Bowel Resection with Colostomy – In more severe cases of diverticulitis, so much inflammation may be present that reconnection is not possible. In these instances, the surgeon will connect the colon to an opening in the abdomen (stoma), where waste can pass into a colostomy bag.
Depending on recovery, the colostomy can be either permanent or temporary.
In most cases of surgery for diverticulitis, a colostomy is not required.
Diverticulitis surgery can be risky. The American Society of Colon and Rectal Surgeons (ASCRS) recommend it only in the following circumstances: When the colon has ruptured, causing the abdomen to leak or develop serious inflammation. This is called peritonitis and requires emergency surgery.
Although most patients hospitalized for diverticulitis do not require immediate surgical resection,2 they remain at a lifetime risk for both recurrent episodes of diverticulitis and emergency colectomy and/or colostomy.
The surgery involves removing the sigmoid colon as well as a small area of the rectum. Because diverticula can also occur in other parts of the intestine, it's usually not possible to remove all of them. After the affected section of intestine has been removed, the ends are sewn back together again.
How is uncomplicated diverticulitis treated? In about 95 out of 100 people, uncomplicated diverticulitis goes away on its own within a week. In about 5 out of 100 people, the symptoms stay and treatment is needed. Surgery is only rarely necessary.
The operation is performed under a general anaesthetic and usually takes 2 to 3 hours. Your surgeon will remove part of your colon. Your surgeon will usually join the ends of your bowel back together inside your abdomen.
You can return to work 1 to 2 weeks after laparoscopic surgery, and 3 to 4 week after an open surgical repair, depending on the type of work and if light duty is acceptable.
You'll spend about two to seven days in the hospital after this surgery while your doctors monitor you and make sure you can pass waste again. Once you go home, do the following to help yourself recover: Don't exercise, lift anything heavy, or have sex for at least two weeks after you leave the hospital.
After the Surgery
It's normal to experience some pain, nausea, and drowsiness as the anesthesia wears off. Your nurse can give you medication to help control your symptoms. Once you are fully awake and your pain is under control, usually within a few hours, you will be wheeled on your bed to a hospital room.
In very rare cases of diverticulitis, the intestine can become blocked. However, bowel obstruction does not necessarily mean a total blockage; the intestinal tube narrows so that large lumps of faeces cannot pass, but liquid faeces can dribble through.
“Generally speaking, inflammation from diverticulitis can cause scar tissue formation and breakdown of the colon wall, and if the colon wall develops a hole, then an abscess will form,” warns Will Bulsiewicz, MD, a gastroenterologist and gut health expert in Mount Pleasant, South Carolina.
Irrigation is an alternative to wearing a colostomy appliance. It involves washing out your colon with water either every day or every other day. To do this, you gently insert a small device into your stoma and attach it to a bag full of water. You slowly move water into your colon so it washes it out.
Recurrent diverticulitis occurs in about 10% after resection. The pathogenesis for recurrence is not completely understood. We studied the incidence and risk factors for recurrence and the overall morbidity and mortality of surgical therapy for diverticular disease.
If the stoma bag fits well there should be no smell except when changing it. If you do notice a smell from your bag, you should check it as there may be a leak under the flange and the bag will need changing.
Your NYU Langone gastroenterologist may recommend surgery if symptoms of diverticulitis haven't improved after nonsurgical treatment; if a perforation or fistula, a connection that forms between the intestines and another organ, develops in the colon wall; or if a diverticular pouch ruptures.
Early surgery is defined as fewer than 3 diverticulitis episodes before resection based on specific claim types.
Contrast test.
In the case of intestinal surgery, your surgeon can check for leaks using a CT scan with contrast dye. The contrast is injected into your rectum near the anastomosis to see if it leaks out of the connection.
The vast majority of patients would live their whole lives without having any sort of complication. The reason to be concerned is that there is a risk for complications, and there are ways that we reduce those complications: Increase your dietary fiber.
Diverticular disease is caused by small bulges in the large intestine (diverticula) developing and becoming inflamed. If any of the diverticula become infected, this leads to symptoms of diverticulitis. The exact reason why diverticula develop is not known, but they are associated with not eating enough fibre.
Most people with diverticulitis recover completely. But, at its most severe, a pouch can burst open, spilling fecal matter directly into a person's bloodstream. This results in an immediate risk of developing a blood infection called sepsis, which can be life-threatening.
About 25% of people with acute diverticulitis develop complications, which may include: An abscess, which occurs when pus collects in the pouch. A blockage in your bowel caused by scarring. An abnormal passageway (fistula) between sections of bowel or the bowel and other organs.
Diverticulitis most commonly affects the sigmoid colon, which is the last part of the large intestine just before the rectum. Doctors think there may be a connection between diverticulitis and the amount of red meat people eat per week, whether they smoke, and whether they have obesity.