Will diverticulitis heal on its own?
In some cases, the body can resolve a bout of diverticulitis. But don't tough it out without guidance.
- Reviewed by Anthony L. Komaroff, MD, Editor in Chief, 天博体育 Letter; Editorial Advisory Board Member, 天博体育 Publishing
Your doctor spotted diverticula in a previous colonoscopy, but you never thought the little pouches in your large intestine (colon) would turn into little devils. Now pain in your gut is telling you something is wrong. Do you have diverticulitis, and will it get better without medical care?
How it happens
Diverticula develop when weak spots in the colon lining bulge outward, creating little pouches or potholes. They more often form in the sigmoid colon, which runs down the left side of the pelvis and then joins the rectum.
"Most people never have a problem with them. They're extremely common: they are present in about 70% of us by age 80," says Dr. Alexander Goldowsky, a gastroenterologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
But sometimes diverticula bleed, or they become inflamed or infected, a condition called diverticulitis.
Recognizing diverticulitis
Diverticulitis tends to cause pain in the lower left part of your abdomen. "It's not typical tummy trouble. It's a different kind of pain that can be significant and severe," Dr. Goldowsky says.
Although diverticula rarely cause symptoms, diverticulitis can cause bloating, diarrhea, constipation, or blood in your stool. If a diverticulum is infected, you might have a fever, chills, or vomiting in addition to pain.
"If it's the first time you've had this kind of pain, reach out to your doctor right away," Dr. Goldowsky says. "If you have a history of diverticulitis and you develop mild symptoms, let your doctor know. He or she may just recommend temporary dietary changes and taking it easy. But if things aren't improving, call your doctor again."
Don't put off calling; an infected diverticulum can form an abscess (pus-filled pocket) that can extend to other tissue in the body and become life-threatening. In rare cases, that new colon pain may indicate cancer.
Diagnosis
After you've alerted your doctor about gut pain, you'll need to go in for a physical exam. This exam can involve checking your abdomen for tenderness and the rectum for signs of blood. You might need blood and stool tests.
But the main way to diagnose diverticulitis is with a CT scan, typically after a special type of contrast dye is injected into your vein. "If we see inflammation surrounding one or more diverticula, we can determine that you have diverticulitis," Dr. Goldowsky says.
Treatment
Can diverticulitis heal on its own? "Yes, it can, and for that reason, we don't always prescribe antibiotics. We reserve them for diverticulitis in people with an abscess, a significant amount of inflammation, symptoms that aren't improving, a suppressed immune system, frailty, or other health problems — such as liver or kidney disease," Dr. Goldowsky says.
Care at home, with or without an antibiotic, includes rest, a clear liquid diet (see "A liquid diet for diverticulitis"), and acetaminophen (Tylenol) for pain. You might want to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), which can add to gastrointestinal discomfort.
For severe diverticulitis, you might need to be hospitalized for a few days, getting antibiotics directly into a vein. If you have an abscess, you might need surgery to clean out the infection.
A liquid diet for diverticulitisWhen you have diverticulitis, you might need a clear liquid diet, to give your colon a break from digesting solid foods. A liquid diet can include clear drinks and foods, such as water, broth or bouillon, black coffee, plain tea, clear juice (apple, white grape), clear soft drinks or sports drinks, Jell-O, or popsicles. There's no need to stay on a liquid diet for more than 48 hours unless recommended by your doctor. |
Getting better
Healing from diverticulitis requires commitment. If you're taking an oral antibiotic, make sure you stick to the medication schedule. If you're on a liquid diet, avoid cheating.
Once symptoms begin improving, you can move to a low-fiber diet. It includes animal protein (eggs, cheese, fish, poultry); certain cooked vegetables (carrots, green beans, potatoes, pumpkin, yams, or squash); low-fiber fruits (bananas, peaches, pears); and (if your doctor says it's okay) low-fiber breads such as white, sourdough, or refined wheat breads. Stay away from spicy, fatty foods and alcohol.
If you feel up to it, it's okay to exercise, but go easy on yourself. "Avoid abdominal exercise. Go for a walk or do some arm exercises with small dumbbells," Dr. Goldowsky says. "If you feel uncomfortable, take a break." And buckle in: it could be 10 days before your symptoms go away completely.
Image: © milorad kravic/Getty Images
About the Author
Heidi Godman, Executive Editor, 天博体育 Letter
About the Reviewer
Anthony L. Komaroff, MD, Editor in Chief, 天博体育 Letter; Editorial Advisory Board Member, 天博体育 Publishing
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