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Abdominal pain, constipation and diarrhea. Diagnosed with diverticulitis. Changed diet but no relief. Treatment?

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Gastroenterologist, Surgical
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2 questions. I'm a nurse and my boyfriend has no insurance to see a doctor. He has diverticulitis flare ups. His bowel movements alternate between constipation and diarrhea. He hasn't had a normal bowel movement in the past few months. He has left sided pain that comes and goes with this. It is relieved when he has a BM. What can he do to help this issue? He has tried dietary measures, eating yogurt, but nothing is helping.
2nd question: last week he developed numbness and tingling on the left side of his left foot that isn't going away. We thought it was due to his shoes being too tight, but it hasn't gone away. No back issues or back pain or radiating pain.
Posted Fri, 27 Apr 2012 in Abdominal Pain
 
 
Answered by Dr. Ajit Naniksingh Kukreja 2 hours later
Hi.

Thanks for posting your query.

Diverticulitis, as you would be aware, needs precise care in form of diet and fiber, and if not managed needs to be submitted to surgery.

I would like know few more things to answer your query better.

1. Has any investigations been done in form of Colonoscopy or CT, X-ray, Barium etc?

2. What is the extent of the disease in the colon?

There are all chances that the left sided pain is due to acute inflammation in the diverticulum in the left colon.

If Diet, Prebiotic are not working, you may try Gastrointestinal Antiseptics like Rifaximin and high fiber in form of psyllum husk under your physician's guidance.

If that also does not work and the disease is extensive, there is no solution other than surgery as one of them can rupture.

I understand the problem of not having insurance, but he needs to get evaluated by Gastroenterologist with appropriate investigation at the earliest for further management.

The next query : It can be due to some form of nerve compression, try giving him Methylcobalamine and Gabapentin.

It is always advisable to start medicines only after consulting a local medical practitioner.

Hope I have cleared your doubts. Please get back to me with a followup query if any.

Wishing your boyfriend a speedy recovery.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Abdominal pain, constipation and diarrhea. Diagnosed with diverticulitis. Changed diet but no relief. Treatment? 18 hours later
Thanks for your reply. I do have a few questions. When you say Antiseptic, do you mean antibiotics? And Rifaxamin? Is that the same as Rifampin? He has had a colonoscopy which was normal. He had tests back in 1996 when he was first diagnosed. His grandmother had diverticulosis as well.
 
 
Answered by Dr. Ajit Naniksingh Kukreja 6 minutes later
Hi,
Thanks for posting your query.

No, rifaximin and rifampicin are different. An antiseptic does not have any systemic effects and cleans the intestine of bacteria only while an antibiotic is different in having systemic effects and clears the body of infection.

The colonoscopy is too old and he needs to get a fresh one done. Yes, diverticulosis can be passed in families.
Please revert back to me if you have any other follow up queries.
Wishing him a speedy recovery.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Abdominal pain, constipation and diarrhea. Diagnosed with diverticulitis. Changed diet but no relief. Treatment? 44 hours later
Thanks for your reply. Does Riifaxamin require a prescription or can you get it over the counter? Would any other Colon cleansers over the counter be effective?
Thanks XXXXXXX
 
 
Answered by Dr. Ajit Naniksingh Kukreja 19 minutes later
Hi XXXXXXX

Thanks for posting your query.

Hopefully there is no colon cleanser documented to be better than Rifaximin, as I told you earlier it is GI (Gastrointestinal) antiseptic and not a cleanser.

In India, it does require a prescription so am sure it will require a prescription in US as well.

Wish your boyfriend a speedy recovery.

Regards,
Above answer was peer-reviewed by
 
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