Why Surgery is Necessary for Diverticulitis

Diverticulitis may sound like something you catch on an exotic vacation, but it’s actually a common digestive problem you should probably know more about.  Diverticulitis affects 10% of people over age 40 and 50% of people over age 60. 

It may 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.

Virtua South medical director for robotic surgery and colorectal surgeon, Keith Meslin, MD, explains this disease and how it’s treated effectively.

What is Diverticulitis?

A diet low in fiber and high in red meat results in small, hard stools, and the colon must exert more pressure to move them. This increased pressure in the colon can cause small pouches to form. When these pouches become inflamed and infected, diverticulitis results. According to Dr. Meslin, patients usually experience left lower abdominal pain and fever.

How is it Treated?

Simple diverticulitis, which is a minor infection of the colon, is treated with bowel rest and antibiotics. Your doctor also will recommend changes in your diet that includes an increase in fiber-rich foods.

Complicated diverticulitis with an abscess (infected, pus-filled area) or peritonitis (inflammation of the abdominal lining) is caused by perforation, or a hole in the colon. An abscess often can be drained with the help of radiology. Peritonitis requires removal of part of the colon, a process called resection.

When is Resection Necessary?

If you have had multiple attacks of infection, especially with hospitalization and antibiotic usage, chances are you experienced these attacks in close succession. Dr. Meslin explains that this 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. It can usually be done with laparoscopic (through a small incision) or robotic surgery, avoiding open surgery or colostomy.

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, Dr. Meslin explains that by using minimally invasive techniques, risks are significantly reduced.

Preparing for Resection

Dr. Meslin recommends eating a healthy diet, exercising, and avoiding drinking alcohol or smoking, which can affect healing.

Recovery

Following resection surgery, you should try to eat healthy and walk (at minimum) as a form of gentle exercise. Dr. Meslin reminds you that a positive attitude usually helps speed recovery. Avoiding popcorn, increasing water intake, and having a healthy diet that includes fiber often helps prevent further diverticular issues in the future.

Updated December 29, 2017