What is the best medication for diverticulitis

Generic name: sulfamethoxazole / trimethoprim systemic

Medications for Diverticulitis

Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall, usually found in the large intestine (colon). The presence of the pouches themselves is called diverticulosis.

Drugs used to treat Diverticulitis

The following list of medications are in some way related to or used in the treatment of this condition.

Generic name: metronidazole systemic

Brand names: Flagyl, Flagyl IV, Flagyl 375

Generic name: ciprofloxacin systemic

Physician is a high-paying career, and American doctors have some of the highest salaries worldwide, with general practitioners earning an average of $185,000 and surgeons earning $306,000 annually, according to MLive Media Group.

Brand names: Cipro, Cipro I.V., Cipro XR

Generic name: metronidazole systemic

Generic name: ciprofloxacin systemic

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: clindamycin systemic

Brand names: Cleocin, Cleocin HCl, Cleocin Pediatric, Cleocin Phosphate …show all

Generic name: sulfamethoxazole / trimethoprim systemic

Brand names: Bactrim DS, Bactrim, Septra, Co-trimoxazole, Septra DS, Sulfatrim Pediatric …show all

Generic name: metronidazole systemic

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: ciprofloxacin systemic

Generic name: ciprofloxacin systemic

Generic name: clindamycin systemic

Generic name: metronidazole systemic

Generic name: clindamycin systemic

Generic name: clindamycin systemic

Generic name: clindamycin systemic

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: hyoscyamine systemic

Brand names: Ed-Spaz, Hyosyne, Levbid, Levsin, Levsin SL, NuLev, Oscimin, Symax Duotab, Symax SL, Symax SR …show all

Generic name: sulfamethoxazole / trimethoprim systemic

Generic name: hyoscyamine systemic

Generic name: hyoscyamine systemic

Generic name: hyoscyamine systemic

Generic name: hyoscyamine systemic

Learn more about Diverticulitis

Care guides

• Diverticulitis
• Diverticulosis

Symptoms and treatments

Legend

Rating	For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity	Activity is based on recent site visitor activity relative to other medications in the list.
Rx	Prescription only.
OTC	Over-the-counter.
Rx/OTC	Prescription or Over-the-counter.
Off-label	This medication may not be approved by the FDA for the treatment of this condition.
EUA	An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access	Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.

Pregnancy Category
A	Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B	Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C	Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D	There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X	Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N	FDA has not classified the drug.

Controlled Substances Act (CSA) Schedule
M	The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U	CSA Schedule is unknown.
N	Is not subject to the Controlled Substances Act.
1	Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2	Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3	Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4	Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5	Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.

Alcohol
X	Interacts with Alcohol.

Further information

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What is the best medication for diverticulitis?

Diverticulitis is an inflammatory condition of the colon. Doctors treat it with antibiotics, acetaminophen, and tricyclic antidepressant. In some cases, surgery may be necessary.

Some over-the-counter medications may worsen the condition, so people should speak with a doctor before taking any medications for diverticulitis.

This article explores diverticulitis symptoms, causes, and complications. Additionally, it discusses the best medications, treatments, and lifestyle modifications doctors may recommend. Finally, it answers some common questions about diverticulitis.

Diverticulitis is a condition in which small pouches in the colon become inflamed. The small pouches, called diverticula, push outward through weak spots in the wall of the colon.

Doctors call the condition diverticulosis when a person has pouches or sacs in the colon without inflammation.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , diverticulosis is relatively common. It affects more than 30% of adults in the United States between the ages of 50–59 and more than 70% of those older than 80.

However, less than 5% of people with diverticulosis develop diverticulitis.

Symptoms of diverticulitis

Diverticulitis can cause the following symptoms :

• pain, usually in the lower left side of the abdomen
• diarrhea or constipation
• nausea or vomiting
• fever and chills

Typically, diverticulitis pain comes on suddenly and is severe. However, pain can also be mild and worsen over several days. The intensity of the pain may also change.

