Why Surgery is Necessary for Diverticulitis

By Keith Meslin, MD, Colorectal Surgeon—Virtua Colorectal Surgery
Section Chief, Colorectal Surgery—Virtua Health

Diverticulitis may sound like something you catch on an exotic vacation, but it's actually a common digestive problem that can have serious consequences. Diverticulitis affects 10% of people over age 40 and 50% of people over age 60. 

It can begin with mild symptoms like cramps or bloating, which are easily mistakable for other minor problems and alleviated by mild pain relievers. But it can evolve into a serious condition accompanied by fever, infection, nausea, vomiting, and constipation. 

Here's what you need to know about the causes and treatment. 

What is diverticulitis?

When you eat a diet that's low in fiber and high in red meat, you produce small, hard stools. To move harder stools, the colon must exert increased pressure, which can cause small pouches to form. Diverticulitis results when these pouches become inflamed and infected, with most people experiencing left lower abdominal pain and fever.

How is it treated?

Simple diverticulitis, a minor infection of the colon, is treated with bowel rest and antibiotics. Your doctor also will recommend changes in your diet that include an increase in fiber-rich foods, such as whole grains, beans, vegetables, and fruit.

Complicated diverticulitis with an abscess (infected, pus-filled area) or peritonitis (inflammation of the abdominal lining) results when a perforation, or hole, forms in the colon. An abscess often can be drained with the help of a radiologist using imaging technology. Peritonitis requires the removal of part of the colon, a process called resection.

When is resection necessary?

If you've had multiple attacks of infection, especially with hospitalization and antibiotic usage, chances are you experienced them in close succession. Recurrent attacks can lead to an increased risk of perforation and difficulty with bowel function due to chronic scarring and narrowing of the colon. Under these conditions, elective resection is recommended. The surgery usually can be done laparoscopically through a small incision or with robotic surgery, avoiding open surgery or colostomy, a procedure that reroutes the colon to allow the damaged part to heal.

Risks of resection

Every colon surgery has risks—including infection, bleeding, hernias, or leakage from the new colon connection— but these also are dependent on the patient's overall health. However, using minimally invasive techniques reduces risks significantly.

Preparing for resection

To prepare for resection surgery, we recommend following a healthy diet, exercising, and avoiding drinking alcohol or smoking, which can affect healing.

Recovery

Following resection surgery, you should try to eat a nutritious diet and walk daily for exercise. A positive attitude can also help speed recovery. 

To prevent further diverticular issues, we recommend NOT eating popcorn, increasing water intake, and following a healthy diet that includes fiber-rich foods. 

Learn more about colorectal surgery at Virtua, or call 888-847-8823 to schedule a consultation with a Virtua colorectal surgeon.

Updated January 14, 2022