What is the best medication for diverticulitis

Diverticulitis Treatments and Medications

Individuals over 70 years old commonly develop diverticulitis but people in their 30’s and 40’s can experience signs of this digestive tract condition. Abdominal pain presenting on the left side of the body or blood in the stool, though common for numerous ailments could be an indicator of diverticulitis.

Nearly 200,000 individuals in the United States are diagnosed with diverticulitis every year. If you have been diagnosed with diverticulitis, understanding your condition and how to manage your symptoms naturally, with medication, or surgically, is necessary to maintaining health and wellness.

What is diverticulitis?

Diverticulitis is a condition in which small pouches, called diverticula, develop in the intestines and become inflamed or infected. Diverticula, or the pouches, alone are not harmful and are referred to as diverticulosis. Undigested food can get caught in the diverticula and cause irritation and inflammation. Once the pouches become infected and diverticulitis has formed, treatment is needed.

If left untreated, diverticulitis can lead to an abscess in the lower part of the bowel called the sigmoid colon. Bowel obstruction, diverticular bleeding, or internal bleeding into the large bowel can also occur if diverticulitis symptoms are ignored.

How is diverticulitis diagnosed?

Abdominal pain in the lower left quadrant is one of the main symptoms associated with diverticulitis. Fever, chills, diarrhea or constipation, bloating, rectal bleeding, bloody stools, nausea, and vomiting are additional symptoms of diverticulitis.

Men are more likely to develop diverticulitis than women. If you are of a certain age and are experiencing these symptoms your doctor may suspect diverticulitis. Other conditions such as irritable bowel syndrome (IBS) may have similar symptoms as an episode of diverticulitis so your doctor will need to do a systematic review of your health.

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Your physician will ask you numerous lifestyle questions and perform a physical examination to further determine if you need to undergo testing for diverticulitis. Individuals who do not exercise and are overweight have an increased risk of diverticulitis. Phlegmon, or the inflammation of the soft intestinal tissue, can occur in individuals who lack dietary fiber. A diet high in fats can increase the potential for pouches to develop in the intestines and become inflamed.

The use of opioids and steroids can also lead to an episode of diverticulitis. In addition, your doctor may ask if you frequently use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The use or overuse of pain relievers is also linked to episodes of diverticulitis.

A physical exam including temperature, weight, and checking the abdomen for tenderness is part of the process of diagnosing diverticulitis. Women often undergo a pelvic exam and a pregnancy test to rule out other conditions including the possibility of pregnancy.

Generally, patients concerned about diverticulitis may need to submit urine or stool samples. Blood tests may also be required to check for an increased white blood cell count that could indicate an infection. Once the results of the blood and urine are examined (or if there is an urgent need) a CT scan, x-rays, or colonoscopy can be ordered to confirm a diagnosis of diverticulitis.

CT Scan

CT scan is short for computed tomography scan. An intravenous (IV) contrast solution or oral contrast solution such as barium sulfate is often used to identify conditions like diverticulitis in the large intestines or bowels. The contrast solutions used for CT scans allow better visibility of the body’s internal workings. The severity of the condition can also be determined through this process.

X-rays

Similar to CT scans, x-ray technology can be used to examine the intestines. Again, a contrast solution creates a better image for the radiologist to review for diagnosis. X-rays of the lower GI tract can be assessed for complications associated with diverticular disease. An x-ray will show if the peritoneum is inflamed or if the diverticulum is blocked with stool.

Colonoscopy

Colonoscopy is an internal examination of the colon and lower bowels. A lit tube with an image transmitter (camera) is inserted in the rectum to gain visual access to the problem area. The doctor will be able to see diverticula and determine what treatment options are needed. In addition, a colonoscopy can help eliminate other conditions such as colon cancer.

Diverticulitis treatment options

Mild diverticulitis may heal with diet modifications, stool softener, rest, or oral antibiotics to fight infection. If the diverticulitis disease progresses to acute diverticulitis due to lack of treatment, intravenous antibiotics and even surgery may be necessary to properly treat the condition.

Your physician may refer you to a diagnostic radiologist or gastroenterologist, or digestion specialist to determine if surgery is necessary.

Diverticulitis medications

Antibiotics and anti-spasm medications are included in the possible pharmaceutical treatments recommended for the management of acute diverticulitis.

Antibiotics

Antibiotics are utilized for treating infections that can occur in acute diverticulitis. Ciprofloxacin, levofloxacin, metronidazole, amoxicillin-clavulanic, and moxifloxacin are typically prescribed to treat infection related to diverticulitis.

Antispasmodics

Muscle relaxants may be helpful in reducing spasms in the large intestine as a result of peritonitis or irritated soft tissue. Levbid may be prescribed to aid spastic muscles related to diverticulitis.

What is the best medication for diverticulitis?

Treating diverticulitis with prescription medication can often prevent the need for surgical intervention. Below is a list of some of the top medicines that are used in treating diverticulitis.

Best medications for diverticulitis
Drug name	Drug class	Administration route	Standard dosage	Most common side effects
Levbid (hyoscyamine sulfate ER)	Antispasmodic	Oral	0.375 mg tablet with 12-hour release twice daily	Tightening of chest, confusion, blurred vision
Anaspaz (hyoscyamine)	Antispasmodic	Oral	0.125 mg dissolving tablet	Anxiety, trouble breathing, dizziness
Augmentin (amoxicillin-clavulanate)	Antibiotic	Oral	One extended-release tablet every 12 hours	Rash, nausea, vomiting
Flagyl (metronidazole)	Antibiotic	Oral	500 mg tablet as directed by a doctor	Dizziness, headache, confusion

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

What are common side effects of diverticulitis medication?

