Acute diverticulitis recovery time

Hi, Mtwok,

We've interacted on this forum before, and our situations are very similar: 

I was diagnosed with acute diverticulitis by CT on April 27th. I was put on Cipro and Flagyl for 10 days.

About one week into treatment, my pain was getting worse so they repeated a CT scan which showed that the inflammation from the diverticulitis had resolved. My increased pain was attributed to muscle spasms and healing.

A few days after I finished the first 10-day round of antibiotics, I started having increasing pain, so I was put on a 21-day course Cipro and Flagyl and restricted to a liquid diet to tide me over until my scheduled colonoscopy, which happened about 5 weeks after my initial diagnosis and showed that I had a single diverticulum (like you), but that it was no longer inflamed. I had evidence of mild inflammation elsewhere in my colon, but biopsies all came back negative for infection or Crohn's or Ulcerative Colitis.

Since then, now at 2 months, I still have random pinching sensations, soreness, and cramping where I had the original diverticulitis pain (for me it was in my right lower abdomen). Some days are better than others, and some days I don't notice it at all. There has, however, been gradual improvement from one week to the next, so it seems like things are heading in the right direction despite the lingering pains.

I can't really tie the pains to anything in particular I've eaten. For me, it seems like physical activity may be more of a trigger than diet (when I ran on the treadmill one day, the pain came back almost instantly), so I've been shying away from too much cardio at the gym and focusing mainly on lifting weights instead, so that my abdomen isn't jostled too much.

I saw my colorectal doctor yesterday. He said that the lingering pain could be due to scar tissue, residual inflammation, muscle spasm, and/or diverticulitis-induced IBS (irritable bowel syndrome). He wants me to see a gastroenterologist in a couple weeks to see what, if anything else there is to be done. My pain is not life-limiting. It's more annoying and an occasional source of anxiety if I dwell on it too much.

Every one is different my pain 2 months now walk as tolerated stick to diet drink lots of water try to avoid stress lol ! I still take probiotics The problem is antibiotics kill the bad and good bacterial my doc says will take 2 years to have a healthy gut after antibiotics He said my gut was a rain forest and now it's a dessert I still feel homemade chicken noodle soup is the best ( most tolerated) thing I can eat My primary care physician says I also have H pylori bacterial in my stomach My GI says one thing at a time treat colon first then in hospital for 2 days intravenous antibiotics for H pylori

I would do colonoscopy, my cat scan showed I had Diverticulitis, after 10 days on antibiotics did another cat scan I developed abcess so in hospital for 5days. Sent home on more antibiotics. And strict diet. Never got better so 3 months later I had colonoscopy I had 6 polyps and severe diverticulosis (3 spots) in sigmoid are. So Cat Scan is not enough. Best wishes. 🙏

Yes, I remember you and I was thinking of you when I re-posted. Your story sounds exactly like mine, but my pain is on the left side.

I wouldn’t describe it as agony, but it’s kind of like yours, in that, it’s hard to completely forget it’s there. And physical activity is exactly what exacerbates it - not a particular type of food.

As sh#%tty as it is to be suffering from this for 2 months, I am taking your news as good news, because the trend is still an overall improvement.

Do you have to take any painkillers at all? Some days I haven’t had to take anything. Others, I need from 1-3 Tylenol and sometimes Aleve or Buscopan when Nothing seems to work.

I don’t usually need pain killers during the day.  At night before bed i will take aspirin or ibuprofen or Tylenol. The sensation I most often have is not necessarily pain but more of a tugging or pressure - just enough to remind me that somethings not quite right. Occasionally I’ll have brief sharper pains or soreness. Sometimes the soreness radiates into my hip/groin, back, and/or under my ribs.

Ya, my pain radiates too hfkmd. In fact, the original localized area where the acute diverticulitis occurred isn’t that painful anymore, the pain has shifted closer to my flank and groin and is more superficial. I feel like even one of the lymph nodes down there might be inflamed too. 

Makes me think/wonder that the feelings I get now are just residual inflammation or hematoma that originally occurred in the fat layer around the acute infection, are now working their way through the fat layer and to the surface. There was a bruise on my skin for a couple weeks near the Diverticulitis. I thought it might just be using too much of a heating pad, but now I think it could be the blood that pooled in the fat layer, working its way to the surface.

I feel that it’s similar to that In the same way that if you get a deep muscle tear (say, in your calf), the inflammation, bruising and pain take a while to disappear, even though the muscle tear has healed. 

Hi Hfkmd, my pain has radiated to my lower left side, hip, buttocks and leg and for awhile under my left rib cage. It’s annoying and sometimes painful. But it’s a daily thing now. Along with the anxiety and panic attacks. Hope your feeling better. 🌺

hi vickie

i hope 3 years later you see this. i just had my first ever disgnosed eoisode of -itis with an abscess. its pretty much resolved but the surgeon insists i need a colon resecrion or it WILL come back. i dont want it and want to manage with massive diet and lifestyle changes. did you have to have surgery? thanks and i hope you're doing well.

