What is diverticulitis?
Diverticulitis happens when small pouches in your digestive tract, known as diverticula, become inflamed. Diverticula often become inflamed when they get infected.
Diverticula are usually found in your colon, the largest section of your large intestine. They usually aren’t harmful to your digestive system. But when they get inflamed, they can cause pain and other symptoms that can disrupt your daily life.
Read on to find out more about the types of diverticulitis surgery, when you should elect to have this surgery, and more.
Diverticulitis surgery is usually done if your diverticulitis is severe or life-threatening. You can usually manage your diverticulitis by doing the following:
- taking prescribed antibiotics
- using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil)
- drinking fluids and avoiding solid food until your symptoms go away
Your doctor may recommend surgery if you have:
- multiple severe episodes of diverticulitis uncontrolled by medications and lifestyle changes
- bleeding from your rectum
- intense pain in your abdomen for a few days or more
- constipation, diarrhea, or vomiting that lasts longer than a few days
- blockage in your colon keeping you from passing waste (bowel obstruction)
- a hole in your colon (perforation)
- signs and symptoms of sepsis
The two main types of surgery for diverticulitis are:
- Bowel resection with primary anastomosis: In this procedure, your surgeon removes any infected colon (known as a colectomy) and sews together the cut ends of the two healthy pieces from either side of the previously infected area (anastomosis).
- Bowel resection with colostomy: For this procedure, your surgeon performs a colectomy and connects your bowel through an opening in your abdomen (colostomy). This opening is called a stoma. Your surgeon may do a colostomy if there’s too much colon inflammation. Depending upon how well you recover over the next few months, the colostomy may be either temporary or permanent.
Each procedure can be done as open surgery or laparoscopically:
- Open: Your surgeon makes a six- to eight-inch cut in your abdomen to open your intestinal area to view.
- Laparoscopic: Your surgeon makes only small cuts. The surgery is accomplished by placing small cameras and instruments into your body through small tubes (trocars) that are usually less than one centimeter in size.
As with any surgery, your risk of complications may be increased if you:
- are obese
- are over the age of 60
- have other significant medical conditions such as diabetes or high blood pressure
- have had diverticulitis surgery or other abdominal surgery before
- are in overall poor health or not getting enough nutrition
- are having emergency surgery
A few weeks before your surgery, your doctor may ask you to do the following:
- Stop taking medications that may thin your blood, such as ibuprofen (Advil) or aspirin.
- Stop smoking temporarily (or permanently if you’re ready to quit). Smoking can make it harder for your body to heal after surgery.
- Wait for any existing flu, fever, or cold to break.
- Replace most of your diet with liquids and take laxatives to empty your bowels.
In the 24 hours before your surgery, you may also need to:
- Only drink water or other clear liquids, such as broth or juice.
- Not eat or drink anything for a few hours (up to 12) before the surgery.
- Take any medications that your surgeon gives you right before surgery.
Make sure you take some time off work or other responsibilities for at least two weeks to recover in the hospital and at home. Have someone ready to take you home once you’re released from the hospital.
To perform a bowel resection with primary anastomosis, your surgeon will:
- Cut three to five small openings in your abdomen (for laparoscopy) or make a six- to eight-inch opening to view your intestine and other organs (for open surgery).
- Insert a laparoscope and other surgical tools through the cuts (for laparoscopy).
- Fill your abdominal area with gas to allow more room to do the surgery (for laparoscopy).
- Look at your organs to make sure there aren’t any other issues.
- Find the affected part of your colon, cut it from the rest of your colon, and take it out.
- Sew the two remaining ends of your colon back together (primary anastomosis) or open a hole in your abdomen and attach the colon to the hole (colostomy).
- Sew up your surgical incisions and clean the areas around them.
Possible complications of diverticulitis surgery include:
- blood clots
- surgical site infection
- hemorrhage (internal bleeding)
- sepsis (an infection throughout your body)
- heart attack or stroke
- respiratory failure requiring the use of a ventilator for breathing
- heart failure
- kidney failure
- narrowing or blockage of your colon from scar tissue
- formation of an abscess near the colon (bacteria-infected pus in a wound)
- leaking from area of anastomosis
- nearby organs getting injured
- incontinence, or not being able to control when you pass stool
You’ll spend about two to seven days in the hospital after this surgery while your doctors monitor you and make sure you can pass waste again.
Once you go home, do the following to help yourself recover:
- Don’t exercise, lift anything heavy, or have sex for at least two weeks after you leave the hospital. Depending on your preoperative status and how your surgery went, your doctor may recommend this restriction for longer or shorter periods of time.
- Have only clear liquids at first. Slowly reintroduce solid foods into your diet as your colon heals or as your doctor instructs you to.
- Follow any instructions you were given for taking care of a stoma and colostomy bag.
The outlook for diverticulitis surgery is good, especially if the surgery is done laparoscopically and you don’t need a stoma.
See your doctor right away if you notice any of the following:
- bleeding from your closed cuts or in your waste
- intense pain in your abdomen
- constipation or diarrhea for more than a few days
- nausea or vomiting
You may be able to have a stoma closed a few months after surgery if your colon heals fully. If a large section of your colon was removed or if there’s a high risk of reinfection, you may need to keep a stoma for many years or permanently.
While the cause for diverticulitis is unknown, making healthy lifestyle changes may curb it from developing. Eating a high-fiber diet is one recommended way to help prevent diverticulitis.