Diverticulitis Treatments and Medications

Individuals over 70 are the most common age group to develop diverticulitis, but even people in their 30s and 40s can experience signs of this digestive tract condition. Abdominal pain on the lower left side of the body and fevers or chills, though common for numerous ailments, could indicate diverticulitis. 

Nearly 200,000 individuals in the United States are hospitalized with diverticulitis every year. If you have been diagnosed with diverticulitis, understanding your condition and managing your symptoms naturally, with medication, or surgically is necessary to maintain health and wellness. 

What is diverticulitis?

Diverticulitis is a condition in which small pouches called diverticula develop in the large intestine (most commonly the sigmoid colon) and become inflamed or infected. Diverticula or the pouches alone are not harmful to the individual and are referred to as diverticulosis. Undigested food can get caught in the diverticula and cause irritation and inflammation. Once the pouches become infected and diverticulitis develops, treatment is usually needed. 

If left untreated, diverticulitis can lead to an abscess outside the lower part of the bowel, usually in the sigmoid colon region. Sepsis or bowel obstruction, requiring emergency surgery, can also occur if diverticulitis symptoms are ignored. 

How is diverticulitis diagnosed? 

Abdominal pain in the lower left quadrant is one of the main symptoms associated with diverticulitis. Fever, chills, diarrhea or constipation, bloating, nausea, and vomiting are additional symptoms of diverticulitis. While rectal bleeding can occur as a complication of diverticulosis, bleeding and diverticulitis rarely occur together.

Men are more likely to develop diverticulitis than women. If you are of a certain age and are experiencing these symptoms, your doctor may suspect diverticulitis. Other conditions, such as Irritable Bowel Syndrome (IBS) or colitis, may have symptoms similar to those of an episode of diverticulitis, so your healthcare provider will need to systematically review your health. 

Your physician will ask you numerous lifestyle questions and perform a physical examination to determine if you need to undergo testing for diverticulitis. Individuals who do not exercise and are overweight are at increased risk of diverticulitis. Individuals who lack dietary fiber are also at increased risk. In addition, a diet high in fats can increase the potential for pouches to develop in the intestines, which may then become inflamed. 

The use of opioids and steroids can also lead to an episode of diverticulitis. In addition, your healthcare provider may ask if you frequently use non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The use or overuse of pain relievers is also linked to episodes of diverticulitis. 

A physical exam, including temperature and weight, and checking the abdomen for tenderness is part of the process of diagnosing diverticulitis. Women often undergo a pelvic exam and a pregnancy test to rule out other conditions, including the possibility of pregnancy.

Generally, patients concerned about diverticulitis may need to submit urine or stool samples. Blood tests may also be required to check for an increased white blood cell count that could indicate an infection. Once the blood and urine results are examined (or if there is an urgent need), X-rays or a CT scan can be ordered to confirm a diagnosis of diverticulitis. Urgent colonoscopy is typically avoided if diverticulitis is suspected, given the increased risk for colon perforation in this situation.

CT Scan

CT Scan is short for computed tomography scan. An intravenous (IV) or oral contrast solution such as barium sulfate is often used to enhance the CT scan to identify conditions like diverticulitis in the large intestine. The contrast solutions used for CT scans allow better visibility of the body’s internal workings. The severity of the condition can also be determined through this process. 

X-rays

Similar to CT scans, X-ray technology can be used to examine the intestines, although X-rays are much less sensitive to abnormal findings than CT scans. Again, a contrast solution can be used with certain X-rays to create a better image for the radiologist to review. X-rays of the lower GI tract can be assessed for complications associated with diverticular disease. An X-ray will show if there has been a perforation or if the colon is blocked with stool.

Colonoscopy

A colonoscopy is an internal examination of the colon and lower bowels. A lit tube with an image transmitter (camera) is inserted in the rectum to gain visual access to the problem area. The doctor will be able to see the diverticula and determine what treatment options are needed. In addition, a colonoscopy can help eliminate other conditions, such as colon cancer. Doctors usually wait four weeks after a bout of diverticulitis before performing a colonoscopy, given an increased risk for bowel perforation with acute diverticulitis.

Diverticulitis treatment options

Mild diverticulitis may heal with diet modifications, stool softener, rest, or oral antibiotics to fight infection. If the diverticulitis disease progresses (worsening symptoms, fevers, increased pain) due to lack of treatment, intravenous antibiotics, hospital admission, and even surgery may be necessary to properly treat the condition. 

Your physician may refer you to a general surgeon, colorectal surgeon, or gastroenterologist to determine if surgery is necessary. 

Diverticulitis medications

Antibiotics, anti-spasm, and pain medications are included in the possible pharmaceutical treatments recommended for managing acute diverticulitis. 

Antibiotics

Antibiotics are used to treat infections that can occur in acute diverticulitis. Ciprofloxacin, levofloxacin, metronidazole, amoxicillin-clavulanic, and moxifloxacin are typically prescribed to treat diverticulitis-related infections. Intravenous antibiotics are typically used for hospitalized patients. In this case, Zosyn (piperacillin/tazobactam) or Unasyn (ampicillin/sulbactam) may be prescribed.

Antispasmodics

Muscle relaxants may help reduce spasms in the large intestine due to peritonitis or irritated soft tissue. Levbid or Bentyl (dicyclomine) may be prescribed to aid spastic muscles related to diverticulitis. 

Pain medications

When patients require hospitalization with acute diverticulitis, stronger pain medications are often needed to control pain. In this situation, Tramadol or Toradol may be used. If pain is still not controlled, narcotic pain medications may be necessary in the short term. Oral oxycodone or Oxycontin may be used, or IV morphine or Dilaudid can be used temporarily.

What is the best medication for diverticulitis? 

Treating diverticulitis with prescription medication can often prevent the need for surgical intervention. Below is a list of some of the top medicines that are used in treating diverticulitis.

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Best medications for diverticulitis