Our Summary

This research paper is examining the value of different treatments used after an episode of acute colonic diverticulitis, a condition where small pouches in the colon become inflamed or infected. The researchers reviewed studies conducted between 1990 and 2020 to understand the effectiveness and risks of different interventions.

They found that the risk of colorectal cancer (CRC) in patients with recent acute diverticulitis is unclear, but it is higher in patients with a more serious form of the condition known as complicated diverticulitis. The team also found that the use of colonoscopy, a test to check the colon, doesn’t seem to affect the long-term diagnosis of CRC, based on the available evidence.

The drug mesalamine, often used to reduce inflammation in the colon, was found to be ineffective in preventing recurrence of diverticulitis. The evidence on other non-surgical treatments was not sufficient to draw conclusions.

The research also showed that elective surgery can reduce the recurrence of diverticulitis in patients who have had a severe or frequent recurrence of the condition. However, it is not clear which patients would benefit most from this approach. Serious complications from surgery were rare.

The study’s limitations include a lack of randomized controlled trials (the gold standard in medical research) and insufficient assessment of the variability in treatment effects.

The study was primarily funded by the Agency for Healthcare Research and Quality and the American College of Physicians.

FAQs

  1. What treatments were found to be effective in preventing the recurrence of diverticulitis?
  2. Does the use of colonoscopy affect the long-term diagnosis of colorectal cancer in patients with acute diverticulitis?
  3. Who would potentially benefit the most from elective surgery to reduce the recurrence of diverticulitis?

Doctor’s Tip

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

Suitable For

Based on the findings of this research paper, patients who are typically recommended diverticulitis surgery include those who have experienced severe or frequent episodes of diverticulitis, especially those with complicated diverticulitis. Elective surgery may be recommended to reduce the risk of recurrence in these patients. Patients with a higher risk of colorectal cancer, particularly those with complicated diverticulitis, may also be considered for surgery. However, the decision to undergo surgery should be made on a case-by-case basis, taking into account the individual patient’s medical history, risk factors, and preferences.

Timeline

Before diverticulitis surgery:

  • Patient experiences symptoms such as abdominal pain, bloating, fever, and changes in bowel habits
  • Diagnosis is confirmed through imaging tests such as CT scans or colonoscopy
  • Patient may be treated with antibiotics and a liquid diet to manage symptoms
  • In some cases, patients may have recurrent episodes of diverticulitis, leading to a discussion of surgical options with their healthcare provider

After diverticulitis surgery:

  • Patient undergoes surgery to remove the affected portion of the colon, either through a traditional open surgery or minimally invasive laparoscopic surgery
  • Recovery period typically involves a hospital stay, pain management, and gradually reintroducing solid foods
  • Patient may need to make dietary and lifestyle changes to prevent future episodes of diverticulitis
  • Follow-up appointments with the surgeon and possibly a gastroenterologist to monitor recovery and any potential complications
  • Long-term management may involve regular colonoscopies to monitor for any recurrence of diverticulitis or other colon-related issues.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with diverticulitis surgery?
  2. How long is the recovery period after diverticulitis surgery?
  3. Will I need to make any lifestyle changes after the surgery?
  4. What are the chances of the diverticulitis returning after surgery?
  5. Are there any alternative treatments to surgery that I could consider?
  6. How will diverticulitis surgery affect my bowel movements and digestive system?
  7. Will I need to follow a special diet after the surgery?
  8. How experienced is the surgical team in performing diverticulitis surgery?
  9. What can I expect in terms of pain management after the surgery?
  10. How long do I need to stay in the hospital after diverticulitis surgery?

Reference

Authors: Balk EM, Adam GP, Cao W, Mehta S, Shah N. Journal: Ann Intern Med. 2022 Mar;175(3):388-398. doi: 10.7326/M21-1646. Epub 2022 Jan 18. PMID: 35038269