What is the primary treatment for diverticulosis?

While uncomplicated diverticulitis may require only a brief doctor’s visit, complicated diverticulitis is a completely different ball game, and treatment isn’t as simple as a few days on a liquid diet.

“Complicated diverticulitis is defined by the presence of a more advanced disease, such as perforation, abscess, fistula, intestinal obstruction, or bleeding,” Bulsiewicz says. “Generally, those with complicated diverticulitis will be hospitalized, and there’s a much higher likelihood of requiring surgery to fix the issue, although not always.”

Here’s what you can expect treatment-wise if you’re diagnosed with a more serious case of diverticulitis.

1. Intravenous Antibiotic or Pain Therapy

If you can’t keep fluids down or if you have a weak immune system, your doctor may recommend being admitted to the hospital.

You’ll receive pain medicine and antibiotics intravenously while in the hospital, which involves connecting a tube to your vein. Intravenous therapy is effective because medication gets into your bloodstream and begins working faster.

2. Surgery

If diverticulitis progresses, your doctor may start discussing the possibility of surgery.

“There are two scenarios when surgery is considered as treatment for diverticulitis. First, if there’s a perforation, abscess, fistula, or intestinal blockage, it may be necessary to perform surgery in order to correct the problem,” Bulsiewicz warns. “In this setting, diverticulitis is usually so severe that there is little choice but to proceed with surgery.”

The purpose of surgery is to remove sections of the colon affected by the condition. One option is a primary bowel resection, which removes the diseased section of the colon and reconnects healthy sections so that you can retain normal bowel function. Your surgeon can perform this procedure with open surgery or a laparoscopic procedure.

If your surgeon can’t remove a diseased section and reconnect healthy sections, you may need a bowel resection with colostomy. This procedure is a bit more intense and involves the creation of a hole or opening for the large intestines through the abdominal wall. Your surgeon attaches a bag to the end of this opening, which collects waste.

The good news is that a colostomy isn’t always permanent, so you may need to wear the bag only temporarily. You’ll follow up with your doctor once your diverticulitis heals to discuss possibly reversing the colostomy and reconnecting your colon.

If you develop an abscess, which is a pocket of pus, it may heal on its own with antibiotics, or your doctor can drain it during surgery. If you don’t need surgery, your doctor can also insert a needle through your skin and drain it this way.

While surgery is usually for complicated attacks, there’s also the option of elective surgery if you have two or more acute, uncomplicated attacks.

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Current classification of diverticular disease of the colon