2015-10-29 17:23:20 UTC

Diverticulitis 106: Managing and Preventing Recurrence of Acute Diverticulitis

Learn more about acute diverticulitis in this patient companion, based on the AGA Clinical Guideline.

Clinical practice guidelines are developed under the guidance of the AGA Institute Clinical Guideline Committee and provide evidence-based recommendations for clinical practice in the field of gastroenterology. The clinical practice guidelines and related Clinical Decision Support Tools support evidence-based clinical decision-making by gastroenterologists and other health-care professionals at the point of care. The below information presents important content from those guidelines in a way that will help patients better understand AGA’s recommendations for evaluating, diagnosing or managing a condition.

AGA Clinical Guideline: The Management of Acute Diverticulitis

The information provided by the AGA Institute is not medical advice and should not be considered a replacement for seeing a medical professional.

Contents:

What is Diverticulitis?

Preventing Recurrence

Questions For Your Doctor

 


What is Diverticulitis?

  • Diverticulitis is a painful form of inflammation in the digestive tract. Diverticulosis is a condition in which pockets (or diverticula) occur in the wall of the colon. When these pockets become infected or inflamed, it is called diverticulitis.
  • Acute diverticulitis is a painful, relatively sudden condition that can usually be treated without surgery.
  • Symptoms usually appear within a few days and can include:
    • Abdominal pain and tenderness, often on the lower left side.
    • Fever.
    • Change in bowel habits (such as diarrhea or constipation). 
  • Your doctor can usually treat diverticulitis with a special diet, plenty of rest and, in some cases, antibiotic medications.
  • Once treated, most people start feeling better within a few days.
  • Approximately 20 percent of patients will have another flare-up, or recurrence. This usually happens within five years.
  • There may be several steps you can take to lower your risk of future attacks.
  • Diverticulitis is a common disorder.
  • Every year in the U.S., patients spend a total of 1.5 million days in the hospital due to the disease. 
  • If diverticulitis keeps recurring, surgery may be considered.

Preventing Recurrence

Reach for foods high in fiber

  • Fiber is a form of carbohydrate that helps keep the digestive system healthy.
  • Studies suggest that eating enough fiber can help you avoid another flare-up of diverticulitis and reduce the need for surgery in the future.
  • After your diverticulitis has cleared, you will want to slowly start getting more fiber in your diet.
  • Americans should aim to get at least 25 grams of fiber per day, but most get only half of what they need.2
  • The best way to do this is to eat more plant foods throughout the day. Try getting at least 8 grams at breakfast, lunch and dinner to meet your daily requirement.
  • Here are some simple, satisfying ways to add fiber to your daily meals: 
    • Berries.
      • Throw some blueberries or raspberries into a smoothie or stir them into a bowl of yogurt. One cup of berries will add 4 to 8 grams of fiber to your meal.
    • Beans.
      • Beans and lentils are packed with fiber: each ½-cup serving contains 5 to 8 grams. Take your taco up a notch by adding some black beans to the mix, or try an online recipe for homemade hummus and dip with carrots and celery for some crunchy, satisfying finger food.
    • Nuts and popcorn.
      • Contrary to what you may have heard, these foods are fine to eat after you recover. Looking for a way to conquer a sweet-and-salty craving between meals? Pair a handful of nuts or a few cups of air-popped popcorn with a piece of fresh fruit. Three cups of popcorn and a pear, for instance, pack more than 8 grams of fiber together.
    • Green veggies.
      • When eating salad, choose spinach or kale over regular lettuce. Oven-roast asparagus or Brussels sprouts in balsamic vinegar for a delicious addition to dinner. One cup of these veggies contains 4 grams of fiber.

Break a sweat for at least 90 minutes a week

  • You probably know that exercise is great for keeping a healthy heart, mind and weight. Some studies even suggest that it can help prevent diverticulitis. 
  • Healthy adults should get at least 90 minutes of vigorous activity every week.
  • Vigorous activity is the kind that gets your heart pumping and makes you break a sweat. Great examples are:
    • Jogging.
    • Swimming laps.
    • Taking aerobics classes.
    • Playing competitive sports.

Take aspirin or acetaminophen for minor aches and pains

  • Some studies suggest that certain over-the-counter (OTC) pain relievers, such as aspirin and NSAIDs, which include ibuprofen and naproxen, may raise your risk of a future flare-up.
  • For occasional aches and pains, it is best to choose acetaminophen.
  • Always remember to read and follow all of your medicine labels and do not exceed dosing guidelines. For pain that lasts longer than a week, see a doctor. Learn more about medicine labels and guidelines here.

Talk to your doctor about getting a colonoscopy after your condition improves

  • In rare cases, diverticulitis can actually be a warning sign for colon cancer. Getting a colonoscopy can rule out this possibility.
  • If you have not had a colonoscopy recently, talk to your doctor about getting one a couple months after you recover.

Questions For Your Doctor

  • How can I tell if I am getting enough fiber in my daily diet?
  • Am I healthy enough to begin/continue vigorous physical activity after I recover?
  • Is there any reason I should not take aspirin or other pain relievers?
  • Should I get a colonoscopy soon to make sure I don’t have colon cancer?

 

References

Matrana, D.A. and Margolin, D.A. Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009; 22: 141–146. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/.

King, D.E., Mainous, A.G. III, and Lambourne, C.A. Trends in dietary fiber intake in the United States, 1999-2008. J Acad Nutr Diet. 2012; 112: 642–648. http://www.ncbi.nlm.nih.gov/pubmed/22709768 .

World Health Organization. What is moderate-intensity and vigorous-intensive physical activity? http://www.who.int/dietphysicalactivity/physical_activity_intensity/en/.

Centers for Disease Control and Prevention. Measuring physical activity intensity. http://www.cdc.gov/physicalactivity/basics/measuring/index.html.

 

Updated March 2016

©AGA, July 2016

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