Diverticular disease and diverticulitis
Taking iron supplements , such as ferrous sulfate, causes a “significant increase in gastrointestinal-specific side-effects,” including constipation, according to one study . One case report also found that iron supplements led to “ileus secondary to bowel obstruction from constipation.” Ileus is a painful temporary paralysis of the small intestine or other part of the intestine.
8 drugs to avoid with diverticulitis
Diseases affecting the colon and GI tract can be excruciating and uncomfortable. Diverticulitis is a condition that can disrupt someone’s life with mild to severe symptoms. When in pain, people want relief quickly—which is why they may seek help from a medical professional.
Healthcare providers can prescribe several treatments for diverticulitis, including prescription and over-the-counter medications. However, there are home remedies you can try to treat diverticulitis and several drugs you should avoid in order to help prevent flare-ups. Continue reading to see what other precautions to consider if you have this condition.
What is diverticulitis?
Diverticulitis is one of several types of conditions that can affect the colon; it’s a type of inflammatory bowel disease that starts as diverticular disease.
“ Diverticulitis is when the lining of the colon becomes inflamed and infected at the area where there are some small outpouchings called diverticula,” says Ellen Stein, MD , a gastroenterologist at Rutgers Health in New Jersey.
The presence of pouches in the large intestine is known as diverticular disease or diverticulosis, but when the pouches are inflamed, it becomes diverticulitis and poses an issue. Any of the inflamed diverticula may rupture and can cause scarring. Any inflammation can cause concern and indicate a more significant health problem, and diverticulitis can be challenging to manage as there are not always clear risk factors. Symptoms of diverticulitis include:
- Constipation
- Change in bowel habits
- Abdominal pain
- Abdominal pressure
- Abdominal tenderness
- Fever
- Chills
- Loss of appetite
- Nausea
- Vomiting
- Diarrhea
- Bloating
- Frequent urination
These symptoms are present in many conditions, including gastrointestinal viruses, peptic ulcers, Crohn’s disease, irritable bowel syndrome (IBS), and others; so always get a checkup if you have ongoing gastrointestinal problems. Your healthcare provider may refer you to a gastroenterologist if you have continuing issues related to bowel problems.
What causes diverticulitis?
It’s unknown why some people develop diverticulitis while others don’t, despite similar health histories and lifestyle factors—but doctors have recognized several patterns in patients who have uncomplicated diverticulitis. For instance, a person might get diverticulitis because of the way their colon passes material.
“Diverticulitis occurs when a diverticula becomes blocked by a fecalith (stool ball) and becomes inflamed,” says Andrew Boxer, MD , a gastroenterologist at Gastroenterology Associates of New Jersey.
A “flare” occurs when someone experiences painful diverticulitis symptoms. Although many would like to identify their flare triggers to avoid symptoms, it’s not always possible to predict or prevent them. For example, it’s a myth that certain foods, such as seeds or nuts, will cause problems, according to Dr. Boxer.
Constipation is a leading cause of diverticulitis symptoms and flares. Chronic constipation can be painful, and the inability to move stool regularly causes colon blockage, which can inflame or damage the colon.
8 drugs to avoid with diverticulitis
Since diverticulitis affects the colon and the passing of solids, medications that cause constipation or straining to pass a stool will make it worse, according to Dr. Stein. There are also classes of medications that can lead to an increased risk for diverticulitis and its complications, such as perforation. Here are 8 drugs that you should avoid if you have had diverticulitis in the past or are having a current flare.
1. Opi o ids
According to multiple studies , taking opioids increases the risk of diverticulitis. A recent study also points to opioids leading to “other complications of diverticulitis, including bleeding, sepsis, abscess formation, fistula formation, and obstruction.”
2. Steroids
Corticosteroids such as prednisone are used to treat conditions like arthritis, but studies show steroids increase the risk of diverticulitis, especially in the older population, and may cause complicated diverticulitis. A one-person study also indicated that “long-term treatment with corticosteroids increases the risk of colon perforation.”
3. Antihistamines
One study showed that a high volume of histamine expression receptors could lead to diverticulitis complications. While you can treat this with antihistamines , the medication’s tendency to lead to constipation could become an issue. Another study indicated that “patients exposed to antihistamines had an increased rate of intraabdominal abscess formation.”
4. Tricyclic antidepressants
According to the Mayo Clinic , constipation is regularly associated with taking antidepressants . This side effect could lead to diverticulitis flare-ups.
5. Iron supplements
Taking iron supplements , such as ferrous sulfate, causes a “significant increase in gastrointestinal-specific side-effects,” including constipation, according to one study . One case report also found that iron supplements led to “ileus secondary to bowel obstruction from constipation.” Ileus is a painful temporary paralysis of the small intestine or other part of the intestine.
6. Blood pressure medications
Calcium channel blockers (CCBs) such as amlodipine treat hypertension, but they can have a negative effect on acute diverticulitis, according to this study . It showed that taking medications to lower blood pressure is “associated with a higher rate of diverticular hemorrhage.”
7. Blood thinners
The study looking at blood pressure medication also showed that anticoagulants like Eliquis or Xarelto are likely to cause diverticular hemorrhage.
8. Nonsteroidal anti-inflammatory drugs
“There is also a thought that NSAIDs such as Advil can make diverticulitis worse,” says Dr. Boxer. According to one study, “Individuals who regularly take NSAIDs have a significantly higher incidence of [diverticulitis] when compared with non-NSAID takers.”
