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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 35808
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I just finished a round of cipro and flagyl for

Customer Question

I just finished a round of cipro and flagyl for diverticulitis. I had horrible time with meds and dr said it was ok tobdtop
JA: What medications do you take daily? Are you allergic to any medications?
Customer: to stop taking them. It is now 3 days later I'm having loose bowels but still need to strain stomach pain and lots of noise. If after meds and only 3 days off pills could I be getting diverticulitis again. Had Ct that confirmed it and 5 days later another Ct and it said it was gone.
JA: Anything else in your medical history you think the doctor should know?
Customer: I take pravastatin thyroid allergy pill elavil 5 mg
Submitted: 5 months ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 5 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  Dr. Arun Phophalia replied 5 months ago.

There can be lingering symptoms of diverticulitis, even after the full course of antibiotic. There are change in the normal commensals (good bacteria of intestines) of the intestines due to antibiotic as well as due to diverticulitis. You may take Probiotics and try to keep a liquid and semi solid diet with more carbohydrates.

Please feel free for your follow up questions.I would be happy to assist you further, if you need any more information.Thanks for using Just Answer.
Customer: replied 5 months ago.
I did liquid for a couple days then was tild eat whatever you want. I notice by end of meds I was getting constipated which I never am. Abdomen is notvtendervto touch but it never was. I don't know how first Ct sand focal area that could become abscess sondr put me on meds then 4 days later felt worse donthey did another Ct and it said no sign of anything in only 4 days. I took them 9'days they killed my joints but wasn't having any of these symptoms tell 3 days later. I am taking a probiotic a very good one.
I'm afraid of the diverticulitis causing this and that maybe meds didn't work and getting a rupture. I don't have fever never do
Customer: replied 5 months ago.
I am taking probiotics and if it's too carbs and liquid where's the fiber to help me go? Should I be adding fiber?!
Expert:  Dr. Arun Phophalia replied 5 months ago.

Thanks for the additional information. I am writing the answer for you and will get back to you in a few minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

Customer: replied 5 months ago.
Another thing is my stomach is gurgling and super noisy
Expert:  Dr. Arun Phophalia replied 5 months ago.

Please do not worry about the perforation, which is not a common complication of the diverticulitis. Also this become exceedingly rare if antibiotics are taken. I feel you may reading too much of the medical literature which may have augmented your anxiety and thus the symptoms. Too much fiber is usually not recommended for diverticulosis.

The reasons for excessive intestinal gas, bloating, super noisy abdomen can be;

1) excessive air swallowing.

Anxious people swallow air when they are stressed or anxiety supervenes.

2) increased intraluminal (inside the intestine) production from mal absorbed (improperly absorbed) nutrients,

3) decreased gas absorption due to some pathological condition of intestines like diverticulitis

4) expansion of intestinal gas due to changes in atmospheric pressure

A solitary reason or combination can be responsible for the excessive gas.

Following may help you;

1) Avoid

a) Cabbage

b) Beer

c) Legumes

d) Cheese

e) Beans

2) This may help;

a) Bismuth subsalicylate

b) Activated charcoal

c) Simethicone; (Maalox, Mylanta); Simethicone causes gas bubbles to break up.

d) Beano; contains an enzyme (alpha-galactosidase), which helps to breakdown certain complex carbohydrates.

All are available without prescription.

Avoid foods that appear to aggravate symptoms. These may include milk and dairy products, certain fruits or vegetables, whole grains, artificial sweeteners etc. But this is based on the personal observation for the aggravating food.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 5 months ago.
I am not eating any of those. I have always ate good. No idea how I even got this. Never hurt to press on stomach. Ct is what found the beginnings of an abscess why the meds. Just seems odd 3 days after I stopped meds I have all the symptoms they were asking me if I had. But if a Ct was fine on 4 days after meds and the one before showed different could it really clear up that much? I'm only doing liquid bread mashed potatoes applesauce but finding it hard the last two days to have bm sontook acstool softener last night and today bad stomach pains loose bowels but still had to strain to pass those and when you do strain lots of lower abdomen pain. I also have a horrible cough that rocks me to the bowels when I cough up the muscles
Expert:  Dr. Arun Phophalia replied 5 months ago.

Try to avoid stool softer for a while. We avoid extra fiber, but fibers in fruits usually are not bad. Try banana, which gives calories and may be good for the intestines. Two things here;

1) Are your symptoms due to anything serious or complications; the answer is highly unlikely.

2) Then why are the lingering symptoms; the reason is course of disease. Almost 25% of people with diverticulitis have lingering symptoms for 2-3 weeks or more.

Customer: replied 5 months ago.
the fact that when I push on my stomach around navel and it hurts doesn't mean I need another round of meds? I feel nauseated when I try to eat much. My worry is wont eating low fiber make me constipated which in turn glares diverticulitis. My lower abdomen now feels like it's bloated big time. Like I said symptoms are much worse than before I was having normal bus and could eat whatever. Not now and you have to strain to go but that might be from so much coughing.
Expert:  Dr. Arun Phophalia replied 5 months ago.

The diverticulitis may not have completely resolved but these residual symptoms usually do not require second round of antibiotic. The tenderness and bloating do indicate the persistent diverticulitis but just the diet management should be able to take care of it. Excessive fiber need to be avoided as it may cause stagnation but otherwise fiber may not be harmful. So on this count one may be slightly balanced.

If need arises one may be prescribed injectable antibiotic, where side effects are low and one can tolerate it better than the oral.

Customer: replied 5 months ago.
what do I eat mashed potatoes white bread applesauce can I do meat? It's just so odd like I said I'm having 100 percent more cramping diaherra feeling of it but can't go and burping then ever before the meds
Customer: replied 5 months ago.
Also why did first scan say abscess second Ct 4 days later say it was all good. I am thinking maybe I should have another Ct.
Expert:  Dr. Arun Phophalia replied 5 months ago.

It is a good idea to get a CT scan again for evaluating it with your persistent symptoms. The abscess can resolve in 4 days. But we cannot say that first CT scan was false positive or second scan was false negative. Medical imaging has its limitation and your symptoms and signs have more importance.

The rule is; if you have persistent symptoms, you need treatment.

The question here is can we pursue diet management or you need further round of antibiotic, which you and your doctor in conjunction can take a decision depending on the severity of signs.

Customer: replied 5 months ago.
I don't have a dr. He retired and clinic closed I was his last patient. I thought you said mostly won't need more meds. I have had 2 cts in less than 2 weeks and my kidneys were hurting after last one. I'm
Not doing that again. Hopefully there are other tests that can work.
Expert:  Dr. Arun Phophalia replied 5 months ago.

MRI can be done. Which does not have radiation. Ultrasound too may be done; though it has far less sensitivity for diverticulitis but it can identify the abscess.

Actually you mentioned that you would like to get a CT scan done in the light of first appearing and than disappearing abscess.

Any investigation is done here to ascertain the severity of the residual disease and to chalk out the further treatment plan. As you know, antibiotics and probiotics with the diet are the main treatment. Last two you are already doing so your symptoms, signs and investigative findings need to determine, whether to start antibiotics again or not. Majority of the patients do not require it. Lingering symptoms may remain for further one week but if you can tolerate them, resolution would occur.

Expert:  Dr. Arun Phophalia replied 5 months ago.

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