Colon Diverticulosis Treatment
Asymptomatic diverticulosis requires no specific treatment. Patients are advised to have a high-fiber diet which helps to keep stools soft and bulky, thus reducing pressure inside the colon. High-fiber diet includes:
- Wholegrain breakfast cereals
- Wholewheat bread and pasta
- Whole grains, fruits and vegetables
- Beans and legumes
Fiber supplements, such as psyllium husks available at pharmacies and health shops may be a good alternative to a natural high-fiber diet. Patients on a high-fiber diet should also drink lots of fluids, like water and tea.
Episodes of mild diverticulitis can be treated at home with a course of oral antibiotics, bowel rest and painkillers like paracetamol. Patients are also encouraged to take plenty of water and clear fluids.
If symptoms are more severe and prolonged (i.e. fever) you may need to be admitted to hospital to receive IV antibiotics, fluids via a drip and painkilling injections.
In cases of complicated diverticulitis with abscesses, perforation and purulent/faecal peritonitis, urgent surgical intervention is required and emergency colectomy is performed. In the emergency setting, two scenarios are possible:
- Primary bowel resection. The diseased part of the bowel is resected and the remaining healthy bowel is reconnected with an anastomosis.
- Bowel resection with colostomy. Sometimes the inflammation of the affected bowel makes it impossible for the surgeon to resect and reconnect the bowel. As a result, the surgeon performs a colostomy, that is, an opening(stoma) in the abdominal wall connected to the healthy bowel through which the stools pass into a collecting bag. Once the inflammation is eased some weeks later, the colostomy may be reversed and the bowel rejoined (Hartmann's procedure).
Elective resection of the affected bowel is generally indicated by consensus guidelines after 2 episodes of uncomplicated diverticulitis in order to prevent further attacks. Younger patients, as well as, immunocompromised patients are also advised to have elective surgery.