Management of Acute Diverticulitis Guideline Patient Companion
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.
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.
- 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.
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:
- 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 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:
- 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?
Matrana, D.A. and Margolin, D.A. Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009; 22: 141–146. link.
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. link .
World Health Organization. What is moderate-intensity and vigorous-intensive physical activity? link.
Centers for Disease Control and Prevention. Measuring physical activity intensity. link.