Diverticulitis: do you always need antibiotics or surgery?
Two things have changed. First, large studies have shown that many otherwise healthy people with a mild (uncomplicated) attack confirmed on a CT scan recover just as well without antibiotics. Second, surgery to remove part of the colon is no longer recommended simply because someone has had two or more attacks. The decision is now based on the individual patient.
What this means for you
- A mild attack can often be managed with rest, a clear-fluid or light diet, and pain control. Antibiotics are still used when they are needed, for example if you have a weakened immune system, signs of a more serious infection, or other health problems.
- Having several attacks does not automatically mean you need an operation.
- Surgery may be recommended if attacks are frequent and affect your quality of life, or after a complication such as an abscess, a narrowing of the bowel, or an abnormal connection to the bladder.
- When surgery is needed, it can usually be done with a minimally invasive (laparoscopic) approach.
- If you have not had a recent colonoscopy, one may be recommended after you recover, to rule out other causes.
Talk to your surgeon
The right plan depends on how severe your attacks have been, how often they happen and your overall health. Your surgeon will go through the options with you. Summit Surgical sees patients by referral only — ask your family doctor or another physician to fax a referral to 587-392-0375.
Sources (for clinicians)
Hall J, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020;63(6):728–747.
Peery AF, et al. AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterology. 2021;160(3):906–911.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis (DIABOLO). Br J Surg. 2017;104(1):52–61.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis (AVOD). Br J Surg. 2012;99(4):532–539.
Reviewed by the surgeons of Summit Surgical, October 2026. General information only — your surgeon will advise on your own situation.
