Not sure what to do.

You haven’t had the colonoscopy yet.  WAIT for that before you jump to any conclusions.  You don’t even know what the situation is.  Im in my 50’s, I have DD, I had about a foot taken off, was told it is nowhere else and I really don’t worry about it.  I eat and drink what I want. But I eat very healthy.  My doctor told me it took a lifetime to develop the disease and they got it all so I have nothing to worry about.    But Rationale for elective surgery is to prevent recurrent complicated diverticulitis and to reduce emergency procedures. Recurrent diverticulitis occurs in about 10% after resection.

YESSSSS!!!  Same here... I am 54, had a colonoscopy last month just routine, no previous problems; everything was ok just that the doctor had been bugging me for 4 years to get one and I finally caved in.  They found two tiny benign polyps and told me I had some small diverticulum but I had never had problems with it.  Suddenly last Tuesday I started having severe abdominal pain in my lower left side - doctor thinks it is an attack of diverticulitis. Last weekend was probably one of the worst couple days in my life.... I am on two kinds of antibiotics but luckily did not have to go to hospital.... I have been reading about diets that will be good when I am back to normal ( I am still eating mostly liquids and very soft bland food now)  and it is so confusing and yes I am feeling same as you that now I can no longer eat all the foods I used to like; the foods seem very restrictive and also seems like some are contradictory; for example, eat lots of fiber, but not too much.... nuts are good source of fiber but don't eat nuts; beans are great protein but might make gas that could irritate.... shoot..... what are we going to eat???????   ( at least I should lose some weight after this).

The reason I have to wait is due to the NHS and waiting time, and also maybe because my sigmoid is so damaged that it needs to heal before they put a camera in there... 

My consultant is very good and ~I trust him to put my welfare first, so I will wait for the appointment which he will be doing. 

I hope and pray that surgery is not required, but if it is, so be it... 

Hi matt I believe the abbreviation you used has to due will insurance In the U.S. doesn't matter how damaged your sigmoid colon is colonoscopy still preformed I'm with infection currently on antibiotics for 5 days colonoscopy tomorrow! I know it's gonna cause more pain but GI said absolutely has to be done I hope you get answers this crap stinks ( literally)

Hi Matt

I've been reading through all these posts and the advice offered.  Once I realised you were in the UK, like me, I thought I could provide some information.  A lot of the advice so far offered to you are from people outside the UK, where the practices are different.

I have had this disease since 2001, have had 6 flares, 2 colonoscopies (both failed), one barium enema and one CT scan.  So - I have experience!  The UK practice is - no colonoscopy during or immediately after a flare, to give the infection a chance to clear, the insides to heal, and lessen the (very low) risk of perforating during the procedure.  As you had an abscess you clearly need plenty of time to heal.  If they were concerned there was anything else going on, you would have been put on the emergency 2 week turn round.  But sometimes abscesses need more antibiotics than just one course, or may need draining. 

The medication will have knocked the stuffing out of your insides and it takes time for the gut bacteria to recover as both good and bad will have been killed off.  So it's very common to have altered erratic bowel movements for several weeks afterwards.  I buy a supermarket probiotic and take it once a day.  As for fibre you should be looking at soluble fibre, not insoluble (comes out the way it goes in).  All Bran - NO, NO, NO.  It's very harsh on your insides which are already inflamed and sore.  Bran Flakes are kinder.  And did you measure your portion size - I'll bet it was far more than the recommended 1oz or 28gm?  There is good soluble fibre in lots of things you don't even think about, like home made vegetable soup, blended smooth. 

As for a perforation, you'd know about it from the pain.  In the UK surgery is almost only ever done in emergencies for a perforation, fistula, blockage.  The treatment is medication from your GP and diet.  This is how I've managed all these years.  In the USA a lot of doctors seem to be chop happy and recommend elective surgery after just one or 2 attacks.  That won't happen in the UK.  Your quality of life has to be very severely compromised, or your life in danger before you get operated on here.

To help yourself I suggest a liquid diet for a couple of days, then the low fibre diet for a week or so.  Vicky47128 made an excellent post on diet suggestions and keeping a food diary, elsewhere in this thread.  I found I couldn't take gluten or full fat, and others list various other foods they can't take.  The doctors are currently saying eat what you like, but I think that if you find something seems to upset you over and over, then don't eat it.  And I LOVE Ben & Jerry's!

