Siouxland GI Surgery
Diverticulosis is the formation of Diverticulum, or ‘pouches’ on the bowel. They grow as we age. Almost all Americans 80 years old will have formed them.
Diverticulosis does not form in areas of the world where high fiber diets are consumed. Age and constipation are the leading causes for development of diverticular disease. They develop over years of ‘increased pressure’ within our large intestine. This pressure weakens the wall of the bowel, gradually pushing out ‘diverticulum’, or pouches. These pouches are thin, containing only part of the lining of the bowel. This leaves them more prone to ‘break’ or bleed. These pockets typically occur in the last part of the colon before reaching the rectum (the sigmoid colon).
The overwhelming majority of us have no problems with diverticulosis. It is mild and causes no symptoms. There are however, 3 problems that can develop:
1. Perforation - The spillage of stool and bacteria into surrounding tissues creating infection. This is called Diverticulitis.
3. Chronic abdominal pain and irregularity - One ‘attack’ does not mean that you will have another.
SYMPTOMS OF DIVERTICULITIS
- Abdominal Pain: Commonly left lower quadrant
-. Physical Exam in your physician’s office
-. Blood testing may be done
-. C.T. scan may be ordered
- Colonoscopy 6-8 weeks after an episode of diverticulitis
Initial treatment depends on severity of disease:
- Home antibiotics and liquid diet
- Hospital antibiotics and bowel rest
- Emergency Surgery
Over the long term, recurrent diverticular disease is minimized by taking daily fiber supplements.
It is important to keep the bowel movement easy, don’t push, strain or struggle.
Seeds, nuts and popcorn are no longer thought to cause diverticulosis, or diverticulitis.
INDICATIONS FOR SURGERY
a. Emergency Surgery:
- Severe infection, unresponsive to antibiotics
- Heavy bleeding, that will not stop
b. Elective Surgery is considered when:
- Single ‘complicated’ attack
- Recurrent attacks, requiring hospitalizations
- Persistent, ‘festering’ documented disease
Surgery involves removal of the diseased colon segment. The aim is to anastomose (join) the bowel together in the initial surgery. In some cases where the bowel is too inflamed, and it is considered unsafe for putting the bowel together, we would create a temporary stoma, which will be reversed in 3-6 months time.
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