Nonsurgical Treatment for Diverticular Disease
Most people with diverticulosis—in which small pouches, called diverticula, form on the colon wall—do not have symptoms and do not need treatment. If the diverticula become infected, a common complication called diverticulitis, our specialists offer state-of-the-art treatment options to help you recover.
Most of the time, diverticulitis does not require surgery. If mild, the condition can sometimes be treated with medication and dietary changes.
In more severe diverticulitis, when a perforation or an abscess is suspected, you may experience significant abdominal pain, an inability to tolerate food, constipation, or fever and chills. In this situation, NYU Langone doctors may recommend hospitalization for treatment and monitoring.
Medication and Diet
If you have mild diverticulitis, your doctor may prescribe a course of antibiotics, medications that fight bacterial infections. He or she may also put you on a liquid or low-residue diet, which includes foods that are easy to digest, to decrease bulk and stool in the intestines. This can reduce irritation and promote healing.
Your doctor determines when you can resume eating solid food. This timeline varies depending on the severity of the condition.
Treatment in the Hospital
When symptoms of diverticulitis are severe and your doctor suspects a perforation, bleeding, or an abscess, he or she may recommend hospitalization so you can be monitored and treated further if symptoms do not improve or worsen.
When you’re admitted to the hospital, your doctor typically recommends diagnostic tests—usually a CT scan—to examine the colon. Treatment depends on the severity of the complications.
If you have signs of diverticular bleeding, your doctor typically performs a colonoscopy to determine the source. During the procedure, the doctor may be able to stop the bleeding by applying a clip, injecting medication, or using a concentrated form of heat to seal the diverticular pouch.
If the source of bleeding cannot be identified, a specially trained radiologist may use a catheter—a slim, hollow plastic tube—to inject contrast dye into the blood vessels that supply the colon. The dye enables the radiologist to visually determine where blood is leaking from the vessels. If necessary, he or she can inject small metal coils or surgical glue into the affected area to stop the bleeding.
If diverticular disease causes substantial blood loss, you may also need a transfusion, a procedure in which you’re given blood intravenously.
For people who have a microperforation or an abscess, a doctor may prescribe bowel rest and antibiotics. Most of the time, antibiotics are administered through a vein with intravenous (IV) infusion.
An abscess may need to be drained. An interventional radiologist—who has expertise in gastrointestinal imaging procedures—inserts a needle into the abscess and drains the infected fluid. This does not require surgery.
Regardless of the type of treatment you receive, your doctor also may put you on a liquid diet and observe you to monitor your symptoms. As your symptoms improve, you can gradually add foods back to your diet under the guidance of your doctor.