Diverticulosis and Diverticulitis

Prevention

People whose diets contain large amounts of fiber are less likely to develop diverticular disease. The American Dietetic Association recommends 20 grams to 35 grams of fiber a day, preferably from fruits, vegetables and grains. Your doctor also may recommend unprocessed bran or a fiber product. It is important to increase fiber intake gradually and to drink more water to increase the bulk of the bowel movements, which reduces pressure inside the bowel.

Physical activity also may lower the risk of diverticulosis. Many doctors previously recommended that people with diverticulosis avoid eating nuts, popcorn and foods with seeds. This restriction has not been proven to prevent diverticulitis.

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. Up to 35% of patients with peritonitis die.

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.