Diverticulitis by Ray Sahelian, M.D.

Diverticulosis is a condition whereby diverticula  (small pouches) develop in the lining of the large intestine, extending into and through the muscular tissue surrounding the intestine. If these pouches become infected or inflamed, the condition becomes known as diverticulitis. Acute diverticulitis is a condition in which diverticula in the colon rupture. The rupture results in infection in the tissues that surround the colon.

Acute diverticulitis symptoms
Acute diverticulitis can cause fever, malaise, elevated white cell count and other symptoms, characteristics that should guide physicians when considering referral for a CT scan.
   The demographics of acute diverticulitis in the United States are changing. In acute diverticulitis, a common intestinal disease related to a low-fiber diet, increased pressure causes pouches, or diverticula, to bulge out in the wall of the intestines. Bacterial infections can develop and cause serious complications, such as perforations. Even though most medical textbooks suggest that acute diverticulitis is primarily confined to elderly patients, the majority of cases occur in patients age 50 or younger.

Diverticulitis treatment
In patients with asymptomatic diverticulosis, a fiber-rich diet is used to reduce intraluminal pressure and slow down the worsening of the disease. Fiber supplementation is also indicated in symptomatic diverticulosis in order to get symptom relief and prevent acute diverticulitis. A combination of soluble fiber, like glucomannan, and poorly absorbed antibiotics, like rifaximin, given 7-10 days every month is a good treatment choice. For uncomplicated diverticulitis the standard therapy is liquid diet and oral antimicrobials, usually ciprofloxacin and metronidazole. Hospitalization, bowel rest, and intravenous antibacterial agents are mandatory for complicated diverticulitis. Once in remission, continuous fiber intake and intermittent course of rifaximin may improve symptoms and reduce diverticulitis recurrence.