The changes in the wall of the colon seen with diverticu-losis can result in a syndrome of intermittent abdominal pain and spasm that mimics IBS. Symptoms are generally mild and are not associated with fever or signs of sepsis. Treatment is usually conservative and includes measures such as a high fiber diet and pharmacologic agents aimed at decreasing colon spasm, such as hyoscyamine. Symptoms are usually self-limited but may recur with some degree of regularity. Many patients with presumed recurrent "diver-ticulitis" may actually be suffering from intermittent spasm associated with diverticulosis. An antibiotic regimen is often started without radiographic confirmation of true diverticulitis, and in patients with spasm alone, it is simply the tincture of time, not antibiotic therapy, which has improved their condition. This fact is important to remember because true recurrent diverticulitis may warrant surgical intervention whereas the treatment of pain associated with spasm alone rarely does.
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