Diverticulitis - Diagnosis and Treatment (2023)

diagnosis

Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a variety of problems, doctors need to rule out other causes of symptoms.

Your doctor will start with a physical exam and check your abdomen for tenderness. In women, a pelvic exam is also usually done to rule out pelvic disease.

Afterwards, the following tests may be performed:

• Blood and urine tests are done to check for signs of infection.
• Pregnancy testing in women of childbearing potential to rule out pregnancy as a cause of abdominal pain.
• Liver enzyme tests rule out liver-related causes of abdominal pain.
• Stool tests rule out infection in people with diarrhea.
• ACTA scan can detect an inflamed or infected sac and confirm the diagnosis of diverticulitis.CTIt can also indicate the severity of diverticulitis and guide treatment.

treat

Treatment depends on the severity of your signs and symptoms.

simple diverticulitis

If your symptoms are mild, you can be treated at home. Your doctor may recommend the following:

• Antibiotics are used to treat the infection, although new guidelines say antibiotics may not be needed in very mild cases.
• Go on a liquid diet for a few days while your bowel heals. As your symptoms improve, you can gradually add solid foods to your diet.

This treatment is successful in most patients with uncomplicated diverticulitis.

complicated diverticulitis

If you have severe seizures or other health problems, you may need to be hospitalized. Treatment generally includes:

• intravenous antibiotics
• Insertion of a tube to drain an abdominal abscess if it has formed

Operation

You may need surgery for diverticulitis if:

• You have complications such as bowel abscess, fistula, or bowel obstruction, or a hole in the bowel wall (perforation)
• You have had multiple episodes of simple diverticulitis
• your immune system is weak

There are two main types of operations:

• One-stage bowel resection.Surgeons remove the diseased part of the bowel and then reconnect the healthy part (anastomosis). This allows you to have a normal bowel movement. Depending on the degree of inflammation, open surgery or minimally invasive (laparoscopic) surgery may be needed.
• Bowel resection and colostomy.If your inflammation is so severe that you cannot reconnect your colon and rectum, your surgeon will perform a colostomy. The opening (ostomy) in the abdomen is connected to the healthy part of the large intestine. Waste enters the bag through the opening. Once the inflammation subsides, the colostomy can be reversed and the bowel reconnected.

Aftercare

Your doctor may recommend a colonoscopy six weeks after you recover from diverticulitis, especially if you haven't had it in the past year. There does not appear to be a direct link between diverticular disease and colon or rectal cancer. But a colonoscopy (which is risky during flare-ups of diverticulitis) can rule out colon cancer as the cause of symptoms.

After successful treatment, your doctor may recommend surgery to prevent future episodes of diverticulitis. The decision whether or not to have surgery is a personal decision and usually depends on the frequency of seizures and the occurrence of complications.

alternative medicine

Some experts believe that people with diverticulitis may not have enough good bacteria in their colons. Probiotics -- foods or supplements that contain beneficial bacteria -- are sometimes recommended as a way to prevent diverticulitis. However, this suggestion has not been scientifically proven.

Get ready for your appointment

You may be referred to a doctor who specializes in digestive disorders (gastroenterologist).

what can you do

• Please be aware of any restrictions before making an appointment.For example, stop eating solid food the day before your appointment.
• write down your symptomsInclude those that may not be relevant to the reason for your appointment.
• Make a list of all your medicationsVitamins and dietary supplements.
• Write down your most important medical information,including other conditions.
• Write down important personal information,Include any recent changes or stresses in your life.
• Ask a relative or friend to accompany youHelps you remember what your doctor says.
• Write down the questions you want to askyour doctor.

questions to ask your doctor

• What is the most likely cause of my symptoms?
• What tests do I need? Do these tests require any special preparation?
• What treatments are available?
• Recurrence of diverticulitis?
• Should I remove or add foods to my diet?
• I have other health issues. How can I best co-manage these situations?

In addition to the questions you want to ask your doctor, feel free to ask any questions during your appointment.

what to expect from your doctor

Your doctor may ask you many questions. When you're ready to answer your questions, you might take the time to review the items you want to devote more time to. You may be asked:

• When did you first have symptoms? How severe are the symptoms?
• Are your symptoms constant or intermittent?
• What, if anything, seems to improve or worsen your symptoms?
• Do you have a fever?
• What medicines and pain relievers are you taking?
• Do you have pain when you urinate?
• Have you ever had a colon cancer screening test (colonoscopy)?

request an appointment

according to

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diverticulitis

• Nursing at Mayo Clinic