Need a Diverticulitis Doctor? Understanding Diagnosis and Treatment

Diverticulitis can cause significant abdominal pain and discomfort, making it crucial to understand how it’s diagnosed and treated. This article provides a comprehensive overview of diverticulitis diagnosis and treatment options, helping you navigate your health journey and know when to seek expert medical advice from a Diverticulitis Doctor.

Diagnosing Diverticulitis: What to Expect

Pinpointing diverticulitis involves a thorough process to rule out other conditions with similar symptoms. Your healthcare provider, potentially a diverticulitis doctor, will start with a comprehensive physical examination and may order several tests.

Physical Examination

A physical exam is the first step in diagnosing diverticulitis. Your doctor will carefully palpate your abdomen to identify areas of pain and tenderness. For women, a pelvic exam might be conducted to exclude issues related to the reproductive organs.

Laboratory Tests

Lab tests play a vital role in excluding other ailments and confirming a diverticulitis diagnosis. Common tests include:

Blood tests: These can detect signs of infection, indicated by elevated white blood cell counts, and assess immune system activity.
Urine test: A urine analysis helps rule out urinary tract infections, which can mimic diverticulitis symptoms.
Stool test: This test can identify infections or other issues in the digestive tract.
Pregnancy test: For women of childbearing age, a pregnancy test may be necessary as pregnancy can sometimes present with abdominal symptoms.
Liver enzyme test: This blood test helps to exclude liver disease as a cause of your symptoms.

Computerized Tomography (CT) Scan

A CT scan is a crucial imaging technique for diagnosing diverticulitis. It provides detailed images of your abdomen and pelvis, allowing doctors to visualize:

Inflamed diverticula: CT scans can clearly show the inflamed pouches characteristic of diverticulitis.
Abscesses: These are collections of pus that can form as a complication of diverticulitis, and CT scans can detect them.
Fistulas: Abnormal connections between organs or tissues, known as fistulas, can also be identified through CT imaging.
Other complications: CT scans help in assessing the extent of the disease and identifying any other complications.

If you are experiencing symptoms suggestive of diverticulitis, consulting a diverticulitis doctor for these diagnostic procedures is essential for timely and accurate diagnosis.

Diverticulitis Treatment: From Home Care to Surgery

Treatment strategies for diverticulitis are tailored to the severity of your condition. A diverticulitis doctor will determine the best course of action based on whether you have uncomplicated or complicated diverticulitis.

Uncomplicated Diverticulitis Treatment

Uncomplicated diverticulitis refers to mild cases without complications. In such instances, treatment can often be managed at home under the guidance of your healthcare provider.

Liquid Diet: Initially, your doctor will likely recommend a temporary liquid diet. This rests your digestive system and allows the inflammation in your colon to subside.
Gradual Reintroduction of Solid Foods: As your symptoms improve, you can gradually reintroduce solid foods. Start with low-fiber options and slowly progress to a regular diet.
High-Fiber Diet: Once fully recovered, a high-fiber diet is recommended for long-term management. Fiber helps soften stools and reduces pressure in the colon, preventing future diverticulitis flare-ups.
Fiber Supplements: Your diverticulitis doctor might also suggest fiber supplements to ensure you’re getting enough fiber, especially if dietary changes are insufficient.
Antibiotics: Antibiotics are often prescribed to treat the infection associated with diverticulitis. It’s crucial to complete the entire course of antibiotics, even if you start feeling better, to ensure the infection is fully eradicated.

Complicated Diverticulitis Treatment

Complicated diverticulitis involves severe symptoms or the presence of complications like abscesses, perforations, or fistulas. Hospitalization is usually necessary for these cases.

Intravenous Antibiotics: In the hospital, antibiotics are administered intravenously (IV). This ensures the medication directly enters your bloodstream to fight the infection effectively.
Drainage of Abscesses: If an abscess has formed, it may need to be drained. This can sometimes be done with a minimally invasive procedure guided by imaging.

Surgical Intervention for Diverticulitis

Surgery becomes necessary in certain situations, particularly for complicated diverticulitis or recurrent episodes. A diverticulitis doctor who is a surgeon might recommend surgery if:

Complicated Diverticulitis: You’ve experienced complications such as colon wall ruptures, fistulas, or significant tissue damage.
Multiple Episodes of Uncomplicated Diverticulitis: Repeated episodes, even if uncomplicated, can indicate a need for surgery to prevent future occurrences and improve quality of life.
Weakened Immune System: Patients with compromised immune systems are at higher risk of severe complications, making surgery a more proactive option.

