Our Summary

This research study aimed to explore whether surgical or medical treatment for uncomplicated diverticulitis (a digestive disease that affects the large intestine) lowers the risk of the disease recurring or requiring a colostomy (a procedure where an opening is made in the abdomen to allow waste to exit the body).

The study looked at the medical records of over 12,000 adults who had at least two episodes of diverticulitis and who had been treated either medically or surgically. The results showed that one year after treatment, patients who had undergone surgery had lower recurrence rates (6%) compared to those treated medically (32%). However, the rates of requiring a colostomy were low for both groups.

The study concludes that while surgery for diverticulitis can decrease the risk of the disease recurring, it does not lower the risk of requiring a colostomy. Therefore, the goal of avoiding a colostomy should not be a deciding factor for choosing surgery.

FAQs

  1. Does surgical treatment for diverticulitis decrease the risk of the disease recurring compared to medical treatment?
  2. Does the surgical treatment for diverticulitis lower the risk of requiring a colostomy?
  3. Should the goal of avoiding a colostomy be a deciding factor for choosing surgical intervention for diverticulitis?

Doctor’s Tip

A helpful tip a doctor might give to a patient considering diverticulitis surgery is to carefully weigh the risks and benefits of the procedure, as well as discuss alternative treatment options with their healthcare provider. It is important for patients to understand that while surgery may reduce the risk of the disease recurring, it may not necessarily prevent the need for a colostomy. Patients should also be informed about the potential complications and recovery process associated with surgery, and should discuss any concerns or questions they have with their healthcare provider before making a decision.

Suitable For

Patients who are typically recommended diverticulitis surgery are those who have had multiple episodes of the disease and have not responded well to medical treatment, or those who have complications such as abscesses, fistulas, or bowel obstructions. Additionally, surgery may be recommended for patients who have severe symptoms that significantly impact their quality of life, or for those who are at a high risk of developing complications such as perforation or sepsis. Ultimately, the decision to undergo surgery for diverticulitis should be made on a case-by-case basis, taking into consideration the individual patient’s overall health, preferences, and treatment goals.

Timeline

Timeline before and after diverticulitis surgery:

Before surgery:

  • Patient experiences symptoms of diverticulitis such as abdominal pain, bloating, constipation, diarrhea, and fever.
  • Patient undergoes diagnostic tests such as a CT scan or colonoscopy to confirm the diagnosis.
  • Patient may be treated with antibiotics and a clear liquid diet to manage symptoms.
  • If symptoms do not improve or if the patient has recurrent episodes of diverticulitis, surgery may be recommended.

After surgery:

  • Patient undergoes surgery to remove the affected part of the colon (partial colectomy) or to create a colostomy.
  • Patient may need to stay in the hospital for a few days to recover from surgery.
  • Patient will need to follow a special diet and avoid certain foods to prevent complications.
  • Patient may need to take pain medication and antibiotics to manage pain and prevent infection.
  • Patient will need to follow up with their healthcare provider for post-operative care and monitoring.
  • Patient may experience changes in bowel habits and may need to adjust to life with a colostomy if one was created during surgery.
  • Patient may need to make lifestyle changes such as increasing fiber intake, staying hydrated, and exercising regularly to prevent future episodes of diverticulitis.

What to Ask Your Doctor

Some questions a patient should ask their doctor about diverticulitis surgery include:

  1. What are the risks and benefits of surgery for diverticulitis compared to medical treatment?
  2. How likely is it that my diverticulitis will recur if I choose surgery versus medical treatment?
  3. What is the recovery process like after diverticulitis surgery?
  4. Are there any long-term effects or complications associated with diverticulitis surgery?
  5. How will my quality of life be affected by having surgery for diverticulitis?
  6. What are the alternatives to surgery for treating diverticulitis?
  7. How will my diet and lifestyle need to change after surgery for diverticulitis?
  8. How often will I need to follow up with my doctor after having surgery for diverticulitis?
  9. Are there any specific factors about my health or medical history that may impact the success of surgery for diverticulitis?
  10. Can you provide me with information or resources to help me make an informed decision about whether to have surgery for diverticulitis?

Reference

Authors: Thornblade LW, Simianu VV, Davidson GH, Flum DR. Journal: Ann Surg. 2021 Jun 1;273(6):1157-1164. doi: 10.1097/SLA.0000000000003639. PMID: 31651534