Diverticulitis: When Does It Warrant Hospital Admission?

Diverticulitis is a complication that can affect people with diverticulosis, small pockets that develop on the inside of the colon. It is a digestive condition that affects the large intestine. If one of these pockets becomes injured or infected, it can cause inflammation inside. Mild diverticulitis can usually be treated at home with antibiotics prescribed by a doctor. However, if at-home treatment hasn't worked, or if you have severe, chronic or complicated diverticulitis, you may need to be admitted to the hospital for treatment.

When to go to the hospital

Mild diverticulitis can usually be treated at home with antibiotics prescribed by a doctor. However, if you are experiencing symptoms of diverticulitis that are not going away, you should go to the hospital for medical attention.

Diverticulitis is a complication that can affect people with diverticulosis, small pockets on the inside of their colon. If one of the pockets becomes injured or infected, it can cause inflammation inside. If you have a sharp pain in your lower left abdominal quadrant, it might be diverticulitis.

Severe diverticulitis symptoms include persistent abdominal pain, nausea, vomiting, fever, and constipation. Other symptoms include sudden and severe lower abdominal or back pain, ongoing fever, excessive nausea and vomiting, persistent diarrhea, and blood in your stools. These symptoms indicate that you should go to the hospital.

If conservative at-home treatment hasn't worked, or if you have severe, chronic or complicated diverticulitis, you may need to stay in the hospital for treatment. Treatment in the hospital may include IV medication, blood transfusion, and endoscopic procedures.

Treatment methods

Mild diverticulitis can usually be treated at home with antibiotics and fluids. However, if conservative at-home treatment hasn't worked, or if you have severe, chronic or complicated diverticulitis, you may need to be admitted to the hospital for treatment.

Intravenous Medication

If admitted to the hospital for diverticulitis, you will likely receive injections of antibiotics and be kept hydrated and nourished using an intravenous drip. Antivirals and pain relief can also be administered through an IV line. In some cases, strong analgesics such as opioids may be necessary.

Blood Transfusion

If there has been severe bleeding, an emergency blood transfusion may be required to replace lost blood.

Endoscopic Procedures

A colonoscope or sigmoidoscope can be used to examine the colon and treat minor complications. Endoscopic procedures can be used to stop active bleeding, drain an abscess, or open up a narrowed section of the bowel.

Surgery

Surgery is usually recommended to treat diverticulitis complications such as perforations, peritonitis, fistulas, abscesses, and intestinal obstructions. Surgery may involve removing the affected section of the intestine or performing a colostomy if it isn't possible to rejoin the healthy sections of the bowel.

Hospital Recovery

After surgery or other treatment for diverticulitis, patients may need to stay in the hospital for a few days until their symptoms improve. They will slowly advance their diet from clear liquids to low-fiber and normal food as directed by their healthcare provider. Regular exercise may be recommended to help prevent future diverticulitis flare-ups.

Surgery

The type of surgery depends on the patient's health, risk factors, and other symptoms. Before surgery, a doctor may prescribe antibiotics to reduce the risk of infection. The patient will also need to inform the surgeon of any medications they are taking, as some may be unsafe to take in the days before surgery.

During surgery, the surgeon will remove the diseased portion of the colon. They may then sew the two ends of the colon back together (primary anastomosis) or create a colostomy, which is an opening in the abdomen where the colon is attached. This will be a temporary measure until the colon has healed, at which point the stoma can be closed.

The surgery usually takes 2-4 hours and the patient will remain in the hospital for a few days. The patient will be given liquids and the doctor will wait for them to have a bowel movement before allowing them to start eating solid foods and go home. The patient should expect to take a few weeks to recover and should avoid heavy lifting or straining the abdomen during this time.

Recovery

However, for more severe cases of diverticulitis that require hospitalisation, the recovery process may involve several steps. Hospital treatment for diverticulitis typically includes intravenous fluid resuscitation, antibiotics, pain relief, and, in some cases, surgery. After receiving treatment, patients are usually monitored in the hospital until their symptoms improve. The duration of hospital stay can vary depending on the severity of the condition and the effectiveness of the treatment.

Following discharge from the hospital, patients may need to follow a specific diet, such as a low-fibre diet, as advised by their healthcare provider. Gradually, they can advance their diet as tolerated, eventually returning to a normal diet. Regular exercise is often recommended to help prevent future diverticulitis flare-ups and encourage bowel function.

In some cases, a colonoscopy may be suggested after full recovery to rule out any other serious conditions, such as colon cancer. Additionally, certain complications of diverticulitis, such as abscesses, may require further procedures like percutaneous abscess drainage, which uses imaging equipment to locate and drain the abscess.

Overall, the recovery process for diverticulitis can vary depending on the severity of the condition and the individual's response to treatment. While mild cases can be managed at home with a good recovery rate, more severe cases requiring hospitalisation may necessitate a more structured recovery plan, including dietary changes, exercise, and follow-up procedures to ensure full recovery and prevent recurrence.

Prevention

Dietary Modifications

Eating a healthy, well-balanced diet is crucial in preventing diverticulitis. Aim for a diet rich in high-fibre foods, such as whole grains, fruits, vegetables, legumes, and nuts. Increasing fibre intake gradually is essential to prevent gas and bloating. It's also important to stay hydrated by drinking plenty of fluids, especially water, to keep stools soft and easy to pass.

Regular Exercise

Regular physical activity encourages healthy bowel function and can help prevent diverticulitis flare-ups. Exercise also has overall health benefits, improving digestion and reducing the risk of constipation.

Managing Underlying Conditions

Certain underlying conditions, such as a weakened immune system or a higher vulnerability to infections, can increase the risk of diverticulitis and its complications. Proper management of these conditions through medical advice and treatment is essential in preventing diverticulitis.

Early Diagnosis and Treatment

Early diagnosis and prompt treatment of diverticulitis are crucial in preventing severe complications. If you experience any symptoms, such as persistent abdominal pain, fever, constipation, nausea, vomiting, or blood in your stools, seek medical attention immediately. Mild cases can often be treated at home with antibiotics and rest, but severe or complicated diverticulitis may require hospitalisation for intravenous fluids, antibiotics, and pain management.

Surgical Intervention

In some cases, surgery may be recommended as a preventative measure after recurrent episodes of diverticulitis. However, this decision should be carefully considered, weighing the risks and benefits, as surgery carries its own set of potential complications.

It's important to note that prevention also involves being aware of the risk factors for diverticulitis, such as age (more common in adults over 70), diet, and lifestyle factors. Understanding these risk factors can help individuals make informed choices to lower their chances of developing diverticulitis.

Frequently asked questions