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Antibiotics should be used selectively in most cases of uncomplicated diverticulitis. However, antibiotic use is strongly advised in immunocompromised patients. [11] Colonoscopy is recommended 6–8 weeks after an episode of complicated diverticulitis or a first-ever episode of diverticulitis.
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 .
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Mild uncomplicated diverticulitis without systemic inflammation should not be treated with antibiotics. [ 63 ] [ 49 ] [ 64 ] [ 65 ] For mild, uncomplicated, and non-purulent cases of acute diverticulitis, symptomatic treatment, IV fluids, and bowel rest have no worse outcome than surgical intervention in the short and medium term, and appear to ...
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Treatment may include antibiotics, aminosalicylates, and corticosteroids. Antibiotics include ciprofloxacin and metronidazole, given for 14 days. If symptoms recur after improvement with antibiotics, a second course of antibiotics may be given. If an initial course of antibiotics is ineffective, then mesalamine may be tried.
While a low-fiber diet is generally used for acute diverticulitis, the NIH guidelines recommend a high-fiber diet for patients with diverticulosis (a condition that may lead to diverticulitis). [17] A Mayo Clinic review from 2011 showed that a high-fiber diet can prevent diverticular disease.
The 5-nitroimidazole drugs (metronidazole and tinidazole) are the mainstay of treatment for infection with Trichomonas vaginalis. Treatment for both the infected patient and the patient's sexual partner is recommended, even if asymptomatic. Therapy other than 5-nitroimidazole drugs is also an option, but cure rates are much lower. [25]