Can diverticulitis go away on its own?
Yes, an attack of uncomplicated diverticulitis can go away on its own. However, you must visit your doctor for a thorough evaluation of the episode. Most attacks of uncomplicated diverticulitis are not life-threatening and usually resolve within a week. Complicated diverticulitis needs medical attention because it can cause serious complications.
What is diverticulitis?
Diverticulosis is a condition in which a person develops pouch-like structures in their gut, typically in the large bowel (colon). These pouches are asymptomatic in most people. However, in some cases these pouches get swollen and infected. This is called a diverticulitis episode. It causes severe bellyache and may even cause blood in the stool.
What is a diverticulitis flare?
Most diverticula cause no symptoms. However, in some cases the pouches may fill with feces and may become swollen and infected. This may cause an abscess (a collection of pus) and may even cause a tear or hole (perforation) in the gut wall. Such episodes are called diverticulitis flares.
Such flares cause pain on the left side of the belly, blood in stools and abdominal cramps. In case of complicated diverticulitis, there may be abscess formation in the pouches causing fever and swelling or inflammation of the abdomen (peritonitis).
How is diverticulitis managed?
Your doctor will examine you thoroughly and conduct certain tests to narrow down the diagnosis. The tests to diagnose diverticulitis include
- Complete blood count to check for infections
- Stool examination to rule out infections and check for a small amount of bleeding in the gut
- Computed tomography (CT) scan of the gut to look for abscess formation
- Endoscopy (a procedure where a thin, flexible tube with a camera is inserted through the anus into the intestines). The camera is connected to a screen on which the images of the inside of the gut can be seen.
In the absence of complications, diverticulitis is managed conservatively. A liquid diet, lots of fluids, oral antibiotics and acetaminophen are needed. Regular follow-up with a doctor is needed to look for potential complications.
If there is development of an abscess in the pouches, or the infection continues to spread, or there is tear in the intestines, it is called complicated diverticulitis. Such cases may need the following treatment
- Medical management
- Intravenous (IV) fluids
- Intravenous antibiotics
- Surgical management
- Bowel resection: This is removal of the affected part of the bowel and sewing of the healthy parts together.
- Colostomy: In cases where it is not possible to sew together the healthy parts of the bowel, a colostomy is performed by a surgeon. Here, a stoma (an opening) is made in the abdomen. The healthy part of the small intestine is connected to this stoma. The stoma opens into a bag that is fixed at the outer side. All the waste is passed into the colostomy bag. Meanwhile, the diseased part of the colon is sealed and allowed to heal.
How do I prevent diverticulitis flares?
If you have had an episode of diverticulitis, the following lifestyle changes may help prevent recurrences in the future
- Maintain a healthy weight: Diverticulitis is common in obese individuals. Hence, maintaining a healthy weight may prevent recurrences. People who exercise regularly have fewer attacks than sedentary individuals.
- High fiber diet: A diet high in fiber is known to help prevent flares. You may increase the content of green leafy vegetables, beans, oats, etc. to up your fiber intake. Adequate water intake is also a must.
- Smoking: Smoking cessation lowers the risk of diverticulitis flares.
- Medications: Long-term intake of steroids has been linked to the development of diverticula. You can discuss with your doctor if you need to take steroids for a long time. They may suggest alternatives.
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