Understanding Treatment Options for Diverticulitis

Understanding Diverticulitis and Its Treatment Options

Diverticulitis is a common digestive condition that affects over 200,000 Americans each year. It occurs when small pouches called diverticula in the wall of the colon become inflamed or infected.

Mild cases can be managed at home with rest, hydration, and a clear liquid diet. However, some cases of diverticulitis can become serious if left untreated. Complications like abscesses, perforations, peritonitis, fistulas, or blockages may require hospitalization and intravenous (IV) antibiotics or surgery.

When diverticulitis flares up, doctors often prescribe medications like antibiotics and steroids to treat infection and reduce inflammation quickly. Understanding common prescription and alternative treatments for diverticulitis can help you discuss options with your doctor.

Antibiotics for Diverticulitis

Antibiotics are typically the first line treatment for diverticulitis, especially moderate or advanced cases. Antibiotics combat infection caused by diverticula perforation and leakage of bacteria into the abdominal cavity.

Common antibiotics prescribed for diverticulitis include:

• Ciprofloxacin broad spectrum antibiotic that fights gram negative bacteria
• Metronidazole antibiotic effective against anaerobic bacteria
• Rifaximin minimally absorbed antibiotic that stays in the GI tract
• Amoxicillin clavulanic acid combination antibiotic good for diverticular abscesses

For mild cases, oral antibiotics for 7-10 days may be sufficient. More advanced diverticulitis is treated with intravenous antibiotics in the hospital to rapidly get infection under control before complications arise.

Prednisone for Diverticulitis Inflammation

Prednisone is a common steroid medication that may be prescribed to reduce severe inflammation caused by diverticulitis. Its potent anti-inflammatory effects help alleviate swelling, pain, and prevent further tissue damage.

Typical dosage is 40-60 mg per day for acute diverticulitis flare ups. After a few days when swelling subsides, the dosage is gradually reduced and tapered off over 1-2 weeks. Side effects of prednisone may include fluid retention, increased appetite, trouble sleeping, and mood changes.

Studies show corticosteroid drugs like prednisone significantly improve recovery when combined with antibiotics for diverticulitis. Prednisone helps manage inflammation so the infection can clear with antibiotics.

Pain Medications

Severe abdominal pain is common during a diverticulitis attack. Doctors may recommend over-the-counter pain relievers like acetaminophen (Tylenol) and NSAIDs like ibuprofen (Advil) to help make patients more comfortable.

For acute pain not relieved by OTC medication, opioids like tramadol or hydrocodone may be prescribed for short-term use under medical supervision. Narcotic pain relievers should only be used for a limited time to manage diverticulitis pain until swelling subsides.

Clear Liquid Diet

Acute diverticulitis requires resting the colon to allow inflammation to resolve. A clear liquid diet is typically recommended, including:

• Water and ice chips
• Clear juices and sports drinks
• Clear broths like chicken, vegetable, or beef broth
• Gelatin
• Popsicles without fruit or cream
• Tea or coffee without milk

A liquid diet prevents solid food from aggravating inflamed diverticula. With rest, the acute symptoms of a diverticulitis flare up usually resolve within a few days. Introducing bland low fiber foods can typically be resumed after swelling has reduced.

Probiotics

Some research indicates probiotic supplements may help prevent diverticulitis complications and facilitate recovery. Probiotics contain beneficial bacteria that support digestive health and immune function.

Studies have found probiotic use decreased duration of hospitalization and prevented further attacks in patients with acute diverticulitis. Multi-strain probiotic formulas with Lactobacillus seem most effective according to clinical studies.

Fiber Supplementation

Low fiber diets are a known risk factor for developing diverticulosis pouches that may become inflamed. Some doctors recommend gradually increasing fiber intake after an attack with supplements or foods to help prevent recurrence.

However, other studies suggest a very high fiber diet during recovery may increase rather than decrease complications. Work closely with your doctor to determine appropriate timing and amounts of post-diverticulitis fiber supplementation.

Surgery for Complicated Diverticulitis

For most people, a mild diverticulitis attack will resolve with conservative treatment at home without complications. But up to 30% of patients suffer recurrent attacks, and 15% develop complex complications that may require surgery.

Reasons surgery may be recommended for diverticulitis include:

• Fistulas/Abscesses surgery drains infections and removes damaged tissue
• Bowel Obstruction blockages may be cleared or resected
• Perforation surgery closes hole in colon and cleans infected abdomen
• Peritonitis portions of colon causing spreading infection are removed
• Recurrent episodes surgery prevents further recurrences of diverticulitis

The most common surgeries for complicated diverticulitis include:

• Laparoscopic peritoneal lavage open abdomen, clean infection, close perforation
• Laparoscopic colectomy remove infected parts of the colon
• Colostomy reroute colon through abdomen to rest intestines
• Bowel resection remove segment of damaged colon

In most cases, laparoscopic approaches allow faster recovery than traditional open surgery. Discuss goals, expectations and concerns thoroughly with your surgeon before undergoing any diverticulitis operation.

Natural and Alternative Treatments for Diverticulitis

Mainstream medicine relies heavily on prescription antibiotics, steroids, and surgery for treating acute diverticulitis. But several natural remedies and alternative approaches may also help manage diverticulitis episodes.