Thanks for doing research I appreciate this information Its going on two months for me im pretty much doing everything by the book and still my life has gone haywire We all agree with you more research and solid information needs to b given to us by our doctors and the medical field in general 😟

Thank you for the commentary. I have pretty much read every study that’s been released in the medical journals since about 2012, so if there’s anything you’re wondering about, let me know and I’ll let you know what kind of things were covered in the studies.

Unfortunately the one consistent finding I took from the studies, is that this has been an evolving field in for last 10 years or so, and there’s still a lot of questions on the best evidence and medical practices when it comes to treatment and outcomes.

The best study I have found is a 250-page Dutch “study of studies” called “Outcome and treatment Of acute diverticulitis“ by Çada Ünlü at the Unicersity of Amsterdam, which basically looks at different aspects of the issue and compares existing studies on it. I believe it is a 2014 release.

The other good one, and easier to read, VERY recent, is from the Annals of Infernal Medicine, April 2018 “In The Clinic -  Acute Colonic Diverticulitis”. 

I agree with Ellen, I’m into this 5 months now and Drs are not very helpful. I am going to look into these books, do they mention treatment and diets? Thank for the information. 👍🤗

Hi Ellen, how are you feeling today? Hope you had a good painfree weekend. I’m still tender and sore from colonoscopy. But working through best I can. 🤗🌺

I had a friend tell me about CBD oils to help with Anxiety and inflammation ang calm gut, so ordered some, hope it works. Lots great reviews on the products. 👍

Trying cbd oils and probiotics hope it will help👍

I'm glad 2 hear your working thru it Stay strong and best wishes your way 👅my weekend was ok only in bed a few times 4 days of fish will do chicken tonight I have gained 3 lbs trying not to let stress get to me as much as possible My back isn't hurting to bad just my abdominal I am scheduled for colonoscopy July 18 say prayer please 😥

Always count on my prayers sent to you daily. Today I made a list of foods I know I can eat off the Low FodMat diet list, and am going to switch to wheat bread. Add more fiber daily. Doing crockpot and smoothies to start. Hope it works. I had a cup of coffee yesterday and I was miserable all day. So no coffee ugh. Sticking to teas. And I really miss burritos and salads and steak. Not ready to try those yet. No garlic or onions or zucchini either. So one day at a time, just so tired of mashed potatoes and veggies, and soups. Chicken and salmon. Gotta try different and not be afraid. Best wishes and prayers for a great pain free day. 🌺🌸🙏

See below, Q&A from the Annals of Internal Medicine...please note, this is for management of ACUTE episodes of diverticulitis, not necessarily for ongoing diverticular disorder (which is believed, by many gastroenterologists, to be more of a chronic, inflammatory IBS-related condition)

How should diet be managed during an acute episode?

There is little evidence to guide dietary recommendations in the setting of acute diverticulitis. Traditionally, a clear liquid diet has been recommended early in the course, with gradual ad- vancement to a low-fiber diet until symptoms resolve. A small, uncontrolled prospective study allowed patients with uncompli- cated diverticulitis to consume an unrestricted diet and found that it generally was well- tolerated; however, 8% of pa- tients had serious events (36). Therefore, in patients with mild diverticulitis, it is reasonable to recommend a clear liquid diet until symptoms begin to im- prove, with subsequent ad- vancement to a low-fiber diet until symptoms resolve. After symptom resolution, a high-fiber diet low in red meat is recom- mended. Patients hospitalized with severe disease should ab- stain from oral intake until they become stable.

How should pain be managed during an acute episode?

As with diet, there are few data to guide pain management in diverticulitis, and most guide- lines do not address this issue. Use of NSAIDs is associated with incident and complicated diver- ticulitis (11) and should thus be avoided in patients with acute diverticulitis. Similarly, opiates have been associated with in- creased risk for perforated diverticulitis (15). However, these agents are often used for pain control in studies of diverticulitis and can be prescribed if pain is refractory to other measures. Acetaminophen and such anti- spasmodics as dicyclomine are first-line agents for managing pain and cramping in mild to moderate disease.

Great info , thank you, I have taken NSAIDs for many years to deal with arthritis and a aspirin. Was also put on a few weeks of steroids and antibiotics for pneumonia. Then 2 months later got Diverticulitis , then abscess, now just Severe Diverticulosis (3 spots) in sigmoid. And possibly IBS. They have done all stool tests to rule out Candida, parasites, salmonella and other bugs of gut. All normal so now I’m having a SIBO test done next week. If it’s normal then they will say IBS, they told me there is no real test for IBS. They just rule out everything else. So on top of all this crap I developed anxiety and panic attacks along with losing 40 lbs in 5 months. This disease has kicked my ass. Eating has been the hardest. Thank you 🙏 

👍👍👍

Good morning vickie you know that's a great idea my friends husband uses the lotion on his back and although it doesn't give him total relief he said it helps quite a bit My niece has bad seizures she is only 7 and the cbd oil has curbed most of them along with diet I live in Colorado where there are shops every couple miles ahhh I will certainly be checking into this! I did smoke a little hash on my worst days and it did bring some relief Wishing you a pain free day!!!!!!😁