http://emedicine.medscape.com/article/173388-treatment#showall

Patients with mild diverticulitis, can be started on an outpatient treatment regimen. This consists of a clear liquid diet and 7-10 days of oral broad-spectrum antimicrobial therapy. According to the World Gastroenterology Organisation practice guidelines for diverticular disease, such a regimen should result in improvement within 48-72 hours. One typical oral antibiotic regimen is a combination of ciprofloxacin (or trimethoprim-sulfamethoxazole) and metronidazole.

Patients should be instructed to be on a clear liquid diet only and can advance the diet slowly as tolerated after clinical improvement, which usually occurs within 2-3 days.

In the first US double-blind, placebo-controlled trial of the anti-inflammatory agent mesalamine for diverticulitis, 117 patients were randomly assigned within 7 days of documented acute diverticulitis to a once-daily regimen of either 2.4 g delayed-release mesalamine or placebo over 12 weeks, followed by a 9-month treatment-free period. Global symptoms scores for 10 gastrointestinal symptoms on a 0-6 Likert scale were persistently lower in patients receiving mesalamine compared with the placebo group. The rate of complete response was significantly higher with mesalamine than placebo at 6 weeks and 52 weeks, while probiotics in combination with mesalamine did not provide additional efficacy.

Any information on what foods might contribute to this condition? Strategies on how to avoid it? Used to, the thinking was to avoid nuts & seeds. What's the latest? I'd like to get ahead of this.

TIA

Clin Gastroenterol Hepatol. 2013 Dec;11(12):1532-7.

"Diverticular disease: reconsidering conventional wisdom.

Abstract: Colonic diverticula are common in developed countries and complications of colonic diverticulosis are responsible for a significant burden of disease. Several recent publications have called into question long-held beliefs about diverticular disease. Contrary to conventional wisdom, studies have not shown that a high-fiber diet protects against asymptomatic diverticulosis. The risk of developing diverticulitis among individuals with diverticulosis is lower than the 10% to 25% proportion that commonly is quoted, and may be as low as 1% over 11 years. Nuts and seeds do not increase the risk of diverticulitisor diverticular bleeding. It is unclear whether diverticulosis, absent diverticulitis, or overt colitis is responsible for chronic gastrointestinal symptoms or worse quality of life. The role of antibiotics in acute diverticulitis has been challenged by a large randomized trial that showed no benefit in selected patients. The decision to perform elective surgery should be made on a case-by-case basis and not routinely after a second episode of diverticulitis, when there has been a complication, or in young people. A colonoscopy should be performed to exclude colon cancer after an attack of acutediverticulitis but may not alter outcomes among individuals who have had a colonoscopy before the attack. Given these surprising findings, it is time to reconsider conventional wisdom about diverticular disease."

full article:
http://www.cghjournal.org/article/S1542-3565(13)00623-X/abstract#/article/S1542-3565(13)00623-X/fulltext?mobileUi=1

https://www.gastro.org/guidelines/Diverticulitis_Guideline_Final.pdf

"AGA Recommendations Diagnosis and Management of Acute Diverticulitis

There are no studies that address whether dietary or supplemental fiber intake reduces the risk of recurrent acute diverticulitis. Risk reduction for recurrent diverticulitis is extrapolated from a study examining patients without a prior history of diverticulitis (incident diverticulitis). Risk reductions for diverticular complications and surgery are based on a single, small case control study. Benefits of fiber for chronic abdominal pain in patients with diverticulosis are inconsistent and do not necessarily imply benefit in terms of recurrent diverticulitis. While both the certainty and the magnitude of benefit of fiber in patients with acute, uncomplicated diverticulitis are difficult to ascertain based on very low quality evidence, the intake of a high fiber diet or fiber supplementation is unlikely to pose substantial risk to patients. In light of the very low-quality evidence base, patient preferences and side effects of fiber such as abdominal bloating need should be considered when counseling a patient. A differential benefit of dietary fiber intake compared with fiber supplementation is unknown, as is the optimal daily fiber dose necessary to achieve benefit. The benefit of fiber in patients with recurrent or complicated diverticulitis is also undefined.

The relevant data on the consumption of seeds, nuts, and popcorn and subsequent diverticulitis outcomes are derived from observational studies of incident episodes of diverticulitis. There are few data on consumption of these products and subsequent recurrence of diverticular disease. The key study reported modest estimates of relative risks and has a high degree of statistical certainty. In the absence of more compelling evidence it seems that advising patients to avoid these items is not useful."

Thanks for the detailed posting. So, as for what brings on an "attack", sounds like more research is indicated. Areas that should be priorities for future research include: "Identifying risk factors for recurrent diverticulitis, to better target potential medical interventions to populations most likely to benefit. "

Grapes make mine flare up...ask doctor and he said grapes aggitate intestines.