If you regularly take NSAIDs and have symptoms of diverticulitis, speak to your healthcare provider about switching to a different pain management method.
To avoid potential drug interactions or worsening of symptoms, always give your complete health history to your healthcare professional, including all medications and supplements. You may need to change your medication protocol to keep yourself healthy.
Other diverticulitis risk factors
Some people simply get diverticulitis for no particular reason, but there are some risk factors.
“The major risk factor to diverticulitis is having an episode of diverticulitis in the past,” Dr. Boxer says. “Other risk factors are not well understood. There is debate around whether smoking, obesity, and lack of activity are risk factors.”
Leading a healthy lifestyle is a good idea regardless of risk factors in your life. Make sure to avoid smoking, eat a balanced high-fiber diet, and exercise as recommended by your healthcare provider to help decrease the chances of diverticulitis or diverticulitis flare-ups. High-fiber foods like lentils, leafy greens, and whole grains help contribute to good digestive health and healthy bowel movements.
Additionally, while stress doesn’t cause diverticulitis directly, “If stress makes you eat poorly and then your diet could contribute to causing diverticulitis,” Dr. Stein says. Stress reduction measures such as mindfulness, physical activity, and self-care can help mitigate your risk of diverticulitis and many health conditions.
What is the best diverticulitis medication?
While a few medications are available for diverticulitis, there may be no need to medicate diverticulitis in mild cases. “There are new studies showing that it will usually resolve over time on its own,” says Dr. Stein. “ Some new studies even report that antibiotics may not be needed for mild cases of diverticulitis.”
However, you should always check with your healthcare provider if you are experiencing diverticulitis-like symptoms. After providing your complete health history and describing any discomfort you’re having, they can help you decide if you need medication.
Most often, people treat diverticulitis with antibiotics, including:
Antibiotics are a short-term solution, as there are no long-term treatment options beyond lifestyle adjustments to help prevent flare-ups.
In addition to antibiotics, Dr. Boxer recommends a “clear liquid diet” to soothe your digestive tract and Tylenol or acetaminophen for pain during an acute bout of diverticulitis. The duration of treatment will depend on your particular prescription and the recommendation of your healthcare professional. If given antibiotics, always take the entire course of treatment, even if you begin to feel better before you are finished.
If you have recurrent issues, your provider may order a stool test, a CT scan of your abdomen and pelvis, or a colonoscopy.
Diverticular disease and diverticulitis
Diverticular disease and diverticulitis are conditions that affect the large intestine (bowel), causing tummy (abdominal) pain and other symptoms. They’re caused by small bulges or pouches in the walls of the intestine called diverticula.
Information:
Diverticulosis is when there are diverticula in your bowel, but they’re not causing any symptoms.
Most people will get some diverticula as they get older, but most people will not get any symptoms.
Symptoms of diverticular disease and diverticulitis
The symptoms of diverticular disease include:
- pain in the lower left side of your tummy (abdomen) – a small number of people get pain on the right side
- tummy pain that gets worse after you eat, and gets better after you poo or fart
- constipation
- diarrhoea
- blood in your poo
- bloating
If your intestine becomes infected or inflamed, it’s called diverticulitis. You may also have symptoms such as:
- severe, constant tummy pain
- high temperature
- bleeding or passing slime (mucus) from your bottom
Information:
The symptoms of diverticular disease and diverticulitis are similar to those of other conditions such as irritable bowel syndrome (IBS).
Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:
- there is blood or slime (mucus) in your poo
- you have tummy pain that’s getting worse or does not go away
- you have a high temperature, or you feel hot or shivery
- you keep being sick and cannot keep fluid down
- you have diarrhoea for more than 7 days or are being sick for more than 2 days
Tests for diverticular disease and diverticulitis
The GP will ask questions to find out what’s causing your symptoms. You may need a blood test or to give a poo sample to help find what’s wrong.
You may need further tests to confirm if you have diverticular disease or diverticulitis and rule out other conditions. Further tests you may have include:
- a colonoscopy or flexible sigmoidoscopy, where a thin tube with a small camera on it is used to check inside your bowels
- a CT scan
Treating diverticular disease and diverticulitis
Treatments that can help with the symptoms of diverticular disease include:
- painkillers such as paracetamol
- bulk-forming laxatives for constipation and diarrhoea
- medicines to help with stomach cramps (antispasmodics)
Diverticulitis is treated with:
- antibiotics if the diverticulitis is caused by an infection
- painkillers such as paracetamol
Things you can do to help with diverticular disease and diverticulitis
If you have diverticular disease or diverticulitis there are things you can do to reduce the risk of your symptoms getting worse in the future.
Don’t
Complications of diverticulitis
Rarely, diverticulitis can lead to serious complications such as:
- a build-up of pus (abscess) in your bowel
- a blockage in your bowel
- an opening from your bowel to another organ, such as your bladder, called a fistula
- a hole (perforation) in your bowel, which can cause a severe infection called peritonitis
These problems can sometimes be treated with antibiotics or surgery.
For example, you may need surgery to drain an abscess or remove an infected part of the bowel.
Some people will need to have a colostomy (where your bowel is brought out of a hole in your tummy and a bag is attached to collect your poo).
Immediate action required: Call 999 or go to A&E if:
You or someone you care for:
- has severe tummy pain and is either vomiting, has a swollen tummy, or cannot poo or fart
- is bleeding heavily from their bottom
- is acting confused, has pale or blotchy skin, has a very high or low temperature, or is breathless or breathing rapidly – these could all be signs of sepsis.
