“Generally speaking, inflammation from diverticulitis can cause scar tissue formation and breakdown of the colon wall, and if the colon wall develops a hole, then an abscess will form,” warns Will Bulsiewicz, MD, a gastroenterologist and gut health expert in Mount Pleasant, South Carolina.
Can diverticulitis be cured? Diverticulitis can be treated and be healed with antibiotics. Surgery may be needed if you develop complications or if other treatment methods fail and your diverticulitis is severe. However, diverticulitis is generally considered to be a lifelong condition.
Abscess. The most common complication of diverticulitis is an abscess outside the large intestine (colon). An abscess is a pus-filled cavity or lump in the tissue. Abscesses are usually treated with a technique known as percutaneous abscess drainage (PAD).
Patients with complications of their diverticulitis may have more chronic or long-term, symptoms. Thin stools or constipation may indicate the formation of a stricture. Dark, cloudy urine or passing air with the urine may indicate the formation of a fistula to the bladder.
How is uncomplicated diverticulitis treated? In about 95 out of 100 people, uncomplicated diverticulitis goes away on its own within a week. In about 5 out of 100 people, the symptoms stay and treatment is needed. Surgery is only rarely necessary.
You have about five feet of colon, and most patients can live a normal, healthy life without the sigmoid section, which is about one foot long.
Computed tomography (CT) scans are commonly used to diagnose acute diverticulitis, but there are overlapping features between diverticulitis and colorectal cancer (CRC) on imaging studies. Hence, colonoscopy is typically recommended after an episode of acute diverticulitis to rule out underlying malignancy.
About 30 to 40 percent of people who have diverticulitis once will never develop it again. For those who have subsequent episodes, particularly two or more, surgery is often required to remove the affected portion of the colon.
Probiotics combined with mesalazine have also emerged as an alternative potential therapeutic strategy in preventing recurrent attacks of diverticulitis. One series reported that treatment with mesalazine and/or lactobacillus casei induced remission in 88% of their patients at a median follow-up of 2 years.
CAUSES. The most commonly accepted theory for the formation of diverticulosis is related to high pressure within the colon, which causes weak areas of the colon wall to bulge out and form the sacs. A diet low in fiber and high in red meat may also play a role.
Diverticulitis most commonly affects the sigmoid colon, which is the last part of the large intestine just before the rectum. Doctors think there may be a connection between diverticulitis and the amount of red meat people eat per week, whether they smoke, and whether they have obesity.
When you have acute diverticulitis, a perforated colon is not that unusual because diverticulitis causes tiny tears — perforations — in the colon walls. These tears can grow larger and become problematic. Colonic perforation can also be a life-threatening complication of recent colon surgery called anastomotic leakage.
A liquid diet and rest are usually the best ways to ease diverticulitis symptoms. If there is a bleed within the intestines you may need to be hospitalized. Only in severe cases is surgery needed to remove the diseased pouches. With the proper care, diverticulosis symptoms may go away within in a few days.
Once diverticula form, they do not disappear by themselves. Fortunately, most patients with diverticulosis do not have symptoms, and therefore do not need treatment.
Percutaneous therapy
However according to the American Society of Colon and Rectal Surgeons (ASCRS) radiologically guided percutaneous drainage is usually the most appropriate treatment for patients with a large diverticular abscess as it avoids the need for emergency surgery and possibility of a colostomy34.
The test can be used to diagnose diverticular disease in people who have symptoms. Colonoscopies are also commonly used as a screening tool for colon cancer. In fact, many people are unexpectedly diagnosed with diverticular disease as a result of a routine colonoscopy.
A mild case of diverticulitis may go away on its own without any treatment. When treatment is necessary, antibiotics and a liquid or low-fiber diet may be all that is necessary to resolve symptoms.
Several factors may increase your risk of developing diverticulitis: Aging. The incidence of diverticulitis increases with age.
If you've had two or three episodes of diverticulitis, your doctor may recommend an elective procedure called sigmoidectomy, in which the affected part of the colon—called the sigmoid colon—is removed to help prevent a recurrence.
Many people will not have a recurrence. In one study of 3,165 patients hospitalized for diverticulitis, only 13.3% had a recurrence after 9 years.
The recent literature does not identify diverticular disease as a long-term risk factor for colorectal cancer. However, the risk of colorectal cancer is increased in the short-term period after hospitalization related to diverticular disease.
Most people who have diverticulosis have no symptoms. Once these pouches have formed, you will have them for life. Up to 25% of people with the condition will develop diverticulitis. This occurs when small pieces of stool become trapped in the pouches, causing infection or swelling.
How often should you have a colonoscopy with diverticulosis? You'll probably need a colonoscopy every 5 to 8 years if you have diverticulosis.
It is possible that stress plays a role in the development of diverticulitis as it is estimated that in 60 percent of cases the condition occurs due to environmental causes. Stress on the digestive system commonly experienced because of low fiber diets. Diets high in fat may also cause diverticulitis.
In most cases of surgery for diverticulitis, a colostomy is not required.