Typically, the patient presents to the ER with Left Lower Quadrant abdominal pain.
ER:
Routine Labs.
CT Abdomen/Pelvis.
IV Fluids.
Blood Cultures.
First dose of antibiotics- Ciprofloxacin 400mgIV and Flagyl 500mg IV.
Surgery Consult for any signs of bowel perforation or abscess. They usually recommend conservative management for small perforations. If big perforation, patient needs urgent surgery and surgery doctors will admit the patient.
NPO.
Hospitalist:
Continue IV Fluids, IV antibiotics
Pain control with iv pain medications-IV Toradol or IV Morphine etc.
NPO
GI evaluation-out patient Colonoscopy in 4-6weeks.
Interventional Radiology [IR] might need to be involved if patient has an abscess that needs drained.
Start Clear Liquid diet once the pain is improving and advance as tolerated.
Surgery Consult for Recurrent Episodes for possible colectomy.
Change antibiotics to PO to finish 10-14 day course.