But for your peace of mind, I think you should contact the GP surgery to talk to a doctor.  It might be a phone consultation, or they might fit you in for an examination, if you stress you are in pain and concerned the abscess is back and you are worried about a perforation.  I would also ask them about getting a prescription for Fybogel (a liquid fibre supplement I have taken daily for 17 years).  It takes time to learn about your body and what pain to worry about and what to treat conservatively with liquids and wait 48 hours.  Best wishes.

That is s very helpful, and a great insight into this condition. 

They can’t drain the abscess as it is behind the pelvis and can’t get to it.. I felt better yesterday, and today was good until about an hour ago, where I have now stared to feel  discomfort I think this is the pressure from my bladder though, I seem to need to pee about 12 times a day and when i do pee the discomfort subsides 

Thanks again so very very helpful. Matt 

Hi Matt

Yes pee problems do seem to go hand in hand with DD.  I seemed to be having repeated bladder infections hand in hand with flare ups.  I bought dip strips online to check my pee, to see if the leucocytes were high or there was blood in the pee.  (Advice I got from my cousin who is a nurse practitioner).  If the markers were up I knew I needed antibiotics, if not I had to ride it out.  My GP said I had an irritable bladder.  I'm not a medical person, but to me inflammation means swelling, swelling means pressure, and it could be that there is pressure on the bladder.  So many others with DD report bladder problems as well.  Oh, 12 times a day is nothing - when mine plays up it is every 30 - 45 minutes and 6+ during the night.  Good job I'm retired as it can be a nightmare if you work.

On the positive side - I cope just fine, and have been pain free for months now.  It can take weeks or even months for the pain to slowly recede.  You will of course be super sensitive to every odd twinge or niggle.  Best wishes.

Quick update, my pain returned overnight so back to hospital today. I have raised WCC and CRP but nowhere near as bad as last time so back on oral antibiotics for a week. 

The only answer I can never get it about diet. So I am going to follow all your advice, have a good diary and see what happens. 

2 quick questions 

1- Can I take fybogel now or wait til the infection goes. 

2- what are thoughts about aloe Vera juice and taking that! 

Thanks 

Matt 

So sorry to hear this, hope your doing ok. When I had my Diverticulitis first round antibiotics at home, didn’t get better, so went back to hospital and had developed abscess so admitted to hospital on IV antibiotics for 5 days. Which cleared the abscess and blood work was good. Sent home on antibiotics also. So it’s possible they did not give you enough rounds of antibiotics. And no fiber, no one gave me food advice either. High Fibers really still irritate me . Make sure do a good probiotics. Felina on this site has given you great advice. I’m in US and it is very diff here. Stay on liquids for a couple days, to give colon rest. Then nothing but mashed soft low fiber foods. No raw. Okay. Hope you get feeling better soon. 🙏

Hi Matt

If your WCC and CRP were up that means you still had infection and I would guess with increased pain it meant increasing infection.  Hence back on the pills.  My worst ever flare took 3 courses of pills before I settled.  My tummy was absolutely rigid and my GP told me he almost sent me to hospital.  When he palpated the tummy he almost had to scrape me off the ceiling!  Fortunately no need once the pills kicked in. 

As for diet we are all different and have to find what suits our body.  Hence the vague woolly information, or lack thereof!!  I am lucky as I can eat many things that others can't.  I do take simple precautions, like peeling my fruits and spuds, and skinning and de-seeding things like peppers, tomatoes, cucumbers.  And I actually don't like nuts and seeds anyway.  As you are on pills for a week, I guess you don't feel great and are on the liquid diet or not eating much. 

Fybogel is a fibre supplement which bulks and softens the stools making them easier to pass.  It does that by absorbing more water into the bowels so it is very important to drink plenty of water with the powder.  And it ensures you don't strain as much, which is also bad for DD.  I always say that with DD a regularly emptied bowel is a good bowel, less chance of developing an infection. 

At this stage I personally would not take Fybogel, because not enough is going in to come out.  I usually wait until a few days after I have finished the pills and am starting to eat more.  Usually the low fibre bland diet at first, slowly increasing the soluble fibre.  But Fybogel does not suit everyone.  You also need to give it a couple of weeks to start to become effective.  It is not like an emetic where you see action overnight, it's much gentler.  Also your bowel movements will probably be erratic anyway after the effects of the pills and DD, and take their own time to settle down.

I am a fan of pure Aloe Vera juice.  It is a natural plant and has been grown and used in the Canary Islands to treat infections for centuries.  I started taking one teaspoon morning and night after my last flare and within 5 days the pain started to decrease.  But it must be the pure juice, not the drink with a tiny amount of juice added.  And it tastes REVOLTING!  After a few months I switched to the Aloe Vera gel capsules and still take them now. Best wishes