Yes, I treat diverticulitis. Diverticulitis is defined as the inflammation and infection of “pouches” (diverticula) in the wall of the colon. Studies have shown that general surgeons, such as myself, who specialize in the treatment of diverticulitis, have as good or better outcomes than colorectal surgeons.
Infected pouches along the colon. (University of Virginia Health Systems)
Many people who are diagnosed with diverticulitis have never heard of it. Here are some of the basics you should know.
Symptoms: Symptoms of diverticulitis, lasting between hours and weeks, may include:
- Abdominal pain and tenderness, usually in the lower left side, that is sometimes worse when moving.
- Chills and fever.
- Bloating and gas.
- Constipation or, less commonly, diarrhea.
- Nausea and possibly vomiting.
Risk factors: You may find that you do not fit into all risk categories. However, these risk factors have been associated with diverticulitis.
- Low-fiber diet. This diet has an abundance of processed foods (food from a box) and is lacking in whole plant-based food (food from the produce section).
- Advanced age. The incidence of diverticulitis increases with age.
- Obesity. Being medically overweight increases your odds of developing diverticulitis, with morbid obesity increasing your risk of needing more-invasive treatments for diverticulitis.
- Lack of exercise. Vigorous exercise appears to lower your risk of diverticulitis.
- Certain medications. Several drugs are associated with an increased risk of diverticulitis, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve).
Diagnosis: Doctors will do an examination and may run several tests to diagnose diverticulitis or rule it out, including blood and urine tests, X-rays and CT scans, and liver function and stool tests. In women, doctors also need to check for pregnancy or pelvic infections as the possible source of pain.
Treatment: Treatment depends on the severity of symptoms and the results of the tests. Milder cases of “uncomplicated” diverticulitis may be treated with antibiotics, rest, pain medicine, and a liquid diet for a while, with possible dietary changes later.
“Complicated” or severe diverticulitis, especially when combined with other health problems, may require hospitalization and/or surgery.
According to the Mayo Clinic, you’ll likely need surgery to treat diverticulitis if:
You have a complication, such as perforation, abscess, fistula or bowel obstruction.
You have had multiple episodes of uncomplicated diverticulitis.
You are immune compromised.
There are two main types of surgery:
- Primary bowel resection, which can be done through traditional open surgery or laparoscopically, depending on the circumstances. The surgeon removes diseased segments of your intestine and then reconnects the healthy segments (anastomosis).
- Bowel resection with colostomy, a more extreme surgical procedure, is done if it is not possible to rejoin your colon and rectum at the time of surgery. Waste passes into a colostomy bag on the outside of the body. In most cases, a colostomy may be reversed and the bowel reconnected after it heals.
Patty got “glamour shots” taken with her colostomy bag for her article on her experience with diverticulitis.
It is common for many patients, when first diagnosed with diverticulitis, to become overwhelmed by the likelihood of surgery. They have particular concerns about receiving a colostomy bag. There is no doubt, this is a life-changing event.
Patients who have undergone treatment confirm that it was indeed a life-changing event… but for the better. The removal of chronic pain and other symptoms frees them up to enjoy life, return to work, and even enjoy eating again.
One specific patient of mine was moved to write an article about her experience. Soon, she is running another half marathon, a hobby she was unable to enjoy before treatment. You can read about her experience here: “Balancing Risk”