Download Diverticular Disease

How is Diverticular disease treated?
What does the surgery involve?
The vast majority of patients that have
diverticulosis rarely need surgery. In
those that have mild problems then the
treatment is largely based on dietary
measures. This may include increasing
to a more high fibre diet, pain
medication and other medications that
will help relieve the symptoms. In those
that have a mild attack of inflammation
of the diverticulae (termed diverticulitis)
then antibiotics are often required.
In those that need to have surgery for
their diverticular disease then the
surgeon will remove the section of the
bowel causing problems. If suitable then
the two ends of the bowel are joined
back together. In some cases of more
complex disease then it may be
necessary to give the patient a
temporary stoma or bag. This decision
is based on the surgeon’s findings at the
operation. The surgery may be carried
out in a “key hole” (laparoscopic) or
open manner depending upon the
surgeon.
If a patient has more severe diverticulitis
then intravenous antibiotics and medical
treatment may necessitate that they are
admitted to the hospital. In the cases of
abscess formation, fistula formation,
perforation or significant bleeding then
hospitalisation is usually required. The
treatment of these more complex cases is
guided by the surgeon and may require
surgery at some stage. The surgery
involved usually means taking away the
section of the diseased bowel causing
the problem. This is a major colorectal
operation and is indicated for those with
complicated or recurrent diverticular
disease problems.
Diverticular
Disease
Department Of
Colorectal Surgery
THE ADELAIDE & MEATH
HOSPITAL, DUBLIN
INCORPORATING THE NATIONAL
CHILDRENS HOSPITAL
Statement of Values
Produced by:
Mr Paul Neary MD, FRCSI
Consultant Colorectal Surgeon
Department of Colorectal Surgery
Adelaide and Meath Hospital
Respect - Caring Openness - Partnership –
Teamwork, Fairness &
Equality
What is Diverticular disease?
How did I get Diverticular disease?
The development of small outpouchings
or a weakness of the bowel wall into
small sac shaped bulgings is termed
diverticulosis. Each one of these little
blind ended sacs from the bowel wall is
termed a diverticulum. When a person has
the presence of these outpouchings from
their bowel wall then they are said to
have diverticulosis. If one or more of
these outpouchings become inflammed or
infected then the person is said to have
diverticulitis. The term diverticular
disease is used to describe both
diverticulosis and diverticulitis.
Diverticular disease is considered to be
related to developing high pressure areas
in the bowel and this pressure causing
outpouchings of the wall itself. This is
similar to a bulge on the bicycle tire from
increased pressure. A lack of a high fibre
diet over the years is thought to contribute
to increased pressure in the bowel wall.
With a lack of high fibre to make the
bowel motion soft and bulky then high
pressures are generated to move the stool
on its way along the colon. This results in
these outpouches forming. By the age of
80 years well over half (50%) of the
population are thought to have some
evidence of diverticular disease due to
their diet over the years. It is known
however that diverticular disease may also
occur in much younger people and can
cause symptoms in those aged between
twenty and thirty years.
What are the symptoms?
Is it a cancer?
The answer is “NO” it is not a type of
cancer. There is no connection between
diverticular disease and colorectal cancer.
The symptoms of a bowel cancer and
diverticular disease however are often
similar and investigation of the bowel to
make sure that there is no cancer present
is advisable
Patients with diverticular disease may
have crampy pain usually on the left side,
bloating, diarrhoea and a change in their
bowel pattern. Occasionally there may be
bleeding and this can be significant in a
small number of patients. In those that
develop symptoms of infection then fever,
chills, pain and a change in their bowel
pattern may occur. This may be either
diarrhoea or constipation. The level of
symptoms varies from patient to
patient and depends upon the severity
of the disease involved. In some
patients further problems may occur
which include perforation (leakage of
the bowel), fistula formation (holes
from the bowel to other organs such as
the bladder) and abscess formation.
These latter complications can be
significant for the patient and require
major surgery to correct.
.
How are patients
Diverticular disease?
assessed
for
As the symptoms of colon cancer and
diverticular disease may be similar
then it is important to assess the colon
to make sure there is nothing
cancerous present. Usually patients
undergo a colonoscopy to examine
their bowel. This is a camera test that
requires a short stay in the hospital. A
CT scan (specialised x-ray) may also
be used to examine for evidence of
diverticular disease. In those that have
more complex disease then other
imaging investigations may be used
but this is decided on a patient by
patient basis by the doctor.