Our Summary

This research paper discusses how acute left colonic diverticulitis (ALCD) - a condition affecting the large intestine - behaves differently in older people compared to younger ones. Older patients with this condition tend to have a higher risk of complications and death during and after hospitalization. However, they are less likely to experience repeated episodes of the disease and if it recurs, they are less likely to need emergency surgery. The paper aims to understand how age-related factors can guide the diagnosis and treatment of ALCD in older people. The findings presented in the paper are based on discussions and consensus reached by a panel of experts at a workshop held in Pisa, Italy in 2019. The paper provides definitive guidelines on diagnosing, managing, choosing surgical techniques, and antibiotic therapy for ALCD in the elderly.

FAQs

  1. Does acute left colonic diverticulitis behave differently in older people compared to younger ones?
  2. What are the guidelines for diagnosing and treating ALCD in elderly patients as presented in the research paper?
  3. What factors related to age can influence the diagnosis and treatment of ALCD in older people as per the findings of the paper?

Doctor’s Tip

One helpful tip a doctor might tell a patient about diverticulitis surgery is to follow post-operative instructions carefully to ensure proper healing and reduce the risk of complications. This may include taking prescribed medications, following a specific diet, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. It is important to communicate any concerns or changes in symptoms to your doctor promptly to ensure a successful recovery.

Suitable For

Patients who are typically recommended diverticulitis surgery include those who have:

  • Recurrent episodes of diverticulitis that do not respond to conservative treatment
  • Complications such as abscesses, perforations, or fistulas
  • Severe symptoms such as persistent pain, fever, and signs of sepsis
  • Chronic diverticulitis that causes frequent flare-ups and affects quality of life
  • Patients with a history of diverticular bleeding that requires surgical intervention
  • Patients with complications of diverticulitis such as strictures or bowel obstructions

It is important for patients to discuss their individual case with their healthcare provider to determine if surgery is the best course of action for their condition.

Timeline

Before diverticulitis surgery:

  • Patient experiences symptoms such as abdominal pain, bloating, constipation, diarrhea, and fever
  • The patient may undergo diagnostic tests such as a CT scan, colonoscopy, or blood tests to confirm the diagnosis
  • Treatment may involve antibiotics, pain medication, and a liquid diet to help manage symptoms
  • In some cases, the patient may need to be hospitalized for intravenous antibiotics and fluids

After diverticulitis surgery:

  • The patient undergoes surgery to remove the infected part of the colon
  • Recovery time varies but may involve a hospital stay of several days to a week
  • The patient will need to follow a specific diet and take medications to prevent infection and promote healing
  • Regular follow-up appointments with the surgeon may be necessary to monitor recovery and address any complications
  • The patient may gradually return to normal activities and diet, with the possibility of some dietary restrictions in the long term to prevent future episodes of diverticulitis.

What to Ask Your Doctor

  1. What are the risks and benefits of surgery for diverticulitis in my specific case?
  2. How will my age impact the outcome of the surgery and my recovery process?
  3. What are the alternative treatment options available for diverticulitis and how do they compare to surgery?
  4. What specific surgical technique will be used in my case and what are the potential complications associated with it?
  5. How long is the recovery process expected to be and what can I do to aid in my recovery?
  6. Will I need to make any lifestyle changes after the surgery to prevent future episodes of diverticulitis?
  7. How often will I need to follow up with you after the surgery?
  8. Are there any long-term effects or risks associated with diverticulitis surgery that I should be aware of?
  9. What is the success rate of diverticulitis surgery in older patients like myself?
  10. Are there any specific factors related to my age that you will take into consideration when planning and performing the surgery?

Reference

Authors: Fugazzola P, Ceresoli M, Coccolini F, Gabrielli F, Puzziello A, Monzani F, Amato B, Sganga G, Sartelli M, Menichetti F, Puglisi GA, Tartaglia D, Carcoforo P, Avenia N, Kluger Y, Paolillo C, Zago M, Leppäniemi A, Tomasoni M, Cobianchi L, Dal Mas F, Improta M, Moore EE, Peitzman AB, Sugrue M, Agnoletti V, Fraga GP, Weber DG, Damaskos D, Abu-Zidan FM, Wani I, Kirkpatrick AW, Pikoulis M, Pararas N, Tan E, Broek RT, Maier RV, Davies RJ, Kashuk J, Shelat VG, Mefire AC, Augustin G, Magnone S, Poiasina E, De Simone B, Chiarugi M, Biffl W, Baiocchi GL, Catena F, Ansaloni L. Journal: World J Emerg Surg. 2022 Jan 21;17(1):5. doi: 10.1186/s13017-022-00408-0. PMID: 35063008