digestive disorders
Diverticulitis
Treatment of Diverticulitis
For mild diverticulitis, rest For severe diverticulitis, no food or fluids by mouth and antibiotics Sometimes surgery Mild diverticulitiscan be treated at home with rest. Diverticulitis symptoms usually lessen rapidly. There are no diet restrictions for people who have mild diverticulitis. Severe diverticulitisrequires different treatment. People who have severe symptoms, such as abdominal pain, body temperature above 101°F (38.3°C), and other evidence of serious infection or complications, are hospitalized. In the hospital, people are given fluids and antibiotics by vein (intravenously), kept on bed rest, and given nothing by mouth until the symptoms subside. People stay in the hospital until their symptoms go away. They can then eat soft foods. Once the episode has ended, people can eat high-fiber foods. To decrease the risk of recurrence, people should avoid using nonsteroidal anti-inflammatory drugs (NSAIDs). After 1 to 3 months, people have a colonoscopy to evaluate the colon. For some people, including those who have small abscesses, rest and sometimes antibiotics are all that are needed to treat severe diverticulitis. Larger abscesses and abscesses that do not go away with only antibiotics or are getting worse are drained with a needle inserted through the skin and guided by a Computed Tomography and Magnetic Resonance Imaging of the Digestive Tract or an If drainage helps, people remain in the hospital until symptoms have been relieved and they have resumed a soft diet. If drainage does not help, people need surgery. Emergency surgery is necessary for people whose intestine has ruptured or who have peritonitis. Other people who need surgery include those who have severe diverticulitis symptoms that are not relieved by nonsurgical treatment (such as antibiotics) within 3 to 5 days. People who have increasing pain, tenderness, and fever also need surgery. The surgeon removes the involved section of the intestine. The ends are rejoined immediately in healthy people who do not have a perforation, abscess, or severe intestinal inflammation. Other people need a temporary colostomy. A colostomy is an opening between the large intestine and the skin surface. About 10 to 12 weeks later (or sometimes longer), after the inflammation has gone away and the person's condition has improved, the cut ends of the intestine are rejoined during a follow-up operation, and the colostomy is closed. In a colostomy, the large intestine (colon) is cut. The healthy end of the large intestine, which is before the blockage, is brought to the skin surface through a surgically created opening in the abdominal wall. It is then stitched to the skin of the opening. Stool passes through the opening and into a disposable bag. The colostomy allows the remaining part of the large intestine to rest while the person recovers. After the person recovers from the surgery and the colon heals, the two ends can be reattached so that stool can pass normally. Fistula treatment involves removing the section of large intestine where the fistula begins, rejoining the cut ends of the large intestine, and repairing the other affected area (for example, the bladder or small intestine). Sometimes, after talking with their doctor, people choose to have elective surgery (surgery that is not needed immediately and can be put off for some time) to manage their diverticular disease. Elective surgery is typically considered for people who have had multiple attacks of diverticulitis or for those who have a complication such as narrowing of the colon due to scarring. 