Diverticulitis

Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms.

Your doctor will start with a physical examination, which will include checking your abdomen for tenderness. Women generally have a pelvic examination as well to rule out pelvic disease.

After that, the following tests are likely:

Blood and urine tests, to check for signs of infection.

A pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain.

A liver enzyme test, to rule out liver-related causes of abdominal pain.

A stool test, to rule out infection in people who have diarrhea.

A CT scan, which can identify inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment.

Treatment depends on the severity of your signs and symptoms.

Uncomplicated diverticulitis

If your symptoms are mild, you may be treated at home. Your doctor is likely to recommend:

Antibiotics to treat infection, although new guidelines state that in very mild cases, they may not be needed.

A liquid diet for a few days while your bowel heals. Once your symptoms improve, you can gradually add solid food to your diet.

This treatment is successful in most people with uncomplicated diverticulitis.

Complicated diverticulitis

If you have a severe attack or have other health problems, you'll likely need to be hospitalized. Treatment generally involves:

Intravenous antibiotics

Insertion of a tube to drain an abdominal abscess, if one has formed

Surgery

You'll likely need surgery to treat diverticulitis if:

You have a complication, such as a bowel abscess, fistula or obstruction, or a puncture (perforation) in the bowel wall

You have had multiple episodes of uncomplicated diverticulitis

You have a weakened immune system

There are two main types of surgery:

Primary bowel resection. The surgeon removes diseased segments of your intestine and then reconnects the healthy segments (anastomosis). This allows you to have normal bowel movements. Depending on the amount of inflammation, you may have open surgery or a minimally invasive (laparoscopic) procedure.

Bowel resection with colostomy. If you have so much inflammation that it's not possible to rejoin your colon and rectum, the surgeon will perform a colostomy. An opening (stoma) in your abdominal wall is connected to the healthy part of your colon. Waste passes through the opening into a bag. Once the inflammation has eased, the colostomy may be reversed and the bowel reconnected.