There are two main surgical approaches for diverticulitis:

Colon Resection with Primary Anastomosis: This involves removing the diseased section of the colon and then reconnecting the healthy ends. This aims to restore normal bowel function in a single procedure.
Colon Resection with Colostomy: In more complex cases, or when there’s significant inflammation, a colostomy might be performed. The diseased colon section is removed, and the healthy colon is diverted to an opening (stoma) in the abdominal wall. Waste is collected in a colostomy bag. This allows the remaining colon to heal. In many cases, this is temporary, and the colostomy can be reversed in a later surgery to reconnect the colon.

Other surgical procedures may be required to address specific complications like peritonitis (infection of the abdominal lining) or fistulas.

Follow-Up Care After Diverticulitis

After treatment for diverticulitis, follow-up care is crucial. Your diverticulitis doctor may recommend a colonoscopy, usually around six weeks after your symptoms have resolved.

Colonoscopy: This procedure involves using a flexible camera to examine the colon and rectum. It’s recommended to check for any abnormalities, such as polyps or cancer, especially as diverticulitis and colorectal issues can sometimes coexist. The timing of a colonoscopy recommendation depends on your individual history, including when you last had one and the severity of your diverticulitis.

Alternative and Complementary Therapies

While conventional medical treatments are the mainstay for diverticulitis, some people explore alternative therapies.

Probiotics: Some small studies suggest that probiotics, which introduce beneficial bacteria to the gut, might reduce the risk of recurrent diverticulitis. However, current scientific evidence is not robust enough to widely recommend probiotics as a standard treatment. Always consult with your diverticulitis doctor before starting any probiotic or other supplements.

Preparing for Your Appointment with a Diverticulitis Doctor

If you suspect you have diverticulitis, being prepared for your appointment can help you get the most out of your consultation with a diverticulitis doctor, potentially a gastroenterologist.

What You Can Do to Prepare

Pre-Appointment Restrictions: Be aware of any instructions given when you schedule your appointment, such as fasting or dietary restrictions.
Symptom List: Write down all your symptoms, even those that seem unrelated to your digestive system.
Medication List: Compile a list of all medications, vitamins, and supplements you take, including dosages and reasons for taking them.
Medical History: Summarize your key medical history, including any other health conditions you have.
Personal Information: Note any significant personal information, such as recent life changes or stressors.
Bring a Support Person: If possible, have a family member or friend accompany you to help remember information and provide support.
Questions for Your Doctor: Prepare a list of questions to ask your diverticulitis doctor.

Questions to Ask Your Diverticulitis Doctor

What is the most likely cause of my symptoms?
What tests do I need, and is any special preparation required?
What treatment options are available for my condition?
How can I prevent diverticulitis from recurring?
Are there any dietary changes I should make?
How will my diverticulitis treatment interact with my other health conditions?

Don’t hesitate to ask additional questions during your appointment.

What to Expect From Your Diverticulitis Doctor

Your doctor will ask you questions to understand your symptoms and medical history. Common questions include:

When did your symptoms start, and how severe are they?
Are your symptoms constant or intermittent?
What factors seem to improve or worsen your symptoms?
Have you had a fever?
What medications, including pain relievers, do you take?
Have you experienced pain during urination?
Have you had a colonoscopy before?

Seeking timely medical attention from a diverticulitis doctor is crucial for accurate diagnosis and effective management of diverticulitis, ensuring better health outcomes and improved quality of life.

References:

AskMayoExpert. Diverticulitis. Mayo Clinic; 2023.
Diverticular disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/all-content. Accessed March 22, 2024.
Gunby SA, et al. Acute colonic diverticulitis. Annals of Internal Medicine. 2024; doi:10.7326/AITC202403190.
Ferri FF. Diverticular disease (diverticulosis, diverticulitis, diverticular hemorrhage). In: Ferri’s Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed March 25, 2024.
Diverticulosis and diverticulitis. American College of Gastroenterology. https://gi.org/topics/diverticulosis-and-diverticulitis/. Accessed March 22, 2024.
Peery AF, et al. AGA clinical practice update on medical management of colonic diverticulitis: Expert review. Gastroenterology. 2021; doi:10.1053/j.gastro.2020.09.059.
Ami TR. Allscripts EPSi. Mayo Clinic. April 17, 2024.