Treating acute diverticulitis

Diverticulitis can usually be treated effectively. In straightforward (uncomplicated) cases, antibiotics often aren’t needed. Surgery is only necessary if the inflammation is so severe that it could lead to complications.
Diverticulitis is a condition where bulging pouches arise in the lining of the large intestine and then become inflamed or infected. These pouches, known as diverticula, are often harmless and may go unnoticed. But diverticulitis causes symptoms such as pain in the lower left side of the abdomen (tummy), fever and digestive problems. There are two types of diverticulitis:
- Uncomplicated diverticulitis: Diverticula and the surrounding intestinal lining are inflamed but there are no signs of pus building up (abscesses) or the inflammation spreading.
- Complicated diverticulitis: Abscesses have formed. Sometimes the inflammation has already spread or the wall of the intestine has torn (intestinal perforation). The intestine may also become blocked or the inner lining of the belly may become inflamed (peritonitis).
About 80% of people who have diverticulitis have the uncomplicated form, and about 20% have the complicated form.
Acute diverticulitis that has been successfully treated may come back again after some time. The risk of this happening is greater after having the complicated form.
In the past, acute diverticulitis was generally treated with antibiotics, and surgery was often recommended if it kept coming back. Nowadays clinical guidelines advise doctors to only use these treatments when absolutely necessary. Painkillers like ibuprofen or diclofenac (NSAIDs: non-steroidal anti-inflammatory drugs) shouldn’t be used to treat diverticulitis because they can increase the likelihood of complications such as intestinal perforations.