WHAT IS Diverticulosis / Diverticulitis?
Diverticular disease is the general name for a common condition that involves small bulges or sacs called diverticula that form from the wall of the large intestine (colon). Although these sacs can form throughout the colon, they are most commonly found in the sigmoid colon, the portion of the large intestine closest to the rectum.
- Diverticulosis: The presence of diverticula without associated complications or problems. The condition can lead to more serious issues including diverticulitis, perforation (the formation of holes), stricture (a narrowing of the colon that does not easily let stool pass), fistulas (abnormal connection between body parts) and bleeding.
- Diverticulitis: An inflammatory condition of the colon thought to be caused by perforation of one of the sacs. Several secondary complications can result from a diverticulitis attack and when this occurs, it is called complicated diverticulitis.
WHAT ARE THE SYMPTOMS OF DIVERTICULAR DISEASE?
Most patients with diverticulosis have no symptoms or complications. However, patients with diverticulitis may experience lower abdominal pain, fever, or rectal bleeding.
WHAT IS THE CAUSE OF DIVERTICULAR DISEASE?
The most commonly accepted theory for the formation of diverticulosis is related to high pressure within the colon, which causes weak areas of the colon wall to bulge out and form the sacs. A diet low in fiber and high in red meat may also play a role. Currently, it is not well understood how these sacs become inflamed and lead to diverticulitis.
HOW IS IT TREATED?
Most people with diverticulosis have no symptoms. However, as a preventative measure, people are advised to eat a diet high in fiber, fruits, and vegetables, and to limit red meat. Most cases of diverticulitis can be treated with antibiotics in pill form (PO) or intravenously (IV). Diverticulitis with an abscess may require treatment with antibiotics and a drain placed under radiologic guidance.
Surgery for diverticular disease is indicated for the following:
- A rupture of the colon that causes pus or stool to leak into the abdominal cavity, resulting in peritonitis. Rupture of the colon often requires emergency surgery.
- An abscess than cannot be effectively drained.
- Severe cases that do not respond to maximum medical therapy, which includes hospitalization and intravenous antibiotics.
- Patients with immune system problems (related to an organ transplant or chemotherapy).
- A colonic stricture or fistula.
- A history of multiple attacks, a patient can undergo elective surgery in order to prevent future attacks.
Surgery for diverticular disease usually involves removal of the affected part of the colon, and may or may not involve a colostomy or ileostomy, where a part of the intestine brought out through the abdominal wall to drain into a bag. A decision regarding the type of operation is made with your surgeon on a case-by-case basis.
WHO IS A COLON & RECTAL SURGEON?
Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases as well as full general surgical training. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions.
