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Antibiotics should be used selectively in most cases of uncomplicated diverticulitis. However, antibiotic use is strongly advised in immunocompromised patients. [11] Colonoscopy is recommended 6–8 weeks after an episode of complicated diverticulitis or a first-ever episode of diverticulitis.
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Treatment may include antibiotics, aminosalicylates, and corticosteroids. Antibiotics include ciprofloxacin and metronidazole, given for 14 days. If symptoms recur after improvement with antibiotics, a second course of antibiotics may be given. If an initial course of antibiotics is ineffective, then mesalamine may be tried.
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset. [1] Patients commonly have elevated C-reactive protein and a high white blood cell count. [10] In Asia it is usually on the right (ascending colon), while in North America and Europe, the abdominal pain is usually on the left lower side (sigmoid colon).
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include constant abdominal pain, localized abdominal tenderness in the left lower quadrant of the abdomen, nausea, vomiting, constipation or diarrhea, fever and leukocytosis .
While a low-fiber diet is generally used for acute diverticulitis, the NIH guidelines recommend a high-fiber diet for patients with diverticulosis (a condition that may lead to diverticulitis). [17] A Mayo Clinic review from 2011 showed that a high-fiber diet can prevent diverticular disease.
The hydrogen breath test involves having the patient fast for a minimum of 12 hours then having them drink a substrate usually glucose or lactulose, then measuring expired hydrogen and methane concentrations typically over a period of several hours. It compares well to jejunal aspirates in making the diagnosis of bacterial overgrowth.
Good news for coffee drinkers: People who have one to three cups a day face a lower risk of developing diabetes, heart disease and other cardiometabolic conditions, new research suggests.