Causes of diverticulitis

The NIDDK notes that doctors are not sure what causes diverticular disease. However, experts think the following factors may play a role:

• genes — around 50% of the risk for diverticulitis is due to genetic factors
• diets low in fiber and high in red meat
• lack of physical activity
• obesity
• certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
• smoking

Additionally, the NIDDK explains that scientists are studying other aspects that may play a role in diverticular disease development. These include:

• problems with the immune system, connective tissue, muscles, or nerves in the colon
• changes in the gut bacteria in the intestines
• bacteria or stool getting caught in a pouch in the colon

Complications of diverticulitis

Sometimes diverticulitis may lead to complications, which doctors may need to treat in the hospital. Complications include :

• bleeding from the rectum
• intestinal obstruction, which is a partial or total blockage of the movement of food, fluids, air, or stool through the intestines
• perforation of the colon
• a fistula, which is an abnormal tunnel between the colon and another part of the body, such as the bladder or vagina
• an abscess, which is a swollen, pus-filled area that occurs due to infection
• peritonitis, an infection of the lining of the stomach wall

One study also indicates that the risk of colon cancer may be higher in people with complicated diverticulitis (7.9%) compared with uncomplicated diverticulitis (1.3%).

Antibiotics are the typical medication for diverticulitis. Sometimes a doctor may also prescribe painkillers or tricyclic antidepressants.

Antibiotics

The American College of Gastroenterology (ACG) advises that doctors typically use antibiotics and a liquid or low residue diet to treat diverticulitis. People with mild symptoms may be able to take their medication at home, but those with signs of infection or complications usually need to receive treatment in the hospital.

According to the American Gastroenterological Association (AGA), doctors may use a combination of oral fluoroquinolone and metronidazole antibiotics to treat mild cases in the outpatient setting. Alternatively, they may use monotherapy with oral amoxicillin/clavulanate potassium.

Additionally, the AGA advises that the duration of treatment is typically 4–7 days but can be longer.

However, people with mild symptoms and no complications may not need antibiotics. A 2019 review suggests that antibiotics have no proven benefit in reducing the duration of uncomplicated diverticulitis or preventing recurrence.

Acetaminophen

Research suggests that acetaminophen is suitable for diverticulitis pain relief.

NSAIDs may lead to diverticulitis complications, and people should avoid using them unless instructed otherwise by their doctor.

A doctor may prescribe other types of pain relief medications for someone to use at home or, in more severe cases, administer them intravenously in the hospital.

Tricyclic antidepressants

The AGA advises that ongoing gastrointestinal symptoms are common after an episode of acute diverticulitis. Therefore, a doctor may prescribe a low to modest dose of a tricyclic antidepressant after a full assessment.

Doctors can investigate diverticulitis symptoms or complications with a colonoscopy. This involves inserting a tube with a camera into a person’s rectum to examine the intestines.

People who have complications of diverticulitis may require treatment in a hospital. Additionally, doctors may recommend that someone with diverticulitis changes their diet and lifestyle.

Surgery

The ACG explains that doctors may use radiologic guided drainage for someone with a large abscess. This procedure involves a doctor placing a tube into the abdomen to drain the abscess.

In rare cases, a person may need surgery to remove a part of the colon that is bleeding.

Dietary modifications

Some people believe that a low residue diet can help with symptoms of diverticulitis.

However, the ACG advises that a large study found people who frequently ate nuts or popcorn were no more likely to experience diverticulitis than those who did not eat these foods. Therefore, the ACG no longer recommends that people with diverticulitis avoid these foods.

Similarly, the AGA notes that there is no association between consuming fruits with small seeds, such as strawberries, and diverticulitis risk.

However, a doctor may recommend a clear liquid diet to make a person more comfortable in the acute phase of uncomplicated diverticulitis.

The ACG also recommends including fiber and reducing the amount of red meat in the diet as studies suggest this helps decrease the risk of developing diverticulitis.

