To understand diverticulitis, we must first discuss diverticulitis in the colon. In our younger years, our colons are perfectly smooth. This smoothness allows the colon to absorb water, flush feces and push waste into the rectum. However, over time, whether due to age or poor lifestyle habits, small pockets may begin to form within the colon wall. These pockets are known as diverticula and most people will develop some of these pockets as they get older. Diverticula are typically left untreated and are relatively normal and expected after the age of 50 or 60. We refer to this condition as diverticulosis.
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Diverticulitis occurs when fecal matter becomes trapped in these diverticula and causes inflammation and infection. For many, diverticulitis does not last very long – this is known as acute diverticulitis. Most cases are simply treated with antibiotics and a modified diet. However, some patients will continue to experience diverticulitis attacks, which may eventually necessitate surgery in the form of a colectomy.
The most common symptom of diverticulitis is pain. As the infection worsens, the pain follows suit. Most commonly, this pain occurs in the lower left quadrant of the abdomen, although diverticulitis can occur along any stretch of the colon. Nausea and vomiting, fever, and constipation are also common during diverticulitis attacks.
Consequences of nontreatment can significantly worsen abdominal symptoms. Abscess and intestinal blockage are common. At worst, one of the infected diverticular pouches can rupture leading to a perforation in the colon and allowing fecal matter to infect the abdominal cavity. This is a medical emergency known as Peritonitis.
The main cause of diverticulitis is age and as such, for some, diverticulitis cannot be prevented. However, the risk of diverticulitis is increased by poor dietary habits, a sedentary lifestyle, and excess weight. Oftentimes, a diet low in fiber causes constipation which can also cause diverticula to form. Some patients may be at higher risk due to certain medications.
In the interest of offering patients the least invasive solutions to their colorectal problems, less severe diverticulitis may be treated with antibiotics and a modified lifestyle regimen. However, diverticulitis attacks tend to worsen over time and patients may eventually be referred to us for surgery.
The curative surgical solution for diverticulitis is the colectomy or removal of the diseased portion of the colon. This process is relatively straightforward and offers excellent long-term results. Most patients will not require a colostomy. Some will require a temporary colostomy, and a few will require a permanent colostomy. Treating diverticular disease early is key to a successful and uncomplicated surgical procedure.
We encourage anyone with abdominal pain to be evaluated by a skilled and experienced medical professional such as those at our practice. During a consultation, we will offer perspective on treatment options as well as potential outcomes.