What is the best treatment for diverticulosis

While uncomplicated diverticulitis may require only a brief doctor’s visit, complicated diverticulitis is a completely different ball game, and treatment isn’t as simple as a few days on a liquid diet.

“Complicated diverticulitis is defined by the presence of a more advanced disease, such as perforation, abscess, fistula, intestinal obstruction, or bleeding,” Bulsiewicz says. “Generally, those with complicated diverticulitis will be hospitalized, and there’s a much higher likelihood of requiring surgery to fix the issue, although not always.”

Here’s what you can expect treatment-wise if you’re diagnosed with a more serious case of diverticulitis.

1. Intravenous Antibiotic or Pain Therapy

If you can’t keep fluids down or if you have a weak immune system, your doctor may recommend being admitted to the hospital.

You’ll receive pain medicine and antibiotics intravenously while in the hospital, which involves connecting a tube to your vein. Intravenous therapy is effective because medication gets into your bloodstream and begins working faster.

2. Surgery

If diverticulitis progresses, your doctor may start discussing the possibility of surgery.

“There are two scenarios when surgery is considered as treatment for diverticulitis. First, if there’s a perforation, abscess, fistula, or intestinal blockage, it may be necessary to perform surgery in order to correct the problem,” Bulsiewicz warns. “In this setting, diverticulitis is usually so severe that there is little choice but to proceed with surgery.”

The purpose of surgery is to remove sections of the colon affected by the condition. One option is a primary bowel resection, which removes the diseased section of the colon and reconnects healthy sections so that you can retain normal bowel function. Your surgeon can perform this procedure with open surgery or a laparoscopic procedure.

What is the best treatment for diverticulosis

If your surgeon can’t remove a diseased section and reconnect healthy sections, you may need a bowel resection with colostomy. This procedure is a bit more intense and involves the creation of a hole or opening for the large intestines through the abdominal wall. Your surgeon attaches a bag to the end of this opening, which collects waste.

The good news is that a colostomy isn’t always permanent, so you may need to wear the bag only temporarily. You’ll follow up with your doctor once your diverticulitis heals to discuss possibly reversing the colostomy and reconnecting your colon.

If you develop an abscess, which is a pocket of pus, it may heal on its own with antibiotics, or your doctor can drain it during surgery. If you don’t need surgery, your doctor can also insert a needle through your skin and drain it this way.

While surgery is usually for complicated attacks, there’s also the option of elective surgery if you have two or more acute, uncomplicated attacks.

“In some cases, diverticulitis just doesn’t go away, or it just keeps coming back,” Bulsiewicz says. “If this is the case, at some point surgery needs to be considered because other therapies have failed.”

Diverticulitis is a disease that affects the digestive tract. Diverticula are small pockets that can form on the lining of your digestive tract. When these pouches form, it’s called diverticulosis. They’re more common after the age of 40.

Most people don’t have symptoms. Straining from constipation can cause these pouches to form. When one or more pouch becomes inflamed or infected, it’s known as diverticulitis.

Diverticulitis can cause:

  • severe abdominal cramping
  • abdominal pain, often on the lower left side
  • nausea
  • fever and chills

Many people feel better without any treatment, but many need antibiotics. Your doctor may recommend dietary changes to help treat your symptoms, especially if your condition is mild. There are other home remedies for diverticulitis that may help as well.

Liquid diet

For an acute episode of diverticulitis, your doctor may recommend a liquid diet. You may also be asked to follow a clear liquid diet for a couple of days before switching to a low-fiber diet to help rest your digestive system.

Follow your doctor’s instructions, and don’t stay on the liquid diet longer than recommended. Begin adding low-fiber foods to your diet as you start feeling better.

Over-the-counter medications

Over-the-counter (OTC) medications, such as acetaminophen (Tylenol), may help relieve some of your pain. Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) aren’t recommended because they increase the risk of bleeding and other complications.

A fiber supplement, such as psyllium (Metamucil) or methylcellulose (Citrucel), may help with constipation and diarrhea. They help by bulking up your stool and making it easier to pass. Fiber supplements can cause gas and bloating when you first begin taking them. Speak to your doctor before adding a fiber supplement to your diet.

Shop for fiber supplements.

Probiotics

Some studies show that probiotics reduce symptoms of diverticulitis, though more research is needed.

