Diverticulitis Treatments and Medications

Diverticulitis is an inflammatory condition in which the small pouches of the walls of the large intestine (diverticula) become swollen or infected. Symptoms often include pain in the lower left abdominal area, fever, nausea, or changes in bowel movements. Although diverticulitis is more common with older age, it is becoming more common in younger adults. Mild cases usually get better with rest and dietary changes, but severe cases usually need to be treated with antibiotics or even surgery.

How is diverticulitis diagnosed? 

Diverticulitis is typically diagnosed based on a person’s symptoms, a physical exam, and specific diagnostic tests, as needed. Since other conditions, such as irritable bowel syndrome (IBS) and colitis, can cause similar symptoms, a healthcare provider may perform specific tests to help pinpoint diverticulitis. A diagnosis may include:

• A physical exam, including checking for tenderness in the abdominal area

• Blood tests, such as a white blood cell count, to see if there’s an infection

• Urinalysis, stool tests, and pregnancy tests to rule out other possible causes

• Imaging tests, such as a CT scan, to look more closely for complications

For people with an acute flare-up, a colonoscopy is not usually recommended due to the risk of perforating the colon. Instead, the procedure will have to be postponed for several weeks until the symptoms subside.

Diverticulitis treatment options

Diverticulitis is a treatable condition, but the exact treatment will depend on the severity of the symptoms. With most mild cases, symptoms improve with bowel rest and a clear liquid diet. Antibiotics are no longer recommended in all cases, since many people recover well without them. However, people with a severe case of diverticulitis and those who are older, frail, or immunocompromised may be prescribed an antibiotic. In more complicated cases, a hospital visit or surgery may be recommended. A specialized healthcare provider, such as a gastroenterologist or colorectal surgeon, can help determine the best treatment options.

Types of diverticulitis medication

Medications are not always prescribed for diverticulitis. However, antibiotics can help treat a severe infection, while some pain relievers may help manage discomfort. 

Antibiotics

If antibiotics are needed, Augmentin (amoxicillin-clavulanate) is a common first-line option. Avelox (moxifloxacin) is an alternative for those with penicillin allergies. Other antibiotic treatments include a combination of Flagyl (metronidazole) and Cipro (ciprofloxacin) or Levaquin (levofloxacin). For severe cases in the hospital, IV antibiotics like Zosyn (piperacillin-tazobactam) and Unasyn (ampicillin-sulbactam) are potential options.

Pain relievers

Acetaminophen, known under the brand name Tylenol, is a preferred option for pain from diverticulitis. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin should be avoided since they are linked to a higher risk of diverticulitis and may come with adverse effects like stomach irritation and bleeding. In some cases, an antispasmodic like Bentyl (dicyclomine) or NuLev (hyoscyamine) may help manage cramping caused by intestinal spasms. 

Over-the-counter diverticulitis medicine

There are no over-the-counter medicines available that can cure diverticulitis. However, acetaminophen is an over-the-counter drug that can help manage pain. In addition, a fiber supplement like Metamucil (psyllium) may help prevent future flare-ups. Probiotics are not generally recommended, as there is insufficient evidence that they provide any benefit to people with diverticulitis.

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