Prescription medicine, such as antibiotics or anti-spasm medications, is often needed to fight infection and reduce internal stress associated with diverticulitis. Every medication has a list of potential side effects. The most common side effects of diverticulitis medication are nausea, vomiting, headache, dizziness, and confusion. Additional side effects are also listed in the table above.

See your medication label or talk to your doctor or pharmacist for more information regarding the side effects associated with your prescription. Be sure you are taking your medication as prescribed and follow-up with your doctor if your medication is causing you unwanted side effects.

What is the best home remedy for diverticulitis?

A variety of home remedies can naturally help relieve diverticulitis, especially mild cases. Rest is often recommended for individuals whether you have mild or acute diverticulitis. A liquid diet or a clear liquid diet is another way to allow the intestinal tract to naturally heal.

Liquid diet

A liquid diet allows the bowels to empty and inflammation to clear up on its own. Undigested food debris can be flushed out of the bowels during a liquid diet regiment and bloating pressure can be relieved. Broth, ginger ale, tea (especially green tea) and clear sports drinks can be consumed while on a clear liquid diet. Juices, such as apple or white grape can give you energy while you are cleansing and resting the intestines. As long as the juice does not contain pulp, almost any juice can work. A less strict liquid diet or soft food diet can also be beneficial if you are suffering from diverticulitis. Gelatin and apple sauce are among many foods that can soothe an infected bowel.

Modified diet

If you are not able to go completely to a liquid diet, a modified diet reducing foods that aggravate the diverticula is suggested. In addition to eliminating diverticulitis triggers, individuals are recommended to increase the intake of foods that support digestive health.

Avoid red meat, fried foods, nuts, corn, and sugary foods. Some individuals are irritated by dairy while others are soothed by dairy. Take personal notes on what foods trigger or comfort your intestines.

A high fiber diet is recommended for digestive health. If you are consuming solid foods, whole-grain breads, pastas, and cereals can be incorporated into your daily meal plan. Adding almost any kind of beans, rice, many vegetables (potatoes or squash), and fruits (pears, peaches, and apples) can increase your fiber intake. Prune juice is also helpful for bowel health.

Superfoods

Green tea, aloe vera juice, turmeric, spinach, garlic, and ginger have healing properties that support healthy digestion. Superfoods are sometimes considered natural medicines, so ask your doctor about what superfoods you can include in your daily diet.

Enzymes

Digestive enzymes and probiotics are available over the counter to promote healthy digestion. Enzyme supplements, similar to the enzymes that occur naturally in your stomach can be taken to increase your body’s ability to digest food.

Probiotic

Management of acute uncomplicated diverticulitis may include the use of probiotics. Probiotics support healthy bacteria in the gut allowing better digestion. Naturally found in fermented foods like sauerkraut and yogurt, probiotics can be purchased in powder or capsule form. Taking a daily probiotic can help aid digestive health and normalize bowel function. If you are taking an antibiotic your doctor may recommend a probiotic to counterbalance the removal of necessary bacteria as a result of the medication. The current literature is inconclusive regarding the impact of probiotics on diverticulitis, however, more research is needed in this area.

Fiber supplement

Fiber supplements such as Metamucil can help keep bowels moving on a regular basis. Usually, fiber comes in a powder mix that is added to water and swallowed once a day, usually in the morning. Fiber substances may initially cause bloating and gas but over time can be extremely helpful in reducing constipation that puts stress on the colon.

Colonics

Colonics or colon hydrotherapy is a method of irrigating the colon using large volumes of water. While a colonic can be helpful in cleaning out the bowels, especially if you are constipated, there are risk factors involved. The colonic process could be irritating to the intestinal tissue and cause damage. Data regarding its beneficial effects for patients with diverticulitis is limited and safety is a concern. If you have diverticulitis and are considering getting colon hydrotherapy, consult your doctor first.

Frequently asked questions about diverticulitis

What is the main cause of diverticulitis?

Age and stress on the colon from constipation over the course of a lifetime can lead to diverticulitis. Diverticulitis is irritated by undigested foods that get trapped in pockets in the intestinal lining.

Can diverticulitis go away on its own?

Rest and a low impact diet such a liquid regiment or soft food meals can naturally alleviate diverticulitis. Antibiotics are often utilized to treat diverticulitis infections.

What is the pain of diverticulitis like?

Pain in the lower left quadrant of the abdomen, bloating, and stomach cramps are typical for diverticulitis pain. The pain may last a few hours to a few days, but is typically not severe and often described as “uncomfortable.”

Is diverticulitis serious?

Generally, diverticulitis is not a serious condition, but if left untreated it may require colon resection surgery.

What foods trigger diverticulitis?

Fried foods and red meat may irritate the intestinal lining causing a diverticulitis flare-up. Other foods like nuts and corn that often go through the body undigested can get caught in the diverticula, also causing inflammation.

Can diverticulitis be caused by stress?

While stress can weaken the immune system and the body’s ability to function, there is not a direct correlation between stress and diverticulitis disease.

Related resources for diverticulitis

• Testing for diverticulitis
• Complications of diverticulitis
• Defend yourself from diverticulitis
• Figure of diverticula in intestines

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

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