Treatments for Diverticular Disease


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Treatment list for Diverticular Disease: The list of treatments mentioned in various sources for Diverticular Disease includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatments of Diverticular Disease discussion: A high-fiber diet and, occasionally, mild pain medications will help relieve symptoms in most cases. Sometimes an attack of diverticulitis is serious enough to require a hospital stay and possibly surgery. 1

Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber keeps stool soft and lowers pressure inside the colon so that bowel contents can move through easily. The American Dietetic Association recommends 20 to 35 grams of fiber each day. The table below shows the amount of fiber in some foods that you can easily add to your diet.


Amount of Fiber in Some Foods

Fruits
apple 1 medium = 4 grams
peach 1 medium = 2 grams
pear 1 medium = 4 grams
tangerine 1 medium = 2 grams

Vegetables
acorn squash, fresh, cooked 3/4 cup = 7 grams
asparagus, fresh, cooked 1/2 cup = 1.5 grams
broccoli, fresh, cooked 1/2 cup = 2 grams
brussels sprouts, fresh, cooked 1/2 cup = 2 grams
cabbage, fresh, cooked 1/2 cup = 2 grams
carrot, fresh, cooked 1 = 1.5 grams
cauliflower, fresh, cooked 1/2 cup = 2 grams
romaine lettuce 1 cup = 1 gram
spinach, fresh, cooked 1/2 cup = 2 grams
tomato, raw 1 = 1 gram
zucchini, fresh, cooked 1 cup = 2.5 grams

Starchy Vegetables
black-eyed peas, fresh, cooked 1/2 cup = 4 grams
lima beans, fresh, cooked 1/2 cup = 4.5 grams
kidney beans, fresh, cooked 1/2 cup = 6 grams
potato, fresh, cooked 1 = 3 grams

Grains
bread, whole-wheat 1 slice = 2 grams
brown rice, cooked 1 cup = 3.5 grams
cereal, bran flake 3/4 cup = 5 grams
oatmeal, plain, cooked 3/4 cup = 3 grams
white rice, cooked 1 cup = 1 gram

Source: United States Department of Agriculture (USDA). USDA Nutrient Database for standard reference. Available at www.nal.usda.gov/fnic/cgi-bin/nut_search.pl. Accessed September 19, 2001.

The doctor may also recommend taking a fiber product such as Citrucel or Metamucil once a day. These products are mixed with water and provide about 2 to 3.5 grams of fiber per tablespoon, mixed with 8 ounces of water.

Until recently, many doctors suggested avoiding foods with small seeds such as tomatoes or strawberries because they believed that particles could lodge in the diverticula and cause inflammation. However, this is now a controversial point and no evidence supports this recommendation. Individuals differ in the amounts and types of foods they can eat.

If cramps, bloating, and constipation are problems, the doctor may prescribe a short course of pain medication. However, many medications affect emptying of the colon, an undesirable side effect for people with diverticulosis. 1

Treatment for diverticulitis focuses on clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications. An attack of diverticulitis without complications may respond to antibiotics within a few days if treated early.

To help the colon rest, the doctor may recommend bed rest and a liquid diet, along with a pain reliever.

An acute attack with severe pain or severe infection may require a hospital stay. Most acute cases of diverticulitis are treated with antibiotics and a liquid diet. The antibiotics are given by injection into a vein. In some cases, however, surgery may be necessary. 1

When is surgery necessary?

If attacks are severe or frequent, the doctor may advise surgery. The surgeon opens the abdomen and removes the affected part of the colon. The remaining sections of the colon are rejoined. This type of surgery, called colon resection, aims to keep attacks from coming back and to prevent complications. The doctor may also recommend surgery for complications of a fistula or intestinal obstruction.

If antibiotics do not correct the attack, emergency surgery may be required. Other reasons for emergency surgery include a large abscess, perforation, peritonitis, or continued bleeding.

Emergency surgery usually involves two operations. The first surgery will clear the infected abdominal cavity and remove part of the colon. Because of infection and sometimes obstruction, it is not safe to rejoin the colon during the first operation. The surgeon creates a temporary hole, or stoma, in the abdomen during the first operation. The end of the colon is connected to the hole, a procedure called a colostomy, to allow normal eating and bowel movement. The stool goes into a bag attached to the opening in the abdomen. In the second operation, the surgeon rejoins the ends of the colon. 1

Footnotes:
1. excerpt from Diverticulosis and Diverticulitis: NIDDK

Last revision: May 27, 2003

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