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Most people with uncomplicated diverticulitis recover following medical treatment. The median time to recovery is 14 days. Approximately 5% of people experience smoldering diverticulitis. [54] Diverticulitis recurs in around one-third of people – about 50% of recurrences occur within one year, and 90% within 5 years.
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include constant abdominal pain, localized abdominal tenderness in the left lower quadrant of the abdomen, nausea, vomiting, constipation or diarrhea, fever and leukocytosis .
However, the course appears to largely benign. In cases that require surgery, recurrence of disease is rare. [9] Long term medication therapy is rarely necessary. [6] Over a course of 7 years, about half of people with SCAD experience a recurrence of symptoms. [10] About a third of people have a mild recurrence. [10]
Perforated diverticulitis often requires surgery due to risks of infection or recurrence. Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities.
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Patients with mild to moderate ischemic colitis are usually treated with IV fluids, analgesia, and bowel rest (that is, no food or water by mouth) until the symptoms resolve. Those with severe ischemia who develop complications such as sepsis, intestinal gangrene , or bowel perforation may require more aggressive interventions such as surgery ...
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