Probiotics are “good” bacteria similar to those that occur in your digestive tract to keep you healthy. They’re available OTC in capsule, tablet, and powder form. They’re also found in some foods, such as yogurt and fermented vegetables.

There are different types of probiotics and each has different strains. Strains of the bacteria, mainly Lactobacillus casei, appear to be the most effective according to research.

Shop for probiotics.

High-fiber diet

The American Gastroenterological Association suggests that people with a history of acute diverticulitis eat a diet rich in fiber or add a fiber supplement to their diet. A high-fiber diet may help ease or prevent symptoms of diverticulitis, though currently there’s only low-quality evidence of its benefits.

Foods that are high in fiber may cause gas and pain, so gradually increasing your fiber intake is important. The current Dietary Guidelines of Americans recommends 14 grams of dietary fiber per 1,000 calories consumed. That would be 28 grams of fiber per day for a diet of 2,000 calories.

Aloe

Aloe vera is believed to have many health benefits, including preventing constipation. It may also be effective in relieving pain and cramping.

You can buy aloe vera juice in most grocery and health food stores. Drink two ounces of aloe a day to help soothe and prevent symptoms.

Shop for aloe vera juice.

Digestive enzymes

Digestive enzymes are proteins produced by your stomach, small intestine, salivary glands, and pancreas. They help break down food during digestion and kill toxins. The enzymes found in papayas and pears are believed to help reduce intestinal inflammation and speed up healing.

While there’s no scientific evidence available on the benefits of digestive enzymes specifically for diverticulitis, a 2014 study found that they can relieve abdominal pain and other common stomach complaints.

Digestive enzymes are sold online and in stores with other supplements and are found in foods like papayas, pears, and pineapples.

Shop for digestive enzymes.

Herbs

Some herbs have been shown to be effective in reducing inflammation and fighting infection. Some herbs that may be helpful for diverticulitis include:

  • Garlic. Studies have found that garlic has antimicrobial and antiviral effects that may help prevent infection. There’s also evidence that garlic may improve digestion and constipation.
  • Green tea. Green tea is known to have many health benefits, some of which may be helpful in relieving or preventing symptoms. Green tea has anti-inflammatory, antiviral, and antibacterial properties which can reduce inflammation and lower your risk of infection.
  • Ginger. Ginger has been used as an herbal medication for the treatment of various gastrointestinal ailments for centuries, including nausea, vomiting, and diarrhea.
  • Turmeric. Turmeric has been used an herbal remedy in China and India for centuries. In recent years, clinical studies have shown it to have several benefits, many related to the digestive system. The anti-inflammatory effect of turmeric may protect the digestive tract, increase the secretion of some enzymes, and relieve pain.

Acupuncture

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into strategic points on the body. It’s most commonly used to treat pain and stress, but some evidence suggests that it may also treat constipation.

Essential oils

While there’s no evidence to support online claims that essential oils have any effect on diverticulitis, they can promote relaxation, relieve stress, and improve pain.

A 2015 study found that diluted lavender oil applied topically provides pain relief similar to that of tramadol, a prescription pain medication. A systematic review published in 2016 found that aromatherapy has a significant positive effect on pain.

Essential oils shouldn’t be taken by mouth. Some diluted oils can be applied to your skin, added to your bathwater, or diffused.

Diverticulitis can cause serious complications that require immediate care, including:

  • tear or hole of the intestinal wall
  • abscesses
  • fistulas
  • intestinal obstruction

Your condition may be worsening if you:

  • are unable to hold down liquids or food
  • have abdominal pain that isn’t relieved by pain medication
  • have blood in your stool or rectal bleeding
  • have a high fever and chills

Call your doctor right away if you have any of the following:

  • excessive vomiting
  • fever over 100°F (38°C)
  • rectal bleeding, even a small amount

When to go to the ER

  • sudden severe abdominal pain
  • signs of bowel obstruction
  • continuous or excessive rectal bleeding

Complications, such as an obstruction, tear, or abscess require urgent surgery.

Mild diverticulitis can sometimes improve on its own. Home remedies can help ease your symptoms and may speed up healing.

See your doctor if you have a fever that lasts more than a couple of days or is higher than 100°F (38°C). If you have severe pain, high fever, or rectal bleeding you may need emergency medical treatment.