Diverticulitis - Treatment & therapy

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Treatment & therapy of a Diverticulitis

The treatment depends on the stage of the disease. In mild cases, surgery may not be necessary. If you suffer from complications, surgery is often unavoidable. Therefore, in severe cases you must be treated in a hospital.  There you will initially receive no solids, but only liquids or IVs. 

Stage I/IIa/IIb: Waiver of surgery

In stage I and in one of the first inflammation in the stages IIa and IIb, a surgery can be omitted. Via IVs, you will receive the following antibiotics:

  • Ampicillin
  • Gyrase inhibitors
  • Sulbactam

If your symptoms are reduced, after two to three days you can return to normal food. In case of repeated inflammations in stages IIa/IIb, the inflamed bowel section must be removed. This takes place within an inflammation-free interval,  i.e. six to eight weeks after the beginning of the antibiotics treatment. If pain persists in spite of the medicine, the surgery can be carried out seven to ten days after the beginning of the infusions. Stage IIc is considered an emergency and in this case surgery must be carried out immediately. In this case, several diverticula have already ruptured and there is a risk of a dispersion to the whole peritoneum. If diverticulitis is recurrent (stage III), surgery is also recommended. 

Stage IIc

The surgeon removes the inflamed bowel section and then connects the healthy ends.  The surgery can be carried out either open via an abdominal section or via a laparoscopy. Compared to a gall bladder resection, only a small incision is needed for the last mentioned option as well (mini laparotomy). If diverticula have ruptured, open surgery is often recommended. In such an emergency case, for the relief of the new connection between the bowel sections, an artificial anus (anus praeter) is placed.  This can be removed during the second surgery. However, sometimes the natural bowel route cannot be restored.