What is Diverticulitis?
Diverticulitis is an infection that occurs typically in the wall of the sigmoid colon. Diverticula are like pockets in the wall of the colon that people get as they get older. Sometimes a piece of food or other material will get stuck in one of these pockets and cause inflammation. We typically classify these kinds of infection into simple or complicated. In the simple version, there is inflammation surrounding the area of the colon. In the complicated version there can be an inflamed mass, an abscess, pus that flows into the abdominal cavity, or feces that has entered into the abdominal cavity.
The simple form of diverticulitis is typically treated with antibiotics and taking a clear liquid diet. Usually, people with the complicated form are admitted to the hospital and will be on antibiotics. They also sometimes need drains or surgery.
Patients who have the simple form of diverticulitis will often have several attacks prior to recommending that they receive surgery. In patients with the complicated form, the decision making is more difficult and is tailored to the patient’s specific situation.
What are the symptoms of Diverticulitis?
When people have diverticulitis, they will often have pain in the lower abdomen, especially on the left side. The pain is often worse with pushing and may be associated with fevers or chills. A lot of patients also have a hard time having a full bowel movement with it.
How is Diverticulitis treated?
Most diverticulitis is managed with antibiotics and diet changes. Sometimes, people have a severe enough form of diverticulitis or enough attacks that they need surgery. With surgery, the area of the colon causing the inflammation/infection is taken out. There are two basic ways of doing surgery for this. This can be done in a laparoscopic (small incisions and using a camera) or open fashion (large incision, placing the hands in the abdomen). Most patients should be able to get the laparoscopic form of the operation with the biggest incision being about 2 inches. Sometimes a surgeon will start laparoscopically, but then make a large incision for the operation. This should be rare. You should ask your surgeon how often he or she makes an incision more than 3 inches long.
Most patients who have surgery before their situation is an emergency can be done with removal of the affected area of the colon and then have the bowel put back together immediately. This typically results in a 1-7 day hospital stay. It is unusual for patients who don’t come in as emergencies to need a colostomy (a bag on the abdominal wall that collects stool).
What are the complications of Diverticulitis surgery?
As with all surgeries, risks include bleeding, infection, and damage of surrounding organs, heart attack, stroke, and death. Whenever a portion of bowel is removed and put back together, it is possible that this will result in a leakage. Ask your surgeon about your specific risk of a leak.
What is my recovery time from Diverticulitis Surgery?
Most patients are in the hospital between one and seven days after surgery. You shouldn’t lift more than 10 pounds for 6 weeks. You shouldn’t shower for 2 days, or take tub baths or swim for 2 weeks. You should get up and move as much as possible. People will often be sore for several days after surgery, but that gets better with time. Some people will have a poor appetite after surgery. There are no specific dietary restrictions after surgery. You can eat what you feel like.