What is Diverticulitis?
Diverticulitis is a form of diverticular disease, which occurs when diverticula, small pouches in the large intestinal (colonic) wall, are present. These pouches arise in the colon and push through weak spots in the colon’s outer muscle layers. Inflammation of these diverticula are called diverticulitis.
What are Symptoms of Diverticulitis?
Symptoms of diverticulitis include:
- Abdominal pain (most commonly in the left lower quadrant)
- Constipation (may be severe)
- Gas (flatulence)
What is the Treatment for Diverticulitis?
Treatment for diverticulitis depends on the severity, the presence of any complications, and other underlying medical conditions.
Treatment for mild diverticulitis includes:
- Clear liquid diet for 2-3 days; progressing to a soft diet as tolerated
- 7-10 days oral broad-spectrum antibiotics if needed
- Acetaminophen (Tylenol) and antispasmodics for pain
In severe cases, hospitalization may be needed and treatment may include:
- Clear liquid diet; progressing to a soft diet as tolerated
- Intravenous (IV) or oral antibiotics
- Abscesses less than 3 cm: Typically resolved with antibiotics
- Abscesses greater than 4 cm: Drain percutaneously
- Pain management
- Elective surgical resection
What Is Surgery for Diverticulitis?
Most people who are diagnosed with diverticulitis will not need surgery. The American Society of Colon and Rectal Surgeons (ASCRS) guidelines recommend emergency surgery for patients with diffuse peritonitis and for those whose do not respond to other treatments.
There are two main types of diverticulitis surgery, both of which may be performed laparoscopically or as an open procedure:
- Bowel resection with primary anastomosis in which the parts of the infected colon are removed (colectomy), and the cut ends of the two healthy pieces from either side of the previously infected area are attached (anastomosis)
- Bowel resection with colostomy involves a colectomy, and the bowel is connected through an opening (a stoma) in your abdomen (colostomy)
What Is the Success Rate for Diverticulitis Surgery?
About 15%-25% of patients who present with a first episode of acute diverticulitis have disease severe enough to require surgery. Up to 22% of those who have surgery will have a future attack.
Complications of diverticulitis surgery include:
- Leak in the colon
- Narrowing or blockage of the colon from scar tissue
- Injury to surrounding organs
- Blood clots
- Abscess formation near the colon
- Fecal incontinence
The surgical mortality rate for diverticulitis is 18%.
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