"Hello I was just diagnosed with diverticulosis and I was just wondering if there are any things I can do to prevent flare ups besides fiber? I am 40 yrs old and I have had flare ups where I bloat and run fever and feel nauseous and sometimes have abdomen pain. But, it's kind of dull, nothing severe. When I do have these pains does that mean I have to start antibiotics? Or is that something that just happens with this?"
Let me answer both of your questions about diverticular disease:
1) When do you need to be treated with antibiotics?
You need antibiotics when you have diverticulitis, an infection or inflammation in the Diverticula you describe having. Diverticulosis just means that Diverticula are present in your colon which is a common finding as we get older. Only 15-25% of people with Diverticulosis ever develop Diverticulitis. During episodes of nausea, decreased appetite and pain associated with fever that you describe you need to see your doctor as you may have Diverticulitis. A CT scan of your abdomen during an episode will help make the diagnosis of Diverticulitis and you will be treated with oral antibiotics (usually Ciprofloxacin and Flagyl) and instructed to consume only clear liquids for a few days. Some people require hospitalization for intravenous antibiotics depending upon the severity of symptoms.
2) How can I change my diet to reduce flares?
During a flare you should consume only clear liquids for 2-3 days after which you can advance your diet slowly. The role of dietary therapy in the prevention of Diverticulitis is debated but consuming a high fiber diet may reduce the incidence of recurrence. People with diverticulosis have historically been advised to avoid whole pieces of fiber (such as seeds, corn, and nuts) because of concern that the undigested fragments could become lodged within a diverticulum, thereby inciting an episode of diverticulitis. While this commonly heard advice to avoid small Undigestable foods (such as seeds) is completely unproven it continues to be recommended by some physicians.
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