Diverticulitis--Continue

Medications
If your symptoms are mild, your doctor will probably prescribe a broad-spectrum to antibiotic, such as amoxycillin/clavulanate (Augmentin) or a combination of metronidazole (Flagyl) and cephalexin (keflex, Ibilex). Even though you're likely to feel better in a few days, be sure to take the full course prescribed.
   For pain, consult your doctor about taking an analgesic. If you have bleeding, you should avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, because they can hinder blood clotting. It may be safest to take paracetamol, but you could need something stronger so ask your doctor first.
 If your symptoms are more severe, your doctor may hospitalise you for intravenous antibiotics, pain relievers and fluids, as well as intravenous feeding to give your inflamed colon a complete rest.

   
Lifestyle changes 

For a milder case, once you have your medications in hand, the best thing you can do for yourself is climb into bed and rest until you're feeling better. During this time, you should watch your diet. Intially, you'll need to stay on liquids and soft foods. In a few days, your doctor will probably start you on a ow-fibre diet.

   After about a month, you're likely to get the go-ahead to begin introducing high-fibre foods to your diet, as well as to start exercising. Your doctor will probably want you to drink plenty of water throughout your recovery as well.

                                                PREVENTING DIVERTICULAR ATTACKS 

If you have diverticulosis or  you've recovered from about of diverticulitis, a trouble-free digestive tract should be a top priority. There's plenty you can  do keep your colon healthy:

• Increase  your fibre. Australian Dietary Guidelines promote a target intake of 30g of fibre daily. Replace white rice and breads with bran, oatmeal, wholegrain breads and brown ice. And put cooked dried beans or peas on the menu once a week. If you're not used to fibre, add these gradually to avoid painful wind.
• Eat your vegetables and fruit--they're fibre-rich too. A good start is to have  five daily servings of fruit and vegetablesou, either cooked or raw, and unpeeled when possible.
• Go when you need to. When you feel the urge to move your bowels, head for the bathroom  right away rather than waiting.
• Drink lots of fluids, at least eight glasses a day of water, juice and soups. This helps move the added fibre through your digestive system.
• Get regular exercise. Three to five times a week go for a brisk walk, ride your bike, jog, swim or dance around the house.
• Use a bulk-forming laxative for occasional constipation. Good choices are products containing psyllium (Metamucil). And don't forget dried fruits; they're a natural laxative and good source of fibre.

DIVERTICUITIS IS VIRTUALLY UNKNOWN in the less developed countries of Africa and Asia. That's because the diet in these countries is vegetable-based and high in fibre. Interestingly, when inhabitants of these nations immigrate to Australia and start eating Western-style diets (lots of meat and processed high-fat foods), they tend to start developing diverticulitis.

Procedures

In the rare situation that your diverticulitis doesn't respond to medication, or you have frequent or severe attacks, your doctor  may recommend surgery. (This is particularly true if you're under age 50 and have even one severe attack because diverticulitis tends to be more aggressive and recur more often in younger people.)
Although a small abscess can be drained with a relatively minor procedure, more invasive surgery may be needed to eliminate a large abscess, remove a fistula or clear an obstruction in your intestine. And if you develop perforations or peritonitis, you'll need emergency surgery to clean the infection out of your abdominal cavity.
  Whatever the complication, the surgeon usually treats it by removing the diseased part of your colon and reattaching the cut ends in a partial colectomy (see illustration on colon cancer). If you have widespread inflammation, you may need two operations. First, the surgeon clears away the infection in your abdominal cavity. He or she then removes the affected part of your colon and attaches the healthy colon to a temporary opening in your abdomen, a colostomy, which serves as an aritificial anus. A bag is attached to the opening to recieve stools and keep them completely away from the infected area. Once the inflammation in your colon  wall clears up, in a second operation, the surgeon will reattach the ends of your colon and close the hole in your  abdomen. As a result, your bowel movements will return to normal fairly quickly.
   If you have diverticular bleeding, it normally stops by itself. However, your doctor may still want to perform a colonscopy, which is an examination of your colon using a long, flexible scope, to find the source of the bleeding (see on later). If you have very heavy bleeding, the doctor may also take specialised X-rays to locate the problem.