Treatments and drugs

By Mayo Clinic Staff

Treatment depends on the severity of your signs and symptoms.

Uncomplicated diverticulitis

If your symptoms are mild, you may be treated at home. Your doctor is likely to recommend:

  • Antibiotics, to treat infection.
  • A liquid diet for a few days while your bowel heals. Once your symptoms improve, you can gradually add solid food to your diet.
  • An over-the-counter pain reliever, such as acetaminophen (Tylenol, others).

This treatment is successful in 70 to 100 percent of people with uncomplicated diverticulitis.

Complicated diverticulitis

If you have a severe attack or have other health problems, you'll likely need to be hospitalized. Treatment generally involves:

  • Intravenous antibiotics
  • Insertion of a tube to drain an abscess, if one has formed

Surgery

You'll likely need surgery to treat diverticulitis if:

  • You have a complication, such as perforation, abscess, fistula or bowel obstruction
  • You have had multiple episodes of uncomplicated diverticulitis
  • You are immune compromised

There are two main types of surgery:

  • Primary bowel resection. The surgeon removes diseased segments of your intestine and then reconnects the healthy segments (anastomosis). This allows you to have normal bowel movements. Depending on the amount of inflammation, you may have open surgery or a minimally invasive (laparoscopic) procedure.
  • Bowel resection with colostomy. If you have so much inflammation that it's not possible to rejoin your colon and rectum, the surgeon will perform a colostomy. An opening (stoma) in your abdominal wall is connected to the healthy part of your colon. Waste passes through the opening into a bag. Once the inflammation has eased, the colostomy may be reversed and the bowel reconnected.

Follow-up care

Your doctor may recommend colonoscopy six weeks after you recover from diverticulitis, especially if you haven't had the test in the previous year. There doesn't appear to be a direct link between diverticular disease and colon or rectal cancer. But colonoscopy — which isn't possible during a diverticulitis attack — can exclude colon cancer as a cause of your symptoms.

Sometimes, surgery is recommended. But previous recommendations for surgery based on the number of attacks have been questioned, since most people do well even after two or more attacks. The decision on surgery is an individual one, and is often based on the frequency of attacks and whether complications have occurred.

Aug. 07, 2014

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