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Treatment of Diverticular problems
Diverticulosis
Treatment for diverticulosis is to increase the amount of fibre in the diet, in order to relieve the constipation. This involves eating more fruit and vegetables, particularly leafy green vegetables like spinach. Other sources of fibre are wholegrain cereal, wholemeal bread and pasta, brown rice and pulses such as beans and lentils. You need 25-30 grams of fibre each day.
It is important to increase the amount of fluid (water) that you drink when you add more fibre to your diet. The recommended daily amount of water is 2 litres.
Most people are advised to increase the amount of physical exercise they take as this will help to ease constipation.
Symptoms may worsen for a while after increasing the amount of fibre in your diet, but they should settle down in a few weeks. You may also experience an increase in wind at first but this will settle.
Your GP may suggest fibre supplements (such as ispaghula) or bulk-forming agents (such as ispaghula husk, sterculia, and methylcellulose) if your symptoms do not improve. There are various laxatives available.
Some people find that taking anti-spasmodic medication can reduce the colicky pain in the stomach. Peppermint tea has a similar effect. Paracetamol can be used for pain relief. Antibiotics are not usually used for diverticulosis.
It is important to see your GP for further investigation if you have recurrent abdominal pain or rectal bleeding or if your bowel habits alter dramatically.
Diverticulitis
Treatment for diverticulitis is usually with antibiotics. Some people may have to be treated in hospital. If the diverticulitis is not severe, treatment will be with painkillers, antibiotics, laxatives and dietary advice. If no improvement is seen then the patient will be admitted to hospital.
Older people and those with existing medical conditions such as problems with their immune system will usually be treated in hospital as soon as the condition is diagnosed.
In hospital, painkillers and broad-spectrum antibiotics are given to clear up the infection.
Occasionally people will have to be given their food intravenously (through the vein)- Parenteral nutrition.This treatment is considered if the person develops complications such as an anal fistula (an abnormal connection between the back passage (anal canal) and the opening to the outer skin surrounding the anus) or paralytic ileus (a type of obstruction within the intestines)
Other conditions such as anaemia will also have to be treated. With treatment, diverticulitis usually improves within 2-3 days.
Sometimes, surgery may be required. This may be a colostomy (making a temporary opening in the abdomen) or removing a small part of the bowel.
More bowel investigations may be needed. A full blood count test, urinanalysis, ultrasound, CT scan, colonoscopy and barium enema are among the further tests that your doctor may suggest.
In 7-35% of people the diverticulitis comes back. After recovery, you will be given advice from your GP on managing your diverticular disease.
