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Suggest Treatment For Diverticulitus

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Posted on Sat, 14 Mar 2015
Question: I was diagnosed with diverticulitus XXXXXXX 1st I was put on augmentom for 7 to 10 days. I stopped taking it after 6 days because of a bad yeast infection and was leaving on vacation. I was fine for 5 days than started getting lower left pain a b d pain and felt constipated. I went to the gastroenterologist and he did a blood count, no high white count every normal. He had me add more fiber in my diet and that caused my pain to be more intense. Every time i eat now I have that same lower left pain and yellow mucus diarrhea. I have a colonoscopy scheduled for this wednesday and I was just trying to eat light so I can still have the colonoscopy, but yesterday I tried eating a little oatmeal and even that left me in pain and mucus diarrhea I also felt weak so I went into the emergency room and diagnosed me with diverticulitus again. Do you think it never cleared up from having it the beginning of January or it is new. They said the ct showed it wasn't as bad as before but I still have inflammation. They put me on the metronidazole and ciprofloxacin, my blood test came back normal. No sign of infection. How can the antibiotic help my diveticulitus when my blood shows no infection. Can antibiotic help with inflammation? Do they sometimes use steroids instead of antibiotics for diverticulitus flare ups. Now I have to wait another 6 weeks for my colonoscopy which is the second time is has been put off. One last question Im wondering if possibly the augmetom could have given me c diff, it seems like my bowels really changed since being on that antibiotic. Can that possibly what showed in the ct scan yesterday a colitis in that area from the antibiotic.
doctor
Answered by Dr. Grzegorz Stanko (43 minutes later)
Brief Answer:
This seems to be the inflammation started in January.

Detailed Answer:
Hello!

Thank you for the query.

First of all few things about diverticulitis. Diverticles are a kind of pouches in intestine wall. Unfortunately this pouches have very thin wall. So thin that an inflammation in this area can cause intestine perforation.
So its a serious condition. So serious that can not be treated with Augmentin only. This is a mistake. Augmentin is an antibiotic which can be used in case of many infections, but not in case of diverticulitis. It is simply not enough.
So in my opinion, the problem has started due to wrong treatment with Augmentin. It is very possible that your inflammation has not been cured since January.
Ciprofloxacin and Metronidazole is a correct treatment. Please note that diverticultis is an indication to stay at hospital. Usually we put our patients on drips for few days without any solid foods. This gives the chance for diverticulitis to heal.

As a conclusion answers for your questions:
1. Inflammation is caused by bacterial infection. So antibiotic will help with it.
2. Steroids can not be used with bacterial infection. They reduce immune response and can make things worse.
3.Yes, Augmentin can cause C.Difficile infection, but you do not have symptoms of such infection. Stool problems are caused because Augmentin has destroyed good intestinal bacteria. You should get Rifaximine treatment along with probiotic intake to normalize this situation.
4. Colitis from antibiotics can not be seen in CT. Diverticulitis is what they have seen.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (1 hour later)
The radiologist said the inflammation seemed a little better than my first scan. I have only drank pedialite and been eating soda crackers and no pain. I will stop eating the soda crackers and just drink clear fluids. The er doctor also gave me ondansetron for nausea from the antibiotic is this ok. Can they see in the ct scan if the pouches are dangerously thin. Im a little nervous now that they sent me home. I have a big fear of having to have part of my colon taken out. How common is that. My white count is normal does that mean I have a small case of diverticulitus. When do you suggest adding fiber back in my diet so I don't get constipated again.
doctor
Answered by Dr. Grzegorz Stanko (14 hours later)
Brief Answer:
With proper diet colon removal chances are low.

Detailed Answer:
Ondasetron is fine. You can take it in case of nausea. Pouches are always thin. This is the main problem. CT can not tell about it. Colon removal is necessary only if diverticulitis keeps returning.
But in most cases with proper diet it does not return very often.
Low WBC level indicates that there is no acute inflammation. But this does not rule diverticulitis out.
Please start fiber intake when you start regular meals. Fiber should be taken regularly.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (41 minutes later)
I have been up all night with dry heaves and severe nausea from the meds, even being on the onasetron. Im so afraid to take my next dose. Is there another antibiotic that might work. I already have very bad stomach can this cause an upper stomach bleed. Which drug do you think is causing this.
doctor
Answered by Dr. Grzegorz Stanko (40 minutes later)
Brief Answer:
Ciprofloxacine is responsible for this side effects.

Detailed Answer:
Ciprofloxacine is an antibiotic which very often gives nausea. Stomach pain can be also present. Both medicines do not cause stomach bleeding, no doubt in that. Your pain can be caused by this antibiotics intake. It is also possible that stress could cause some stomach irritation. Please try to add Omeprasole 20 mgs for this pains.
Ciprofloxacine is the best one for this condition. If it has to be replaced, Cefuroksym can be tried.

Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5795 Questions

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Suggest Treatment For Diverticulitus

Brief Answer: This seems to be the inflammation started in January. Detailed Answer: Hello! Thank you for the query. First of all few things about diverticulitis. Diverticles are a kind of pouches in intestine wall. Unfortunately this pouches have very thin wall. So thin that an inflammation in this area can cause intestine perforation. So its a serious condition. So serious that can not be treated with Augmentin only. This is a mistake. Augmentin is an antibiotic which can be used in case of many infections, but not in case of diverticulitis. It is simply not enough. So in my opinion, the problem has started due to wrong treatment with Augmentin. It is very possible that your inflammation has not been cured since January. Ciprofloxacin and Metronidazole is a correct treatment. Please note that diverticultis is an indication to stay at hospital. Usually we put our patients on drips for few days without any solid foods. This gives the chance for diverticulitis to heal. As a conclusion answers for your questions: 1. Inflammation is caused by bacterial infection. So antibiotic will help with it. 2. Steroids can not be used with bacterial infection. They reduce immune response and can make things worse. 3.Yes, Augmentin can cause C.Difficile infection, but you do not have symptoms of such infection. Stool problems are caused because Augmentin has destroyed good intestinal bacteria. You should get Rifaximine treatment along with probiotic intake to normalize this situation. 4. Colitis from antibiotics can not be seen in CT. Diverticulitis is what they have seen. Hope this will help. Feel free to ask further questions. Regards.