Treatment for Diverticular Disease

How do doctors treat diverticular disease?

Your doctor will recommend treatments based on whether you have chronic symptoms of diverticula, diverticulitis, or other complications of diverticular disease.

Chronic symptoms of diverticula

If diverticula cause chronic symptoms, your doctor may recommend one or more treatments, such as

• high-fiber foods or fiber supplements
• antibiotics
• medicines to reduce inflammation
• probiotics

For safety reasons, talk with your doctor before using probiotics or any complementary or alternative medicines or medical practices.

Diverticulitis

For people who have diverticulitis without complications, doctors may recommend treatment at home. However, people typically need treatment in a hospital if they have severe diverticulitis, diverticulitis with complications, or a high risk for complications.

Treatments for diverticulitis may include

• antibiotics, although not all people with diverticulitis need these medicines.
• a clear liquid diet for a short time to rest the colon. Your doctor may suggest slowly adding solid foods to your diet as your symptoms improve.
• medicines for pain. Doctors may recommend antispasmodics or acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may increase the chance of diverticulitis complications.

If your diverticulitis doesn’t improve with treatment or if it leads to complications, you may need surgery to remove part of your colon, called a colectomy or colon resection.

How do doctors treat the complications of diverticular disease?

Doctors typically treat the complications of diverticular disease in a hospital.

Diverticular bleeding

If you have bleeding from your rectum—even a small amount—you should see a doctor right away. In some cases, diverticular bleeding may stop by itself and may not require treatment. In other cases, doctors may need to find the source of the diverticular bleeding and stop it, or give blood transfusions if a lot of blood has been lost.

Doctors can find and stop diverticular bleeding with procedures such as

• colonoscopy. During a colonoscopy, a doctor can insert special tools through the colonoscope to stop the bleeding.
• angiogram, a special kind of x-ray that uses dye to detect blood vessels in the colon. During an angiogram, a radiologist can inject medicines or other materials into blood vessels to stop the bleeding.
• surgery.

Diverticulitis complications

Doctors typically treat the complications of diverticular disease in a hospital.

Doctors may recommend different treatments for abscesses. Doctors may

• prescribe antibiotics to treat small abscesses
• drain abscesses that are large or don’t improve with antibiotics
• recommend surgery after a large abscess heals, to prevent the abscess from coming back

Doctors typically recommend surgery to treat other diverticulitis complications, including

• fistulas
• intestinal obstruction
• perforation
• peritonitis

Can I prevent diverticulitis?

In some cases, doctors may recommend lifestyle changes or surgery to prevent diverticulitis.

Lifestyle changes

Research suggests that certain lifestyle factors may lower the risk of developing diverticulitis. These factors include

• eating a diet high in fiber and low in red meat
• being physically active on a regular basis
• not smoking, or quitting smoking if you smoke
• reaching and maintaining a healthy weight

Talk with your doctor about whether you should take steps to lower your risk of diverticulitis.

If you had diverticulitis in the past, talk with your doctor about whether lifestyle changes may lower your chance of having diverticulitis again. Also, talk with your doctor about the medicines you take and whether they could increase your risk of diverticulitis.

Surgery

In some cases, after a person has diverticulitis without complications, doctors may recommend surgery to remove part of the colon and prevent diverticulitis from occurring again. Whether a doctor recommends surgery depends on the person’s history of diverticulitis, health conditions, and other factors.