What treatment is there for diverticular disease?
The management of diverticular disease is outlined here. More detailed information for individual treatments of each complication is given under ‘What are the complications of diverticular disease?’.
Non-surgical treatment
The main goals of treating diverticular disease are controlling the pain, resting the bowel, treating any infection and preventing the development of complications. Remember that only 25 per cent of patients with diverticulosis are symptomatic or run into problems:
- A high-fibre diet helps to prevent and ease the symptoms of diverticular disease.
- Bulk-forming laxatives such as psyllium (Metamucil) or methylcellulose (Celevac) can be added as a supplement if a high-fibre diet is not tolerated or effective.
- Drink plenty of water (preferably not tea or coffee) to prevent constipation. The recommended amount is two to three litres a day.
- Paracetamol is first line for controlling pain.
- Codeine-based painkillers should be avoided because they are constipating and can increase the risk of perforation.
- Non-steroidal anti-inflammatory medications such as ibuprofen should be avoided because they can increase the risk of bleeding and perforation.
- Anti-spasmodics may be useful for abdominal pain and distension due to spasm.
- Antibiotics are used to treat bacterial infections and the duration of treatment is a minimum of seven days. Choices of antibiotics include ciprofloxacin, metronidazole, gentamicin and amoxicillin/clavulanic acid. Broad-spectrum antibiotics are required because the natural colonic flora is a combination of anaerobic and aerobic bacteria (bacteria that live without and with oxygen). If you fail to respond to antibiotics you may require hospital admission for intravenous antibiotics (that is, into the vein). The antibiotic of choice depends on your allergy status, local hospital guidelines and the type of bacteria that may be grown from a sample of your blood
- You may be advised to have a liquid diet or low-fibre diet to rest the bowel and to allow for healing of the inflamed and infected colon. A high-fibre diet can slowly be re-started once the flare-up or complication has resolved.
