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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.
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).
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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.
Treatment for diverticulitis may involve antibiotics to limit bacterial overgrowth, and some may recommend a high-fiber diet after patients have recovered. In more severe cases, though, the affected area of the colon might be surgically removed.
More time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED). [29] Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1/3 of the time.
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