ask your doctor about what superfoods you can include in your daily diet.
Digestive enzymes and probiotics are available over the counter to promote healthy digestion. Enzyme supplements, similar to the enzymes that occur naturally in your stomach can be taken to increase your body’s ability to digest food.
Management of acute uncomplicated diverticulitis may include the use of probiotics. Probiotics support healthy bacteria in the gut allowing better digestion. Naturally found in fermented foods like sauerkraut and yogurt, probiotics can be purchased in powder or capsule form. Taking a daily probiotic can help aid digestive health and normalize bowel function. If you are taking an antibiotic your doctor may recommend a probiotic to counterbalance the removal of necessary bacteria as a result of the medication. The current literature is inconclusive regarding the impact of probiotics on diverticulitis, however, more research is needed in this area.
Fiber supplements such as Metamucil can help keep bowels moving on a regular basis. Usually, fiber comes in a powder mix that is added to water and swallowed once a day, usually in the morning. Fiber substances may initially cause bloating and gas but over time can be extremely helpful in reducing constipation that puts stress on the colon.
Colonics or colon hydrotherapy is a method of irrigating the colon using large volumes of water. While a colonic can be helpful in cleaning out the bowels, especially if you are constipated, there are risk factors involved. The colonic process could be irritating to the intestinal tissue and cause damage. Data regarding its beneficial effects for patients with diverticulitis is limited and safety is a concern. If you have diverticulitis and are considering getting colon hydrotherapy, consult your doctor first.
Age and stress on the colon from constipation over the course of a lifetime can lead to diverticulitis. Diverticulitis is irritated by undigested foods that get trapped in pockets in the intestinal lining.
Rest and a low impact diet such a liquid regiment or soft food meals can naturally alleviate diverticulitis. Antibiotics are often utilized to treat diverticulitis infections.
Pain in the lower left quadrant of the abdomen, bloating, and stomach cramps are typical for diverticulitis pain. The pain may last a few hours to a few days, but is typically not severe and often described as “uncomfortable.”
Generally, diverticulitis is not a serious condition, but if left untreated it may require colon resection surgery.
Fried foods and red meat may irritate the intestinal lining causing a diverticulitis flare-up. Other foods like nuts and corn that often go through the body undigested can get caught in the diverticula, also causing inflammation.
While stress can weaken the immune system and the body’s ability to function, there is not a direct correlation between stress and diverticulitis disease.
Dr. Anis Rehman is an American Board of Internal Medicine (ABIM) certified physician in Internal Medicine as well as Endocrinology, Diabetes, and Metabolism who practices in Illinois. He completed his residency at Cleveland Clinic Akron General and fellowship training at University of Cincinnati in Ohio. Dr. Rehman has several dozen research publications in reputable journals and conferences. He also enjoys traveling and landscape photography. Dr. Rehman frequently writes medical blogs for District Endocrine (districtendocrine.com) and hosts an endocrine YouTube channel, District Endocrine.
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