Treatment for diverticulitis depends on the severity of a person’s symptoms as well as their overall health goals and needs. Since diverticulitis can lead to complications in some cases, treatment may also require management of these additional issues. To ensure treatments are modified to meet each person’s needs, it’s important to consult with a doctor before employing any of the following interventions.
Antibiotic medications are used to treat infections caused by bacteria. In mild cases of diverticulitis, however, they may not be indicated. In complicated cases involving more severe infections, antibiotics may need to be provided intravenously instead of in pill form.
Common antibiotic medications used to treat diverticulitis include:
- Metronidazole (e.g., Flagyl®)
- Ciprofloxacin (e.g., Cipro®)
- Trimethoprim-sulfamethoxazole (e.g., Bactrim®)
- Amoxicillin and clavulanic acid (e.g., Augmentin®)
Over-the-counter pain medications such as acetaminophen (e.g., Tylenol®) may help alleviate cramps and pain associated with a flare-up. Many people also use heating pads and other drug-free pain relief techniques to ease discomfort.
Many doctors recommend a liquid diet for a few days during a diverticulitis flare-up in order to help the irritated intestinal tract “rest” and heal. Solid foods, including foods with more fiber, may be slowly introduced as symptoms resolve.
In certain cases (generally speaking, severe, complicated, and/or frequently recurring ones) surgery may be indicated. The two main types of surgery used for diverticulitis include a bowel resection with anastomosis and a bowel resection with a colostomy.
- Bowel resection with anastomosis: a surgeon removes inflamed and damaged parts of the large intestine, then reconnects the healthy segments together (anastomosis). This can be done in a minimally invasive (laparoscopic) procedure or through an open abdominal surgery.
- Bowel resection with colostomy: this surgery is done if there is so much inflammation in the colon that it’s not possible to reconnect the colon to the rectum. A surgeon will create an opening (stoma) in the abdominal wall, which is then connected to the healthy part of the colon. Then, instead of going through the rectum, waste is excreted through the stoma and collected in a bag attached over the opening. A colostomy can be “reversed” in some cases once the inflammation has improved enough for the colon to be reconnected to the rectum.
Can diverticulitis go away on its own?
Mild cases of diverticulitis can go away on their own without any special treatment. But diverticulitis may lead to complications or more severe symptoms that require medical attention. Even when diverticulitis flare-ups go away, the diverticula (small pouch-like growths on the walls of the large intestine) will remain. So, it’s possible for diverticulitis to recur.
What triggers diverticulitis flare-ups?
It’s not entirely clear what causes diverticulitis flare-ups or “attacks.” Most experts agree flare-ups can occur due to a combination of factors, including diet (especially diets that are high in fat and sugar), stress, physical inactivity, other lifestyle habits, and genetics. About one third of people who have one episode of diverticulitis will experience recurring flare-ups.
Some people find that certain types of food trigger their diverticulitis symptoms; many of these foods are also thought to trigger other gastrointestinal diseases like irritable bowel syndrome. They include:
- Brussels sprouts,
- nuts, and
- anything with added sugar (including juices and soft drinks).
Not everyone who has diverticulitis have trouble eating these foods, however, so it really depends on the individual.
How long does a diverticulitis flare up last?
Uncomplicated and mild cases of diverticulitis can resolve within a few days to a week. If a person receives medical treatment for their symptoms (such as oral antibiotics), relief can be seen within a day, with significant improvement seen after 3 to 5 days. Complicated cases of diverticulitis may take longer than 10 days to heal.