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Chronic diverticulitis

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I am a woman, 58 years old. I had a left colectomy in 2006 and still had repeated diverticulitis attacks since then (twice a year in average). I am treated with oral antibotics and respond well to the treatment. Lead a near-normal "safe diet" life in between attacks.

I am very worried about the repeated attacks and antibiotherapy make my intestines weaker and weaker. Can this be true? Are my intestines becoming worse and worse upon each attack? I really want to know your expert opinion please.

What medecine can I take at an early stage when I sense that the inflammation is taking hold (first feeling of pain on the left side) to make the inflammation subside and go away? (before I get to the stage of pain, 38 °C and antibiotics) ?

Thanks a lot for your answers.


Category: Gastroenterologist, Medical

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Category: Hepatologist
Dr. Ratnakar Kini is online now

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

I have read your post about recurrent attacks of diverticulitis. There is a
recurrence rate of up to 45% within one year after an attack of acute
diverticulitis. You have mentioned you get two attacks on an average
per year.
Similarly after surgery, up to 10% may have recurrence of symptoms.
Repeated attacks of diverticulitis can lead to various complications
like abscess formation, perforation, fistula and obstruction.

There are two options available for preventing frequent recurrence.
1.Treatment with mesalamine or rifaximin or a combination of these
two. This decreases the rate of recurrence.

2. The second option is a repeat surgery.

You have asked about the medicine to take when you sense an attack of
diveriticulitis is imminent. You need to take antibiotics only, even at
the start of an attack.Take clear liquid diet and antibiotics. In
spite of these if you develop pain, fever and inability to tolerate
oral fluids, then you need to visit your doctor immediately.

Hence you need to take the antibiotics to prevent any complications to your intestine more as a protective option.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.



Patient replied :

Many Thanks for your answer, it is clear and helpful.

Repeat surgery is not a good option I am convinced, as I have diverticulosis in transversal, ascending (and descending) colons. (anyway my diverticulitis attacks have always been on the left side).

From a preventive viewpoint, in between attacks, I am adhering to safe food only, and am very careful about all my intake. I take probiotics everyday, and sometimes a medicine called Bedelix (which has a soothing effect).

Can I take some natural/light medecine everyday over months/years in order to prevent recurrence of infection in the intestines? at least reduce the chances? meaning how to fortify the defensive power of my intestines against infection?

Any helpful vitamins or other supplements?

Many Thanks in advance,
Best Regards,
Vasu




Expert:  Dr. Ratnakar Kini replied 3 Days.

Hi,
Thanks for getting back to me with more questions.

Diverticulosis occurs when your constipated.
Taking high fiber diet and drinking plenty of fluids will prevent diverticulosis.
Diverticula are small pouches in the intestinal wall.
Diverticulitis is a complication of diverticulosis. This occurs when there is infection or inflammation. Fecolith can cause inflammation. This has to be prevented by having good bowel movements by taking high fiber diet and drinking lot of water.

Unless there is a risk factor, you will not get any infection.
Moreover you are taking probiotics which will replenish the gut flora and boost immunity of the gut.
So all you need to do is ensure good bowel movements by taking high fiber diet, fiber supplements and drink lot of fluids.

Let me know if I can assist you further.
Regards,
Dr.R.K


Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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