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Diverticulitis / Diverticular disease

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is diverticulitis?

DiverticulitisA diverticulum is a small pouch that sticks outward from the large bowel, or occasionally small bowel. They are formed when the inner lining of the bowel pushes through the outer lining. Up to one half of the population of Western Europe and North America will get diverticulae in the colon at some point, and the incidence increases with age. When diverticulae are present, the term is said to be 'diverticular disease'. If they become inflamed and cause symptoms then it is termed 'diverticulitis'.

The increased risk of diverticulae in the West is generally attributed to poor dietary intake; those with a higher intake of fibre have a lower risk of diverticulae.

 

 

What are the symptoms of diverticular disease?

Many people have no symptoms whatsoever. Those that do have symptoms can vary in severity; pain can be experienced in the tummy, usually in the lower left area. Constipation is common, although this can alternate with bouts of diarrhoea, and occasionally bleeding from the back passage.

 

What complications can happen from Diverticular disease?

Whilst many people never get any complications, inflamed diverticulae can cause problems. Diverticulitis can lead to abdominal pain, vomiting and fever. About half will settle and have no further problems, but some will need surgery.

If the inflammation from Diverticular disease is very severe then the diverticulum can burst. This usually requires surgery and can be life-threatening.

Long-standing inflammation can lead to scarring of the bowel and narrowing; this can cause bowel obstruction, requiring surgery.

Occasionally bleeding from the back passage can occur in Diverticular disease; this may stop in time or may be severe enough to require surgery.

 

What tests can be done for suspected Diverticular disease?

Your doctor may arrange a number of tests, including blood tests, special x-rays, scans and telescope tests such as colonoscopy.

 

What treatment options are there for Diverticular disease?

Many people have no problems at all, and no specific treatment is needed. Often, a high-fibre diet is all that is needed. If you do get problems, then tablets may help to calm things down. The need for surgery is rare, and is aimed at removing the part of bowel that is causing the problems.

 

What are the risks of surgery for Diverticular disease?

  • Hernia - if the deep tummy muscles do not heal well after the surgery, the underlying bowel could push through the muscle, being seen or felt as a lump. Hernias may need an operation to treat them.

  • Infection - this may require antibiotics, or rarely further surgery.

  • Injury to other structures - injury to bowel, nerves or blood vessels is rare in Diverticular surgery but can occur, which may need further surgery.

  • Bowel leakage - after the bowel ends are joined together there is a small risk that a leak may occur, allowing bowel contents to escape into the abdomen. This often needs further surgery.

  • Adhesions - surgery in the abdomen will lead to scar tissue forming. This can stick to nearby bowel, which may cause problems such as obstruction. This can require further surgery.

  • Difficulty passing urine - if this happens you may need a tube (catheter) for a day or two to help you pass water.

  • Recurrence - once the problem area has been removed, you may have no further recurrences. Occasionally, though, diverticulae in other areas of the bowel can flare up at a later date.

  • Blood clots in the legs - clots in the calf (deep vein thrombosis / DVT) can usually be treated with medication, but a DVT can (rarely) move to the lungs. This can cause breathing difficulty, or even be life threatening.

 

 

Other SurgeryWise articles

You may also be interested to read our articles on Bowel Cancer, Crohn's disease or Ulcerative Colitis

 

Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer

 

 

 
 
 
 
 

 

 

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