Lifestyle modifications

According to the ACG, people who maintain a moderate weight and exercise regularly are less likely to develop diverticulitis and diverticular bleeding. Additionally, avoiding smoking helps to prevent diverticulitis, especially the type with perforations.

Avoiding NSAIDs

The AGA explains that regular use of NSAIDs can increase the risk of diverticulitis. Therefore, doctors may advise a person with a history of diverticulitis to avoid using NSAIDs twice or more in a week. However, there may be exceptions for people with cardiovascular disease.

Below are answers to some common questions about diverticulitis.

What is the best medication for diverticulitis pain?

Acetaminophen may be suitable for diverticulitis pain. However, a doctor may advise a person to take something different.

People should speak with a doctor before taking any medications for diverticulitis pain.

What can trigger diverticulitis?

Contrary to past opinion, experts suggest that eating foods such as nuts or popcorn does not trigger diverticulitis. However, people who eat a low fiber diet may be more at risk of developing the condition.

What are the early signs of diverticulitis?

Abdominal pain that comes on suddenly may be a sign of diverticulitis. A person may also experience altered bowel movements, nausea, or vomiting.

Doctors may prescribe antibiotics to treat diverticulitis. They may also recommend acetaminophen or tricyclic antidepressants to manage ongoing abdominal pain.

Experts do not advise people to take NSAIDs for diverticulitis as they may cause further complications. However, doctors may advise people with cardiovascular disease differently. A person should always follow a doctor’s advice.

Someone with symptoms of diverticulitis should contact a doctor for an assessment and to discuss treatment options.

Last medically reviewed on August 10, 2022

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Diverticular disease. (2021).
  https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/all-content
• Diverticulosis and diverticulitis. (2022).
  https://gi.org/topics/diverticulosis-and-diverticulitis/
• Peery, A. F., et al. (2020). AGA clinical practice update on medical management of colonic diverticulitis: Expert review.
  https://www.gastrojournal.org/article/S0016-5085(20)35512-8/fulltext
• Swanson, S. M., et al. (2018). In the clinic: Acute colonic diverticulitis.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430566/
• Sweeny, A., et al. (2019). The management of diverticulitis: A review of the guidelines [Abstract].
  https://onlinelibrary.wiley.com/doi/abs/10.5694/mja2.50276

What Foods Should You Eat — and Avoid — on a Diverticulitis Diet?

So you’ve been diagnosed with diverticulitis, a form of diverticular disease. Eating and avoiding certain foods can help you manage and prevent symptoms — but there’s a lot of misinformation out there.

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The best diet for diverticular disease depends on whether you’re having a flare-up, says registered dietitian Anna Taylor, MS, RDN, LD.

Here, she clears up the confusion about how to manage diverticular disease with diet.

Diverticular disease: diverticulosis vs. diverticulitis

Diverticular disease means you have polyps (small growths) called diverticula in your gut. These polyps can exist without causing any symptoms and without you even knowing they’re there. This is called diverticulosis.

If the polyps become inflamed or infected, they can cause symptoms such as abdominal cramping, pain or tenderness in the area, swelling, bloating, constipation or diarrhea. This is called diverticulitis.

How to follow a diverticulosis diet

Constipation often contributes to the development of diverticula. “People develop polyps due to years of excessive muscular contractions as the body attempts to move small, hard stools,” explains Taylor. A high-fiber diet helps fight constipation by softening stool, which then moves through the GI tract more comfortably and easily. There’s also less pressure against the polyps, which prevents diverticulitis flare-ups.

To eat a diet rich in fiber (doctors recommend 25 to 35 grams per day), choose minimally processed plant foods such as:

• Whole grains.
• Fruits.
• Vegetables.
• Beans.
• Legumes including lentils and nuts.

