Diverticulitis treatment - not sure it's working - Bowel Disorders Message Board

ljturner · 10-06-2005, 12:05 PM

I am on my second round of antibiotics for diverticulitis and still feel the same pain. I also feel nauseated, very tired, and any attempt at physical exertion is too much for me. I am pale, and have been having frequent, sometimes painful bm's. I finish the meds soon but I truly question whether or not they have helped with this at all, and I am worried that it may turn into something worse if I assume that I am cured when I am really not...they are saying I should have started feeling better within a few days of the first antibiotic and when that didn't happen they prescribed round 2 (flagyl & levaquin, now cipro). Should I be worried???

goody2shuz · 10-08-2005, 01:52 PM

Hi

Welcome to the boards. You should definitely be feeling better in terms of the pain. Sometimes the meds have side effects that often make us feel just as miserable as the condition which makes this disease difficult to manage.

The nausea you are feeling is most likely from the flagyl. I found that I had terrible side effects from this med and the doctors decreased me from 500mg to 250mg which I tolerated far better.

Have you had a colonoscopy yet??? Ususally this is done after the infection is under control and inflammation is down....around 4-6 weeks after an infection. Obviously they cannot do this with you until your pain is under control.

Are you being treated by a gastroenerologist?? If not I highly recommend you get an appointment with one ASAP.

Diverticulitis runs rather aggressively in younger people (those under the age of 50). Diverticulosis is the appearance of tics or pouchlike areas within the colon. Alone these will not cause problems....however when food particles become stuck in these pouches due to the bowels not being emptied properly (eg:constipation) or the ingestion of undigestible foods that increase the likelihood of them getting caught in these tics (eg: popcorn, corn, nuts, seeds), they become infected and by the time you feel the pain a large portion of the colon is inflammed/infected. Depending upon how much inflammation there is & how long it has gone untreated...there is a good chance of abcesses or perforation occurring in which the colon leaks into the abdominal cavity. This will be evidenced with increasing pain, fever, chills, and nausea vomitting & diarrhea which will require emergency intervention in a hospital setting.

From what you describe...you are not responding well to the meds. The pain should definitely be letting up and the pain with BM's is not good either. What is your diet??? While the colon is infected/inflammed it needs to have minimal stress or pressure on it. That is why a lo residue diet is necessary to allow for the colon to be minimally working while it heals. That means avoiding high fiber foods such as whole grains, raw fruits & veggies, salads, fatty & spicy foods aand of course anything that is difficult to digest such as corn, nuts, popcorn, seeds etc. This should be for at least 3-4 weeks after an infection. Then it's back to a high fiber diet which will prevent further episodes from occurring. But evenso....some people despite dietary changes and increased fiber in their diets are victims of this disease's aggressive nature and must resort to surgical interventions in order to avoid perforation, sepsis and even death.

I happen to have been one of those lucky people who needed the surgery and have to say that since having the surgery (a colon resection) in which they remove the area of the colon that has the tics and reattach it to the rectum, I haven't had one regret. I had been hospitalized twice for a week each time and been treated 3 more times on back to back meds like yourself over the course of 2 years. When the surgery was first suggested after my second infection I ran the other way. However, having 3 more infections within months of one another I decided that my body was telling me that this was only going to get worse. And so....I had the surgery and haven't had an infection since (that was since May 2004).

You need to call your gastroenterologist & tell him that the pain is not getting any better. If it gets worse or continues to stay the same you need to get to the ER and be further evaluated. Did they at least do a CAT scan or barium enema & bloodwork to rule out an abcess or perforation:??? If they didn't then I strongly recommend you go to the ER and be further evaluated especially since you are not responding well to the meds and you may have micro perforations which can be life threatening. I certainly do not mean to scare you only to inform you that this disease is dangerous if left untreated.

Please post & give us a further update.....Goody

ljturner · 10-10-2005, 09:16 AM

Goody,

Thanks for your reply, I have been following the resectie's thread because i sometimes think I will be joining it! Here's a glimpse of my adventure so far (over a year now)...

Last September I went to my primary doc complaining of llq abdominal pain. Initially she referred me to a surgeon, he basically gave me a quick once over and said I was in the wrong place. So then I went to a gastro doc. I had an upper GI series, abdominal ultrasound which were normal. I was also having frequent bms which were floating. This continued and in March of '05 I had a colonoscopy, which showed nothing remarkable. Basically they said IBS. I continued seeing the gastro doc and in the meantime I mentioned that I was also having upper right quadrant pain. They sent me for a HIDA scan, my ejection fraction from my gall bladder was 0%. So in July I had my gall bladder out.

After the surgery I continued to have llq pain and constipation, and I also thought I might be passing a kidney stone (which I also have had before) because of flank pain. So I went back to the primary doc who ordered a cat scan, and that's when they found the diverticulitis in my sigmoid colon with no abcess. Back to the gastro doc, where they put me on flagyl and levaquin for ten days, but went back again because I had no relief. They put me on cipro for another ten days which I just finished. They ordered another cat scan which I had on this past thursday and I go back today to the gastro doc. In the meantime, I am still having llq pain, and I alternate between having frequent pellet like bm's and huge, very painful ones. I have a bm within 30 to 45 minutes of every meal or snack that I eat.

I have been staying mostly low residue with my diet and stopped fiber supplements for the time being. The flank pain is also there and the llq pain is worse before bm's but never completely subsides. I have family history of diverticulitis and colon cancer. I am also feeling an emotional toll from all of this, as I said it's been over a year since it all started, and being in pain all of the time does drag me down.

Again, thanks for the reply, I will post again after I see the doc this afternoon. I really appreciate the advice!

goody2shuz · 10-10-2005, 01:19 PM

Funny how your history sound so similar to mine. I also had my gallbladder removed around 15 years prior to my resection. Have a history of kidney stones too....seems that whenever I get sick it is with big things.

Anyway...my tics were also in my sigmoid which is not a great place to have them since this is where the colon takes a bend and where most of our foodstuff sits while it is preparing for it's final evacuation

This leaves more chances for things to get stuck and thus infection. So....if you continue to have problems with diverticulitis that does not improve with diet & meds you may need to go the surgical route. Time will tell, my friend.

After my gallbladder was removed I also had a bowel routine like you describe of things going right through me.

I was told that this was due to the bile dumping right into the colon and irritating it since it had no where else to be stored. However, since my resection this has definitely improved.

We will await more info from your doctor's visit. You may be best going to the resection thread....there are alot of us who have been in your 2 shoes who would love to help. You don't have to have a resection to get the support that you will find there. Most of us have had diverticulitis....doesn't mean you have to have the surgery....but you will definitely get many answers to your questions there. Nevertheless, I will find you and look forward to your update....Goody

ljturner · 10-10-2005, 01:33 PM

Thanks again Goody...just got back from the doctor. They said the cat scan came back showing that the inflammation was resolved and everything looked good. They want me to try adding the fiber supplement back every night and donnatol for the IBS. The nurse practioner asked the doc about doing a sigmoidoscopy but he said to wait to see what happens with the fiber & donnatol. So we'll see I guess. Still I wonder about this pain...it can't be normal! I guess I will have to go with what the cat scan said though. Oh and I do have two very tiny kidney stones that are not obstructing...fun!