Can Diverticulitis Go Away on Its Own?

An attack of uncomplicated, mild diverticulitis may go away on its own. It is important to see a doctor to assess the severity and determine if treatment is needed, however, because severe diverticulitis can cause serious complications including death.

Diverticulitis is a form of diverticular disease, which occurs when diverticula, small pouches in the wall of the large intestine (colon), push through weak spots in the colon’s outer muscle layers. Inflammation of these diverticula are called diverticulitis.

Diverticulitis occurs when there is infection or inflammation of the diverticula. 

Early symptoms of symptoms of diverticulitis include:

Abdominal pain (most commonly in the left lower quadrant)

• Nausea
• Vomiting
• Constipation (may be severe)
• Fever
• Gas (flatulence)
• Bloating

In Western countries, the diverticulitis is thought to be caused by the classic high-fat and low-fiber diet. 

It may also be caused by increased pressure from constipation or increasing abdominal girth in obesity.

Diverticulitis is diagnosed based on a medical history and physical examination. 

Laboratory tests that may be indicated include:

• Blood tests
  • White blood cell count 
  • Hemoglobin level 
  • Electrolyte assays 
  • Renal function tests
  • Liver enzyme and lipase levels
  • Blood cultures 
• Urine tests
  • Urinalysis 
  • Urine culture 
• Stool test for blood
• A pregnancy test for females of childbearing age with abdominal pain

Imaging tests that may be indicated include:

• Computed tomography (CT) scan of the abdomen 
• Contrast enema, using water-soluble medium
• Abdominal radiographic (X-ray) series

Treatment for diverticulitis depends on the severity, complications that may be present, and other underlying medical conditions.

An attack of uncomplicated, mild diverticulitis may go away on its own, but it is important to see a doctor to assess the severity and determine if treatment is needed. 

Treatment for mild diverticulitis includes:

• Clear liquid diet for 2-3 days; progress to a soft diet as tolerated
• 7-10 days of oral broad-spectrum antibiotics if needed, such as:
  • Ciprofloxacin (Cipro) plus metronidazole (Flagyl)
  • Trimethoprim-sulfamethoxazole (Bactrim) plus metronidazole (Flagyl)
  • Amoxicillin-clavulanate (Augmentin) 
  • Moxifloxacin (Avelox) (for patients intolerant of both metronidazole and beta-lactam agents)
• Acetaminophen (Tylenol) and antispasmodics for pain

In more severe cases, hospitalization may be needed. If hospitalized, treatment may include:

• Clear liquid diet; progress to a soft diet as tolerated
• Intravenous (IV) or oral antibiotics
  • Beta-lactamase-inhibiting antibiotics such as piperacillin/tazobactam (Tazocin) and ticarcillin/clavulanic acid (Timentin)
  • Carbapenems such as ertapenem (Invanz) 
• Abscesses less than 3 cm: Typically resolved with antibiotics 
• Abscesses greater than 4 cm: Drain percutaneously
• Pain management 
  • Morphine is preferred, though it may affect bowel tone and sphincters
  • Acetaminophen and antispasmodics such as dicyclomine are first-line medications used to manage pain and cramping in mild to moderate disease
• Elective surgical resection