Diverticular Disease

How Is Diverticular Disease Treated?

Many people with diverticular disease have no symptoms and require no treatment. Treatment is required if symptoms develop.

Usually symptoms can be treated successfully, and most people who have an episode of inflamed diverticular disease do not suffer a recurrence.

If serious complications do develop, surgery may be required to remove the affected parts of the colon. But few people with the disease require surgery.

Treatment of diverticular disease may include:

• Treating acute symptoms
• Maintaining fiber in the diet
• Treating serious complications
• Surgery

Treating Acute Symptoms

When diverticula become inflamed, causing symptoms such as pain, fever, and chills, a doctor will typically prescribe antibiotics and a liquid diet until symptoms subside.

Hospitalization may be necessary if an infection is severe or if a person feels intense pain. In the hospital, the patient receives antibiotics and fluids through a vein. Antibiotics can usually cure an infection in a few days if there are no further complications.

Maintaining Fiber In The Diet

Usually, all that is prescribed once the initial inflammation passes is a high-fiber diet. A doctor may also suggest the use of stool softeners and mild pain medications

Treating Serious Complications

Serious complications require immediate surgery. Complications that are slightly less severe can usually be treated with planned surgery or other interventions.

• Bleeding from the rectum – Often, bleeding from the rectum stops soon after it starts. But if it does not, a colonoscopy may help avoid surgery. A long, flexible device with a light on the end is maneuvered through the colon to find the bleeding diverticula. At the same time, drugs or cautery devices (which burn wounds shut) can be introduced into the colon to stop the bleeding.
• Abscess – Antibiotics will usually clear up most small abscesses. Larger ones may need to be drained. A doctor will insert a thin tube (a catheter) through the skin and into the abscess to drain it. If the abscess cannot be drained successfully, surgery may be necessary to clean away the abscess or, in severe cases, remove part of the colon.
• Perforations and peritonitis – Peritonitis, an infection of the lining of the abdomen caused by a perforation (tear) in the colon, can be fatal. Immediate surgery is required to clean the infected parts of the abdomen and remove the perforated part of the colon.
• Intestinal obstruction – When scarred tissue blocks the intestine, surgery is required to clear the blockage.
• Fistula – The most common kind of fistula (an abnormal connection between two organs) is between the colon and bladder in men. This is corrected with surgery. The connection is freed and the damaged part of the colon is removed.

Surgery

When doctors perform surgery on patients with diverticular disease, they typically remove the diseased part of the colon and reattach the remaining sections back together. This procedure is called resection.

Sometimes, resection will involve two operations:

1. In the first, surgeons remove the diseased part of the colon and perform a colostomy, a procedure in which part of the colon is attached to the skin through a temporary opening made in the abdominal wall. A bag is attached to the skin to drain the stool.
2. After the infection clears up, the cut ends of the colon are reattached together in a second operation, and normal bowel function is restored. The hole in the skin is surgically closed and will heal.