One minute, you feel fine. The next, you’re dealing with sharp pain in the lower left side of your abdomen, fever, nausea, or changes in your bowel habits.
A diverticulitis flare can be painful enough to send you searching for answers and wondering whether surgery is in your future.
Dr. Mikhail A. Botvinov can evaluate the severity of your condition and determine when conservative treatment is enough and when it may be time to consider surgery at Bergen Bariatric and Surgical Solutions.
Small pouches called diverticula can develop in weak areas of your colon wall. Having these pouches is called diverticulosis, and many people never know they have them.
Diverticulitis develops when one or more of these pouches become inflamed or infected. (The suffix -itis means “inflammation.”)
Symptoms of diverticulitis can include:
The severity can vary quite a bit from person to person. Some people have an uncomplicated episode that resolves with conservative care, while others develop an abscess, perforation, or another complication requiring more aggressive treatment.
If your diverticulitis is uncomplicated and you’re otherwise stable, surgery usually isn’t the first step. Your treatment may include temporarily changing your diet, managing pain, and closely monitoring your symptoms. You may also need antibiotics.
Once you recover, Dr. Botvinov may also recommend dietary and lifestyle changes to support your digestive health.
His first goal is to get you through the flare safely without performing an unnecessary operation.
There isn’t a magic number of diverticulitis attacks that automatically means you need surgery. Instead, the decision depends on the severity of your disease, whether complications have developed, how often symptoms return, and how much diverticulitis affects your life.
We may discuss surgery if:
Severe inflammation can cause a hole, or perforation, in the wall of your colon. This can allow intestinal contents to leak into your abdomen and cause peritonitis, a serious infection of the abdominal cavity. A perforation with widespread infection can require emergency surgery.
An abscess is a pocket of infected fluid that can form near an inflamed diverticulum. Small abscesses may sometimes respond to antibiotics, but larger ones may need to be drained using imaging guidance.
If an abscess can’t be successfully treated this way, or you continue to experience problems after recovering, Dr. Botvinov may recommend surgery.
Repeated inflammation can lead to scarring and narrowing of your colon. If the opening becomes too narrow, stool may have difficulty passing through, which may then result in a bowel obstruction.
A significant obstruction may require surgery to remove the narrowed section.
Inflammation from diverticulitis can sometimes create an abnormal connection, called a fistula, between your colon and another organ.
For example, a fistula may form between your colon and bladder. This can lead to recurrent urinary tract infections or other unusual urinary symptoms.
Surgery is often needed to repair the affected organs.
Surgery isn’t reserved only for emergencies. If you find yourself repeatedly missing work, changing your plans, visiting the emergency room, or worrying about when the next flare will happen, you might consider elective surgery.
In these cases, we may discuss elective surgery after you’ve recovered from the acute infection.
Surgery for diverticulitis typically involves removing the diseased portion of your colon, a procedure called a colon resection or colectomy. There are several ways to perform this surgery, and the right approach depends on where the disease is located, how severe it is, and whether you’re having planned or emergency surgery.
After removing the affected section, Dr. Botvinov can often reconnect the healthy ends of your colon. In more complicated cases, you may temporarily need an ostomy, which allows waste to leave your body through an opening in your abdomen while your colon heals.
When appropriate, Dr. Botvinov performs colon surgery using minimally invasive techniques. These procedures use several small incisions rather than one large incision and may mean less postoperative discomfort and a faster recovery.
Before surgery, Dr. Botvinov explains which approach he recommends, why it’s right for you, and what you can expect during recovery.
Call our Westwood, New Jersey, office at 201-731-6919 or request an appointment online to discuss your diverticulitis treatment options.
