Diverticulosis occurs, when small, bulging pouches, called diverticula, are formed along the lining of intestinal walls. If diverticula are infected or inflamed, then it gives rise to painful symptoms, the condition is referred to as diverticulitis. This disease is mainly associated with aging. As the age progresses, the intestinal wall becomes weak. When the hard stool passes through the colon, the pressure inside the colon gets increased, leading to the formation of diverticula. Also, low-fiber diet is considered to play a contributory role in developing diverticulitis. Fiber helps to make the stool soft and bulky, so that it can easily pass through the colon and thus, prevents constipation. Other risk factors include smoking, being overweight and lack of exercise. Diverticulitis can cause the symptoms like tenderness and pain in the lower left side of abdomen, nausea, vomiting, loss of appetite, changes in bowel movements like diarrhea or constipation and high fever.
Treatment for Diverticulitis
Mild cases of diverticulitis can be treated with simple home remedies and over-the-counter pain-killers. Simple home remedies can also be effective in relieving the symptoms. If the symptoms of diverticulitis are seen, then oral antibiotics like ciprofloxacin, cephalexin and metronidazole are administered. If the symptoms are severe, then hospitalization is required to give intravenous antibiotics. If the sufferer is not responding to the antibiotics and if complications like formation of fistula, abscesses, peritonitis or perforation are developed, then surgery may be recommended.
Diverticulitis surgery is recommended for the patients with recurrent attacks of diverticulitis or development of serious complications like fistula. The surgical treatment for diverticulitis involves the removal of diseased part of the colon (partial colectomy), in most cases left or sigmoid colon and then reconnecting the remaining parts. Depending upon the nature and severity of the symptoms, multiple surgeries may be needed to relieve the problem. When multiple surgeries have to be done, the patient has a colostomy in between the surgeries. In the surgical procedure called, colostomy, the upper part of the intestine is connected to the opening made in the abdominal skin. The stool passes out of the body from this opening into the disposable bag.
Colectomy: In colectomy, the affected portion of large intestine is removed. This surgical procedure can be performed in two ways. In an open colectomy, a large incision is made in the abdomen and a section of large intestine is removed. Another method is laparoscopic colectomy. It is a type of key-hole surgery, in which many small incisions are made in the abdomen and a section of large intestine is removed using a special instrument guided by the camera. Both these types of surgeries are equally effective in treating diverticulitis. The major advantage of laparoscopic surgery over open colectomy is a faster recovery time and less post-operative pain.
Stoma Surgery: In some cases, your large intestine needs to be healed before it is reattached. Sometimes, a large portion of colon may be removed, making it difficult to reattach it. In such cases, stoma surgery provides a way to remove fecal matter from your body without using all of the large intestine. In this surgical procedure, the surgeon makes a small hole or stoma in the abdomen. In an ileostomy, the stoma is made in the right-hand side of the abdomen. The small intestine is separated from the large intestine and connected to the stoma. The rest of the large intestine is then sealed. The patient needs to wear a pouch or sac connected to the stoma to collect the waste material. In colostomy, the stoma is made in the lower abdomen. An affected portion of large intestine is removed and connected to the stoma. In most cases, the stoma is temporary and it can be removed after the recovery of large intestine from the surgery. This may take a period of at least nine weeks. If a big portion of large intestine is affected by diverticulitis and removed surgically, then you may need a permanent ileostomy or colostomy.
Generally, surgery is successful in most cases, although it may not cause a complete cure in all cases. After the surgery, one in 12 people may show recurrence of symptoms of diverticulitis.