Our Summary

This research paper aims to provide an update on the latest evidence-based treatment strategies for a common gut condition called diverticular disease. The researchers reviewed a number of studies on the topic.

Diverticular disease includes a range of conditions that can cause different symptoms. The way doctors treat these diseases has evolved over time and this paper highlights some changes. For example, recent data has made researchers question the need for antibiotic treatment for a mild form of the disease, called Hinchey I, and for a procedure to drain an abscess for a more severe form, called Hinchey II.

The paper also points out that clinical trials have shown laparoscopic lavage (a type of minimally invasive surgery where the area is washed out) can be a suitable option for some patients with a more severe form of the disease, called Hinchey III. They also suggest that another surgical procedure, which involves removing part of the colon and creating a stoma (an opening in the stomach for waste to pass through), may be a potential treatment option for the most severe form of the disease, Hinchey IV.

In conclusion, the paper suggests that treatment strategies for diverticular disease are becoming more tailored to the individual patient and the specifics of their disease.

FAQs

  1. What is the modern evidence-based treatment for acute diverticulitis?
  2. How has the treatment strategy for Hinchey I and II diverticulitis evolved over time?
  3. What are the operative decision-making strategies for acute diverticulitis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative instructions carefully, including taking prescribed medications, avoiding heavy lifting, and eating a high-fiber diet to prevent constipation and promote healing. It is also important to attend follow-up appointments to monitor recovery and address any concerns.

Suitable For

Patients who are typically recommended sigmoidectomy for diverticular disease include those with recurrent episodes of diverticulitis that do not respond to conservative treatments, those with complicated diverticulitis such as abscess formation or perforation, and those with chronic symptoms such as bowel obstruction or fistula formation. Additionally, patients who have recurrent bleeding from diverticula or who have a high risk of developing complications may also be candidates for sigmoidectomy. Ultimately, the decision to recommend sigmoidectomy is based on a combination of patient factors and the severity of the disease.

Timeline

Before sigmoidectomy:

  1. Patient presents with symptoms of diverticulitis, such as abdominal pain, fever, and changes in bowel habits.
  2. Diagnosis is confirmed through imaging studies, such as CT scans, and possibly colonoscopy.
  3. Patient may be treated with antibiotics and dietary modifications to manage acute symptoms.
  4. In cases of severe diverticulitis or complications such as abscess formation or perforation, surgical intervention may be recommended.

After sigmoidectomy:

  1. Patient undergoes sigmoidectomy surgery to remove the affected portion of the colon.
  2. Recovery time in the hospital varies depending on the individual patient and the extent of the surgery.
  3. Patient may experience temporary changes in bowel habits and dietary restrictions post-surgery.
  4. Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns.
  5. Long-term management may include dietary modifications and monitoring for any signs of recurrent diverticulitis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sigmoidectomy surgery?
  2. How long is the recovery time after sigmoidectomy surgery?
  3. Will I need a temporary colostomy after sigmoidectomy surgery?
  4. What dietary and lifestyle changes should I make after sigmoidectomy surgery to prevent future episodes of diverticulitis?
  5. How often will I need follow-up appointments after sigmoidectomy surgery?
  6. Are there any alternative treatment options to sigmoidectomy for my condition?
  7. What is the success rate of sigmoidectomy surgery for treating diverticular disease?
  8. Will I need to take antibiotics after sigmoidectomy surgery to prevent infection?
  9. How can I best prepare for sigmoidectomy surgery, both physically and mentally?
  10. Are there any long-term effects or complications I should be aware of after sigmoidectomy surgery?

Reference

Authors: Zaborowski AM, Winter DC. Journal: Int J Colorectal Dis. 2021 Mar;36(3):467-475. doi: 10.1007/s00384-020-03788-4. Epub 2020 Nov 6. PMID: 33156365