Can surgery for diverticulitis solve your abdominal pain?

If you’ve experienced an attack or frequent attacks of diverticular disease (diverticulitis) you’ll know how painful this relatively common condition can be.  

In mild diverticulitis, diet and medication (antibiotics) are usually considered enough to settle irritation and promote healing. However, if you are one of the quarter of people who continually experience more severe recurrent symptoms, colorectal surgeon Dr Terence Chua explains why surgery for recurrent diverticulitis might be a better option.

What is diverticulitis?

Diverticular disease is a condition that affects the colon (large intestine). It occurs when small pouches called diverticula form in weak spots of the colon wall. Diverticulitis is a condition where these bulging pouches become inflamed or infected, often because food or bacteria is stuck in the pouches, and symptoms start to appear.

A bout of diverticulitis can be very painful. Common symptoms include abdominal pain, often on the lower left side, as well as fever, nausea, vomiting and constipation. Initial tests arranged by your GP will indicate whether you may have diverticulitis.

A colonoscopy performed by colorectal surgeon Dr Terence Chua can also confirm the diagnosis and to exclude other rare causes of similar symptoms such as colon cancer.

The difference between complicated and uncomplicated diverticulitis

Diverticulitis is usually diagnosed as either uncomplicated (mild) or complicated (severe). 

When symptoms are mild, people are usually admitted to hospital for monitoring and treatment with IV antibiotics. In severe diverticulitis, symptoms progress quickly leading to complications. Without treatment, an attack can lead to a perforation or an abscess in the wall of the colon or cause an abnormal connection between the colon and another organ (fistula) to develop.  

Uncomplicated (mild) diverticulitis refers to the absence of complications. Symptoms are similar and include abdominal pain, constipation, nausea and vomiting. While less severe in nature, they can still be very disruptive and uncomfortable to live with. 

In uncomplicated diverticulitis, your GP will usually prescribe oral antibiotics and put you on a special diet designed to reduce irritation and promote healing. However, without treatment, uncomplicated diverticulitis over a long time can cause serious problems.

Should I have surgery for diverticulitis?

Many patients are told that diverticulitis surgery should only be done if your diverticulitis is severe or life-threatening. The advice regarding treatment follows the usual protocols: take prescribed antibiotics, painkillers (paracetamol), drink fluids and avoid solid food until your symptoms go away.

However, many people still experience ongoing symptoms despite taking these medications and are waiting long and longer before considering surgery as an option. This can lead to dangerous and painful consequences.

Repeated attacks of uncomplicated diverticulitis can lead to a build-up of scar tissue, narrowing the colon to cause narrowing and eventually bowel obstruction. At times, some people may have constant diverticular symptoms suggestive of chronic diverticulitis implying that the inflammation although less severe after the acute episode continues to linger and not completely resolve. When the colon has ruptured, this is called peritonitis and requires emergency surgery.

Dr Chua believes that in some patients having surgery for diverticulitis can prevent the condition from getting worse and help relieve some of the unnecessary ongoing discomfort in the gut.

What surgery is recommended for diverticulitis?

As a colorectal surgeon, Dr Terence Chua regularly performs surgery for diverticulitis.

The most common procedure is a called a bowel resection with primary anastomosis. In this procedure, Dr Terence Chua will remove any infected colon (colectomy) and connect the two healthy pieces from either side of the infected area (anastomosis). If there’s too much colon inflammation, Dr Terence Chua may perform a bowel resection and connect your bowel through an opening in your abdomen (colostomy). This procedure can be either temporary or permanent depending upon how well your colon recovers over the next few months.

If your bowels have been bothering you or you are having ongoing problems with constipation or diarrhoea, talk to your GP about a referral to see Brisbane colorectal surgeon Dr Terence Chua.

Dr Chua can complete a comprehensive review to understand your symptoms to work out whether surgery for diverticulitis is the right treatment for you.

Book an appointment with Gold Coast colorectal surgeon Dr Terence Chua.

Dr Terence Chua consults and operates across Brisbane and the Gold Coast. See consulting locations for Dr Terence Chua.