Hello.

Thanks for posting your query.

I understand that your concern is regarding suspected Diverticulitis and currently on treatment with ESOGUARD (Rabiprazole), PREPRO HS (Lactobacillus Acidophilus), FYBOGEL ( Ispaghula husk).

Usually, this is a mild condition that responds well to treatment. Some people will have more than one attack of diverticulitis.

You are on the right treatment and can continue with that.

But, I would suggest you to get the Colonoscopy done at the earliest to confirm the diagnosis.

During acute attacks, you can follow these measures.

1. Rest in bed and possibly use a heating pad on your belly.

2. You can try Anti-inflammatory drugs for pain after discussion with your treating doctor.

3. Drink only fluids for a day or two, and then slowly begin drinking thicker liquids and then eating foods.

4. Eating more fiber can help prevent future attacks.

Keep yourself well hydrated with plenty of fluids. Dehydration could be the cause for your dry lips and shrunken eyes. Avoid constipation.

To help you further, I need some more details to give you more specific suggestions.

1. Type of pain and duration.
2. Your age.
3. Bowel habits and stool consistency.
4. Basis of the diagnosis of diverticulitis.

I hope, you find my recommendations helpful. Awaiting your reply with the answers to above question and possible colonoscopy report.

Regards.

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Hello XXXXXXX

Thanks for the clarifications.

The CT description indeed suggests diverticulitis. The Fat stranding may suggest a localised leak / sealed of perforation or may be the sympathetic reaction of the sorrounding fat.

Diverticulitis is usually associated with intestinal motility problems and secondary bacterial overgrowth.

Dysmotility as well as bacterial overgrowth cause a sense of bloating and abdominal discomfort by altering the elasticity of the intestines and also by certain chemical release.

A high fibre diet is said to improve motility and prevent as well as retard development of diverticulae.

Fybogel - fibre is fermented in some people and can worsen the bloated feeling.

As for management, I would suggest - increase dietary fibres, add prokinetics and avoid milk and milk products except the fermented ones. You can also discuss the treatment of bacterial overgrowth with your doctor.

I hope, this answers your query.

Wish you good health.

Regards.
Dr XXXXXXX

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Hi XXXXXXX

Thanks for writing back.

Surgery for diverticular disease is advised only in case of recurrent diverticular bleed or complications of diverticulutis like stricture development, perforation or fistula.

Historically and by the CT results there isn't much of inflammation.

The symptoms that you have described are quite mild to merit a surgery.

As I had written earlier removal of (L) colon may not totally relieve the symptoms ( but reduce the severity) as the abnormal motility in the rest of colon will persist.

Colonoscopy helps to rule out other causes and confirms the diagnsis. It is best done when there is no diverticulitis (When there is no active inflammation going on).

Removal of only (L) colon doesnot cause much serious problems, there may be some increase in bowel movements and some fluidity of the stools. Rest are the routine surgical risks for your age (which can best be discussed with your treating doctor).

hence i feel you should discuss all the possible treatment approaches with your doctor as he knows you best and decide on further management

Wishing you a speedy recovery.

Regards
Dr. XXXXXXX

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