Diverticulitis – Diagnosis and Treatment
Diagnosis
Spotting diverticulitis usually starts with a close look at your symptoms and some targeted tests. Healthcare providers ask about things like abdominal pain, fever, nausea, vomiting, or any changes in your bathroom habits, such as constipation or diarrhea.
During the physical exam, the doctor gently presses on your abdomen to check for sore spots. Sometimes they’ll do a pelvic exam to rule out other issues.
Common diagnostic tests might include:
- Blood tests to check for infection or inflammation
- Urine and stool tests to rule out other causes
- Pregnancy tests for women
- Liver enzyme tests
Doctors often order a CT scan (computed tomography). CT scans clearly show inflamed diverticula, abscesses, fistulas, or other complications. These results really shape the treatment plan.
In some cases, if symptoms are mild and there’s no sign of complications, a doctor might recommend waiting before performing a CT scan.
For people with recurring episodes or chronic symptoms, additional imaging studies such as MRI or ultrasound may be used, especially if radiation exposure is a concern.
Occasionally, once the inflammation has subsided, a colonoscopy may be done to examine the colon more closely and rule out conditions like colon cancer.
However, colonoscopies are typically avoided during the acute phase of diverticulitis due to the risk of bowel perforation.
Treatment
Care for Simple Cases
If your symptoms aren’t too bad, your doctor will probably recommend staying home. Here’s what you might do:
- Clear Liquid Diet: You’ll likely need to stick to clear liquids like broth, water, or juice at first. It gives your gut a break.
- Gradually Returning to Food: When things start to feel better, you can add soft, low-fiber foods. Later, a high-fiber diet is usually the goal.
- Fiber Supplements: Your doctor might suggest fiber powders or pills once you’ve recovered.
- Antibiotics: You’ll likely get oral antibiotics. It’s important to finish the whole course, even if you start to feel better.
Note: Avoid over-the-counter painkillers like aspirin or NSAIDs unless your doctor says otherwise. These can actually make things worse or cause new problems.
Treatment for More Serious Cases
If symptoms get worse or complications pop up, you’ll need hospital care.
- Intravenous Antibiotics: Doctors give antibiotics through an IV to fight infection.
- Monitoring: The medical team keeps a close eye on you for issues like abscesses, ruptures, or tissue damage.
- Supportive Care: You might need extra fluids or other medicines.
Complications sometimes come up:
| Problem | Possible Treatment |
|---|---|
| Abscess | Draining the area |
| Peritonitis | Surgery is often needed |
| Fistulas | Surgical repair |
| Bleeding | May require surgery |
Surgical Options
Some people need surgery. This usually happens if you’ve got complications, repeated attacks, or a weak immune system.
There are two main surgeries for diverticulitis:
- Removing the Problem Area: The surgeon takes out the sick part of your colon and then connects the healthy ends.
- Temporary Colostomy: The surgeon connects the healthy colon to an opening in your belly, so waste collects in a bag outside your body. After healing, they can often reconnect your colon and close the opening.
Most surgeries use small tools and tiny cuts (laparoscopic surgery). Occasionally, a bigger cut is necessary. Other surgeries might be needed for things like fistulas, ongoing bleeding, or really bad infections.
Ongoing Monitoring and Care
After treatment, your doctor will probably want a check-up to see how your colon’s doing. They usually recommend a colonoscopy about six weeks after symptoms clear up. This helps spot any growths or signs of cancer.
Whether you need a colonoscopy depends on when you last had one and how bad your last bout of diverticulitis was.
Holistic Therapies
Some people try probiotic supplements to boost the good bacteria in their colon, hoping it might lower the risk of future flare-ups.
While a few small studies show some promise, there just isn’t enough strong proof yet. It’s a good idea to check with your doctor before starting anything new.
Getting Ready for Your Medical Visit
Getting ready ahead of time can make your appointment smoother and a lot less stressful. Here are some things to keep in mind:
- Follow all eating and drinking instructions, like not eating solid foods before certain tests.
- Record your symptoms. Jot down even the little things that might not seem important.
- List your current medications. Include prescriptions, vitamins, or supplements, plus dosages and why you take each one.
- Add info about your medical background. Mention other health problems, recent stress, or major life changes.
- Bring personal notes about your lifestyle. That could be your activity level, diet (low- or high-fiber foods), red meat intake, or smoking habits.
- Ask someone to come with you. Having a friend or family member there can help you remember what the doctor says.
- Prepare questions ahead of time. Writing them down ensures you get the answers you need.
Here’s a quick checklist for your appointment:
| Task | Completed? |
|---|---|
| Followed pre-appointment instructions | Yes or No |
| Listed symptoms and medical history | Yes or No |
| Listed current medicines and supplements | Yes or No |
| Noted lifestyle factors (diet, exercise) | Yes or No |
| Invited a companion, if needed | Yes or No |
| Prepared list of questions | Yes or No |
Helpful Questions for Your Specialist
Don’t be shy about asking questions during your visit. Some ideas:
- What could be causing these symptoms?
- Which tests do I need, and how do I get ready?
- What are my treatment options?
- How can I prevent symptoms from coming back?
- Should I change my diet, like adding more fiber or eating less red meat?
- How do I manage this with my other health conditions?
You might want to add your own, like questions about exercise, quitting smoking, or keeping a healthy weight.
Topics Your Provider May Ask About
Doctors usually want to get a sense of your symptoms and daily habits, so expect a few questions. They’ll probably ask things like:
- When did your symptoms first show up? Do they stick around or just pop in and out?
- Which foods or habits—like eating mostly low-fiber stuff, smoking, or skipping exercise—seem to make things worse?
- Have you had any fevers or pain, maybe even pain when you pee?
- What medications or pain relievers do you take right now?
- Did you already do any screening tests, like a colonoscopy?
- Have you gone through any recent changes, like more stress or a new diet?
If you think about these questions ahead of time, your appointment will probably move along faster. Plus, your doctor gets clearer info to help figure out what’s going on.