Years ago, doctors thought that eating corn, popcorn, nuts and seeds could inflame the polyps and cause diverticulitis, but there’s no research to support that. “It’s safe to eat these types of foods, including tomatoes and strawberries with seeds,” Taylor notes. “All that normal roughage and fiber is fine.”

To get the most out of a high-fiber diet, Taylor also recommends:

• Drink at least 64 ounces of water a day – more if you’re active.
• Exercise regularly (it helps propel waste through your system).
• Eat a variety of food groups, including five or more servings of fruits and vegetables, three of whole grains and a serving of nuts or beans each day.
• Limit American diet favorites, such as red meat and processed and high-fat foods.

“Diverticular disease may be common in Western societies because our diets are so low in fiber,” Taylor says. “Americans, on average, eat around 14 grams each day — about half of what’s recommended.”

How to follow a diverticulitis diet

“On the flip side, when you have diverticulitis, the polyps are upset, inflamed and maybe even infected. We want to reduce traffic in your GI tract so that nothing else irritates them,” says Taylor. “Decreasing the fiber in your diet helps with that.”

During a diverticulitis flare-up, your doctor may recommend rest, antibiotics and either a clear liquid or low-fiber diet.

Clear liquid diet for diverticulitis

If a diverticulitis flare-up is severe or requires surgery, your doctor may recommend a clear liquid diet. “After a day or two, you progress from clear liquids to a low-fiber diet,” says Taylor. “Even if your pain does not subside, you still move toward regular food. You can’t be on a liquid diet long-term because you can become malnourished.”

On a clear liquid diet, you can eat:

• Clear broths (not soup).
• Clear, pulp-free juices (such as apple and cranberry juice).
• Jell-O.
• Popsicles.
• Water.

Low-fiber diet for diverticulitis

For milder cases of diverticulitis, eat a low-fiber, or GI soft, diet. A low-fiber diet limits fiber intake to between 8 and 12 grams of fiber, depending on the severity of the flare-up.

Good low-fiber food options include:

• Grains: Lovers of white pasta and white bread, rejoice! Those are good low-fiber options, along with white rice and white crackers.
• Low-fiber starches: Get your peeler out. Potatoes without skin can be on the menu. Mash, roast or bake them. Certain low-fiber cereals also get a thumbs-up, including corn flakes and puffed rice cereal.
• Proteins: Choose eggs and egg whites, tofu, and meat or seafood. “It should be tender, so shredded chicken, lean ground beef and soft baked fish work best.”
• Fruits: Use caution since fruits have lots of fiber. Good options include canned fruits such as peaches or pears, applesauce, ripe bananas, and soft, ripe cantaloupe and honeydew. “It’s not a lot of fiber because you’re not eating the skin. The skins are the source of insoluble fiber, which can irritate inflamed polyps.”
• Dairy: “Cottage cheese and Greek yogurt are real winners if you’re recovering from a flare-up: They’re high in protein, calcium and other nutrients and don’t have any fiber. They’re also soft, moist and easier to get down if you’re not feeling well,” says Taylor. You can also have milk and cheese.

Foods to avoid with diverticulitis include high-fiber options such as:

• Whole grains.
• Fruits and vegetables with the skin and seeds.
• Nuts and seeds.
• Beans.
• Popcorn.

Follow the low-fiber diet until diverticulitis symptoms subside. “Usually they start to improve after several days of being on antibiotics,” Taylor says.

If they do, your doctor will have you gradually increase your fiber intake over several days to weeks to avoid constipation and bloating. “The goal is getting back to a high-fiber diet to decrease your risk for future bouts of diverticulitis,” Taylor adds. “But if you’re not feeling better within a few days, talk to your doctor.”

Talk to your doctor about a long-term plan, too. And if you’ve recently been diagnosed with diverticular disease, meet with a dietitian to learn practical and sustainable ways to get more fiber into your diet. “Dietitians can also give you more specific recommendations to feel better during a diverticulitis flare-up,” Taylor says.

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