The class of medication that treats more severe cases of diverticulitis is antibiotics. In many cases, this will require the use of combination antibiotics. The two most common regimens are metronidazole with fluoroquinolone or amoxicillin-clavulanate.
Other possible antibiotics include:
Trimethoprim/sulfamethoxazole DSCiprofloxacinLevofloxacinPiperacillin/tazobactam
This article discusses possible treatment options for people with varying severities of diverticulitis.
Types of Diverticulitis Medication
Medication isn’t necessary for all cases of diverticulitis, but there are several that can help heal the condition and provide symptom relief.
Without Infection
If a person has uncomplicated diverticulitis (in which they haven’t developed complications), they may not need any medication. In roughly 95% of people with this type of diverticulitis, it clears up within seven days. The other 5% will need medical intervention. Antibiotics may cause harm if used inappropriately, so they are reserved for treating infection cases.
Typically, oral antibiotics are reserved for those who have underlying health complications that can increase the risk of complications, such as:
Weakened immune system High blood pressure Allergies Chronic kidney disease
With Infection: Antibiotics
When an infection develops, antibiotics will be necessary to treat diverticulitis. This type of condition is often called complicated diverticulitis and can require a stay in the hospital for treatment, though mild cases may resolve with oral antibiotics at home. There are three antibiotic administration methods for treating cases of complicated diverticulitis:
Suspension (liquid form)TabletsInfusions (given through a needle and drip directly into the bloodstream)
The most commonly taken antibiotics for this are Flagyl (metronidazole) with fluoroquinolone or amoxicillin-clavulanate. Metronidazole and fluoroquinolones are combination drugs that combine two effective antibiotics into one medicine to help with diverticulitis infections and complications.
Symptom Management
Medications can also help manage symptoms, most notably pain. Tylenol (acetaminophen) is recommended for pain management.
Trimethoprim/sulfamethoxazole DSCipro (ciprofloxacin)Levaquin (levofloxacin)Piperacillin/tazobactamInvanz (ertapenem)MoxifloxacinPrimaxin (imipenem/cilastatin)Merrem (meropenem)Doribax (doripenem)Tygacil (tigecycline)
Antispasmodics reduce spasms in the large intestines that can contribute to pain. Acetaminophen blocks the communication pathways that send pain signals to the brain.
Treatments to Avoid With Diverticulitis
Some medications that can treat pain or inflammation should not be taken by someone with diverticulitis. They include:
VomitingNauseaDiarrheaConstipationUpset stomachCrampsAppetite lossHeadachesDry mouthMetallic taste in the mouthIrritation in the mouth or tongueSkin rash
NSAIDs
Taking non-steroidal anti-inflammatory drugs (NSAIDs) can help with both pain and inflammation. Because diverticulitis can present with both, many people may reach for NSAIDs to heal from the condition.
However, NSAIDs can increase the risk of diverticulitis complications. The drugs have been associated with an increased risk of perforations, which are cuts, holes, or tears in the colon wall. These are serious and can become life-threatening. Diverticular bleeding can also occur as a result of NSAID use.
Corticosteroids
Corticosteroids can treat a wide range of inflammatory conditions, such as inflammatory bowel disease because they can lower inflammation. However, people with diverticulitis should not take them because they can increase the risk of colon perforation.
Opioids
Opioids are pain relievers that reduce the brain’s feelings of pain while increasing feelings of pleasure. They are rarely prescribed and are reserved for only the most severe cases because they are highly addictive.
People with diverticulitis should avoid opioids because they are associated with an increased risk of complications, such as diverticular bleeding and perforation.
Additional Treatment of Diverticulitis Besides Medication
For acute (short-term) cases of uncomplicated diverticulitis, at-home remedies may help to manage symptoms until the intestines heal.
Home Remedies
Diet and lifestyle changes are at the forefront of home remedies for diverticulitis. They include:
Eating anti-inflammatory foods to help lower inflammation Reducing how much alcohol you drink Avoiding foods that are high in fat Avoiding red meat Quitting smoking
Summary
The most common medications for treating diverticulitis are antibiotics. That said, not all people with the condition will need to take medication at all. In cases of uncomplicated diverticulitis, people may be able to recover at home without antibiotics or any other prescriptions. During that time, they can take medications to help with pain, such as acetaminophen and antispasmodics.
In cases of complicated diverticulitis, medication is necessary to treat infection or complications. Antibiotics are still the drug of choice, but people take them in tablet or suspension form or directly into the bloodstream through an IV. In more severe cases, people must stay at the hospital during treatment.
Medications that can increase the risk of complications in people with diverticulitis include NSAIDs, opioids, and corticosteroids. These should be avoided. To help the body heal better, people can adopt healthy lifestyle changes by eating more fiber and anti-inflammatory foods and reducing their intake of red meat, alcohol, and high-fat foods.
