urgently need info on severe diverticulitis

[Liberty Belle]

I need help. My best friend was hospitalized a few days ago with severe upper right abdominal pain. They diagnosed diverticulitis based on a CT scan. But he's not any better, and still can't tolerate a bite of food without severe cramping or diarrhea days later, even after being on 2 antibiotics. (He had the diarrhea before the antibiotics).

I'm concerned because everything i've read said diverticulitis usually presents with LOWER not upper left side pain. He also had inguinal hernia surgery a year ago and has continued discomfort from that, also on the left side. The dopes at the hospital didn't bother to scan the hernia area, even though he'd been back to his doctor in AZ last month complaining of pain there.

He has lost nearly 20 pounds in 2 weeks and is so weak I'm scared he won't pull through. He has no health insurance except through an Indian clinic that doesn't have emergency care.

Any suggestions on how to confirm the diagnosis and/or treat diverticulitis? He's already tried liquid diet, low fiber after the attack and gradually adding fiber, but can't tolerate even liquids without severe cramping. This has gone on for 2 weeks!

Any help or suggestions would be graetly appreciated. This is a strong Democratic progressive activist leader, and he needs your help and prayers!

[mopinko]

1. no colonoscopy?

i would think that would be in order, but maybe they don't want to put him through the prep.
diverticulitis is dx-able with a cat scan. i have had a small bout, and it is usually below the navel. not sure if that translates to lower and upper for you/him. you would think they would look at the whole lower gi tract, tho.
can't really give you any advise. hopefully the ab's will kick in soon. they do take a little time. i'm sure that your devotion will be a healing force for him.

[Liberty Belle]

2. Thanks. He sees his doc Friday; will ask about that.

[Quakerfriend]

3. Diagnosis sounds correct. This is usually pretty evident

from CT scan.

He should ask for a consultation with the hospital nutritionist. Diverticulitis is usually treated with a clear liq diet for several days and then a low residue diet, as tolerated.
It is not uncommon for patients to require surgical removal of a section of bowel. This is usually reserved for patients who have had several bouts of severe diverticulitis.

Sounds as though he would benefit from PPN (peripheral parenteral nutrition) which is given via IV for a maximum of ~ 10 days. This will prevent further wasting. And, allow his bowel to rest.

If after 10 days he still cannot take anything by mouth he would likely need TPN (total parenteral nutrition) via central line. All of his caloric needs can be met with this and this is is good for a longer period of time. I have had patients on TPN for many months.

Just my 2 cents. Hope he's OK soon.

O8)

[Liberty Belle]

4. Thanks. Turns out he had salmonella- food poisoning.

Once they got him on the right antibiotic, he started improving and is much better now.