Diverticulitis surgey is needed when you experience diverticultis, a gastrointestinal condition that causes small pouches or bulges in the lining of your intestine (diverticula) to swell or become infected. Diverticula form in your large bowel’s inner lining due to pressure in its weak spots. When you have diverticulitis, you can experience severe abdominal pain, nausea, vomiting, fever, chills, bloating, diarrhea, or constipation. 

The treatments for diverticulitis are rest, diet adjustments, and medication. If you are experiencing frequent symptoms, you should consult your physician immediately.

When is diverticulitis surgery needed?

Diverticulitis surgery comes with risks. The American Society of Colon and Rectal Surgeons generally only recommends it if your condition persists or doesn’t respond to treatment. However, if your symptoms are left untreated, you might develop complications that need surgery, too. Here are some instances when the procedure may be required:

  • Fistula

This happens when a passage forms between your colon and other organs, such as the small intestine, bladder, or vagina.  You might experience discomfort while you urinate, air or stool in your urine, and abnormal vaginal discharge. 

  • Perforation

Bowel walls sometimes get tiny tears which causes them to weaken,, which might lead to abdominal swelling and infection.

  • Bowel obstruction

When your colon becomes too narrow from scarring or swelling, a blockage or bowel obstruction happens. 

  • Abscess

If your diverticula becomes infected or fill with pus, an abscess may form. If it’s small, antibiotics can usually treat it, but you might have to undergo surgery if it’s large or undrainable.  

  • Rectal bleeding

This complication happens when your pouches damage blood vessels in your colon wall, so you’ll see maroon or red blood in your stool. 

  • Peritonitis

You may have severe swelling or a leak in your abdomen because your colon has ruptured. This type of complication needs immediate medical attention because it can be life-threatening.  

  • Diverticulitis flare-ups

When you’ve had either one complicated or two uncomplicated diverticulitis attacks, it might be because you have a weakened immune system. You may want to consider having an operation to prevent further attacks. Persistent diverticulitis attacks can be dangerous because they can lead to abdominal bleeding and perforation in your colon. 

Surgery risks

Diverticulitis procedure does not guarantee that you’ll be free from experiencing the symptoms again. Any surgical procedure comes with risk. Below, you’ll find some risks associated with diverticulitis surgery. 

  • Accidental injury to bowels or nearby organs.
  • Scarring in the abdominal cavity that could cause digestive problems and pain.
  • Excess bleeding.
  • General risks of surgery such as pneumonia or thrombosis. 
  • Anastomotic leak. This means that the stitches that bind the two ends of your intestine come undone, so its contents can leak into the abdominal cavity. 
  • Abscesses and wound infections.

Diverticulitis surgery types

The procedure you’ll undergo depends on your case. Several options exist to treat diverticulitis. Here are the most common types:

  • Bowel resection with anastomosis

A surgeon will remove the affected parts of your intestine and reconnect the remaining healthy areas together. Once your wound has healed, you can still have normal digestion and regular bowel movements. 

Typically, surgeons conduct an open surgery for diverticulitis. But if your case allows it, you can also undergo a less invasive approach called a laparoscopic bowel resection. It involves small incisions where a surgeon will use a scope (a tube with instruments and a light) to perform the surgery. 

  • Colon resection with colostomy

If the swelling does not allow for anastomosis (reconnecting the bowel), the surgeon may decide that the best option is to  reroute your colon through your abdomen. Your stool will now pass through a surgically created hole called a stoma instead of your rectum. A colostomy bag will collect your output. 

In certain cases, your colostomy may be reversed. Surgeons may be able to reconnect your bowels once your colon has healed. However this is not always possible and it may be a permanent colostmy. 

  • Emergency surgery

If you have peritonitis from complicated diverticulitis, pus might go to your abdominal cavity, which might lead to sepsis. Surgeons will wash out your abdominal cavity and perform a colostomy. This is done on an emergency basis. 

Diverticulitis surgery preparation

Before your operation, your healthcare team helps you prepare for surgery with the follow recommendations:

  • Clear liquid diet

Several hours before surgery you will be placed on a clear fluid diet to reduce bowel residue during the procedure. Residue in the bowel might resemble blood. With that in mind, you can drink beverages like water, coffee, or tea. The healthcare team will also tell you how many hours before surgery you must stop eating and drinking completely (NPO).

  • Medication

Some medications, like nonsteroidal anti-inflammatory drugs, can increase your risk of bleeding. Some medications, like aspirin or ibuprofen, may also thin your blood. Therefore, your physician will tell you which medications to continue or discontinue prior to surgery.

  • No smoking

Smoking can lengthen your recovery. Surgeons will tell you to avoid smoking before your surgery because it can put you at risk of postoperative problems such as heart attacks, pneumonia, blood clots, or even death. In addition, smoking can complicate the anesthesia.

Diverticulitis surgery recovery

You won’t get to eat immediately right after surgery. At first, you will receive intravenous fluids, then transition to clear liquids, thick liquids, and soft food. Once your bowels work again, you can eat solid food. 

It typically takes one to two weeks before you can resume your day-to-day activities. You will need to rest. Walking in the post-operative period is highly encouraged to decrease the risks of complications. 

Learning about diverticulitis surgery can help you adapt to it. If you want to know more about this procedure or the condition, get in touch with us at Better Health today. Just call 415-475-8444 to consult one of our experts. 

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