Acupuncture

Acupuncture is a therapeutic treatment based on Traditional Chinese Medicine that stimulates specific points on the body with very thin needles. Some studies have found acupuncture significantly reduces diverticulitis pain and may rival drug treatments.

Possible mechanisms include releasing natural pain-relieving endorphins, reducing inflammation, and balancing energies thought to influence organ health according to Chinese Medicine.

Peppermint Oil

Peppermint oil contains menthol and menthone which have analgesic, anti-inflammatory, and antispasmodic effects. Enteric-coated peppermint oil capsules may relax colon muscles and soothe irritated tissues inflamed by diverticulitis.

One study on 72 patients with acute diverticulitis found those who received peppermint oil for 8 weeks had greater improvements in symptoms and quality of life compared to placebo. Peppermint oil was also well tolerated with minimal side effects.

Probiotic Foods

Eating probiotic-rich foods may support digestive health during and after a bout of diverticulitis. Fermented foods contain beneficial bacteria that reduce gastrointestinal inflammation and normalize gut microbiota.

Some examples of probiotic-containing foods to try include sauerkraut, kimchi, kefir, kombucha, miso, tempeh, pickles, raw cheese, and yogurt with active cultures.

Chamomile Tea

Chamomile is an herb traditionally used for its anti-inflammatory, antispasmodic, and analgesic properties. Drinking chamomile tea may relax the intestines and ease abdominal discomfort during a diverticulitis flare.

Apigenin, a bioactive compound in chamomile, appears responsible for reducing inflammation. Try having a few cups of chamomile tea each day during diverticulitis episodes.

Turmeric

The Indian spice turmeric contains the powerful anti-inflammatory compound curcumin. Both turmeric spice and curcumin supplements have been shown to decrease inflammation in laboratory studies.

Taking a turmeric or curcumin supplement and using lots of turmeric when cooking may potentially alleviate diverticulitis pain and swelling. Turmeric compounds appear very safe at culinary doses.

Aloe Vera

For centuries, aloe vera gel has been used topically to accelerate wound healing and orally to improve digestion. Aloe contains anti-inflammatory compounds like beta-sitosterol that may soothe diverticulitis swelling and irritation.

Drink 2-4 ounces daily of pure aloe vera juice combined with water. Be sure to look for a high-quality, purified juice without added sugars or thickeners.

Acupuncture

Gentle, modified yoga poses may help stretch inflamed tissues and reduce spasms associated with diverticulitis. Simple twists, hip openers, and lower abdominal stretches allow movement while preventing strain.

Avoid forceful twisting of the abdomen, intense core work, and inverted poses during an acute flare up. Work with an instructor knowledgeable about adapting yoga for diverticulitis.

Diet and Lifestyle Changes to Help Prevent Diverticulitis

While medications and alternative remedies can help manage acute diverticulitis episodes, making certain long-term diet and lifestyle changes may be able to prevent recurrent attacks.

Increase Fiber Gradually

Low fiber diets are associated with developing diverticulosis and diverticulitis. Gradually boosting fiber over time can help reduce pressure in the colon and prevent pouches from forming.

Focus on getting at least 25-30 grams of fiber daily from high fiber foods like fruits, vegetables, whole grains, nuts and seeds. Increase fiber slowly and drink plenty of fluids to prevent gas or bloating.

Avoid Foods that Constipate

Straining during bowel movements can exacerbate diverticula inflammation. Avoid foods that cause constipation like cheese, meat, eggs, white bread, chips, and processed foods. Stay well hydrated and incorporate fruits, veggies, beans, lentils, and whole grains to keep bowel movements regular.

Limit Red Meat Intake

Some research indicates restricting red meat may help prevent diverticulitis recurrence. Compounds released from digesting red meat may increase colonic inflammation. If you eat meat, choose leaner options like chicken, turkey, and fish instead of beef and pork.

Maintain a Healthy Weight

Carrying extra abdominal weight increases pressure inside the colon, raising diverticulitis risk. If overweight, gradually losing excess fat through diet and exercise can relieve pressure on the intestines.

Take Anti-Inflammatory Supplements

Supplements like vitamin D, omega-3s fish oils, magnesium, and turmeric contain compounds that decrease systemic inflammation. Taking daily anti-inflammatory supplements may help prevent recurrent diverticulitis.

Quit Smoking

Smoking is strongly associated with developing diverticulitis, especially complications like perforations. The toxins and chronic inflammation from smoking increase risk. Quitting can significantly improve diverticulitis outcomes.

Manage Stress

Stress and anxiety can manifest physically by altering gut motility and immunity. Developing healthy coping mechanisms like meditation, yoga, therapy, and spending time outdoors can reduce stress long-term.

Get Regular Physical Activity

Regular moderate exercise like walking, swimming, or cycling supports gut health through immune benefits, controlling weight, and preventing constipation. Try for at least 30 minutes per day of moderate activity.

Work Closely With Your Doctor for Optimal Diverticulitis Management

Although diverticulitis is common, its symptoms should never be ignored due to potential complications. Pay attention to symptoms like fever, nausea, constipation, severe abdominal pain, bloody stool, or vomiting.

Work closely with your doctor to create a personalized diverticulitis treatment plan using both conventional and alternative therapies for fast, lasting relief. With an integrative approach, most cases of diverticulitis can be successfully managed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.