Health A-Z

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Treatment

The only possible treatment for diverticulosis is to increase fiber in the diet. Fiber will not heal existing diverticula, but it may prevent more from forming.

If you have diverticulitis, your doctor will prescribe antibiotics, and may recommend a liquid diet and bed rest to help your colon recover. If you have severe pain or an infection, you may need to be treated in a hospital so that antibiotics can be given intravenously (into a vein).

If fever continues, you may have an abscess, which can develop when a diverticulum becomes perforated (develops a hole). An abscess is a collection of pus. A surgeon then will help your doctor plan the next step: drainage or surgery. The choice depends on the extent of the problem and your overall health. Drainage means that the surgeon cleans out the pus.

Emergency surgery is required to treat peritonitis, the most serious potential complication of diverticulitis. Peritonitis requires surgical repair as well as intravenous antibiotics.

Surgery also may be required during the hospital stay to treat a particularly severe episode of diverticulitis or other complications. These include continuous bleeding, perforation of an abscess, attachment of two organs by a fistula, or colon obstruction caused by scarring from previous episodes of diverticulitis.

The most common procedure, known as a colon resection, involves removing the part of the colon that contains diverticula and reattaching the ends. When done during emergencies, a colon resection is a two-stage process. First, a section of colon is removed, but because of infection, it is not safe to rejoin the ends. Instead, the surgeon creates a temporary hole, or stoma, in the abdomen and connects the colon to it, a procedure called a colostomy. A bag is attached to collect the stool. Later, a second operation is done to reattach the end of the colon, and remove the colostomy. Sometimes, if the situation is not an emergency, the surgery can be done all at once.

After successful treatment for diverticulitis, your doctor normally will recommend a high-fiber diet. Later, you may need to have a procedure called a colonoscopy, which is an internal examination of the colon. Surgery usually is not recommended after only one attack without complications. However, it often is recommended after a second episode. Repeated episodes of diverticulitis can lead to internal scarring and narrowing of the colon, which also may require surgery to remove a piece of the colon.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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