Diverticulitis occurs when weakened areas of the colon become infected, usually when stool becomes trapped. Diverticulitis can be divided into simple and acute types, depending on the severity of the episode. Each type has distinctive symptoms and treatment options.
Most cases, approximately 75 percent, are classified as simple diverticulitis. The symptoms of simple diverticulitis include abdominal pain, tenderness in the lower abdomen, and sometimes mild nausea. Simple diverticulitis usually settles within a week. It is treated with oral medications and a modified diet that includes reducing the amount of solids and fiber you eat.
Acute diverticulitis is a more complicated form of the condition and is diagnosed when there are abscesses, a fistula, peritonitis, and/or sepsis. Abscesses are pus-filled, infected areas that occur around areas of inflammation. A fistula is a connection between two organs that should not occur. For example, in diverticulitis, a fistula may form between the colon and bladder. Peritonitis is an inflammation of the area surrounding the intestines. Severe infection may cause sepsis, which means an infection has reached the blood stream and other organs.
Acute diverticulitis requires admission to the hospital for treatment. If you are admitted to the hospital, you cannot eat or drink and will be given intravenous antibiotics until your condition improves.
Surgery for Acute Diverticulitis
In approximately 15 percent of acute diverticulitis cases, surgery is required. The type of surgery you need will depend on the underlying problem. For example, if you have an abscess, the first-line treatment is to use a drainage tube to remove the infection. If this is not successful, surgery is the next treatment. Surgery is also needed if you experience a persistent fistula. Peritonitis requires emergency surgery.
Most patients that have surgery will have a temporary colostomy. During the procedure, part of the colon is brought up through the skin of the abdomen. A bag is attached to the colostomy to collect waste. Once the infection has cleared, the colon is reattached to the large intestine. The reattachment usually occurs after four to six months of having a colostomy.
In elective situations where the patient is eating and the infection has cleared, the surgeon may remove the infected portion of the intestines and connect the two healthy ends together. This is usually performed in a single operation.
To determine the best course of action for your diverticulitis case, contact Richmond Gastroenterology Associates and make an appointment.