Diverticular Disease

Diverticula are small pouches that bulge outwards through weak points in the muscle wall of the colon, most often on the left side (the sigmoid colon). They become more common with age and are found in many people who have no symptoms.

Diverticulitis occurs when one or more pouches become inflamed or infected, causing pain in the lower left abdomen, fever and a change in bowel habit. Diverticula can also occasionally bleed, causing bright red blood from the bowel.

Most episodes of diverticulitis are mild and settle with rest, a modified diet and sometimes antibiotics. A CT scan is usually performed to confirm the diagnosis and to check for complications such as an abscess, a perforation or a fistula between the bowel and the bladder or other organs. After an episode has settled, a colonoscopy is often recommended to check the rest of the bowel.

An abscess may be treated by drainage with a needle under X-ray guidance. Perforation with widespread infection is an emergency that requires urgent surgery.

Planned surgery is considered for patients who have repeated attacks that affect their quality of life, ongoing symptoms after an attack, a stricture causing blockage, a fistula, or where there is concern that the appearance could represent cancer. The decision is individual, and your surgeon will discuss the benefits and risks with you.

The operation, usually a sigmoid colectomy, removes the affected section of colon and joins the healthy ends together. It is normally performed using laparoscopic or robotic keyhole techniques. In planned surgery a stoma is rarely needed, although it may be required in emergency operations for severe infection.

Most patients are in hospital for a few days and return to normal activities within a few weeks. Once recovered, a high-fibre diet and good hydration are encouraged.