Diverticular disease

Diverticular disease refers to the presence of small pouches or bubbles (diverticula) that develop in the wall of the colon, most commonly in the sigmoid colon. When these pouches become inflamed or infected, the condition is called diverticulitis.

Symptoms may include:

Lower abdominal pain (usually left-sided)
Fever
Bloating
Constipation or diarrhoea
Nausea
Rectal bleeding in some cases

Most cases are managed medically, but surgery may be required for:

Recurrent diverticulitis
Perforation
Abscess formation
Fistula formation
Bowel obstruction
Severe bleeding or chronic symptoms

Each complication of diverticulitis is managed in it's own manner:

Diverticulitis - intravenous antibiotics
Perforation - depending on size may be treated with intravenous antibiotics or may need surgery
Abscess formation - depending on size may be treated with intravenous antibiotics or may need surgery
Fistula formation - surgery
Bowel obstruction - surgery
Severe bleeding or chronic symptoms - depending on nature treatment ranges from conservative with intravenous medication or may need surgery

What to expect

Before Your Surgery

Authorization will be arranged by the rooms or hospital staff.
Fasting:
No solid food for 6 hours before surgery
No clear liquids for 2 hours before surgery
Most chronic medications may be taken, except diabetic medication (to be discussed with your doctor).
Inform your doctor if you are taking blood-thinning medication.
Bowel preparation may be required before surgery depending on the procedure planned.

Day of Surgery

You will be admitted to hospital and prepared for theatre. The surgery is performed under general anaesthesia. After the operation you will recover in the recovery unit before returning to the ward. You may have:

A urinary catheter
Intravenous drips
Surgical drains
A nasogastric tube in some cases

Procedure

Surgery for diverticular disease usually involves removal of the diseased section of bowel, most commonly the sigmoid colon. This procedure is called a sigmoid colectomy or bowel resection.

The surgery may be performed:

Laparoscopically (keyhole surgery) using several small incisions, or
Open surgery through a larger abdominal incision, depending on the severity and complexity.

The healthy ends of the bowel are usually reconnected (anastomosis). In complicated cases, a temporary or permanent colostomy or ileostomy may be necessary.

Drains may be placed during surgery if infection or contamination is present.

Procedure Length

The operation typically takes 2–4 hours, depending on the extent of disease, previous surgeries, and whether a stoma is required

Possible Complications

Bleeding
Infection
Anastomotic leak (leak at the bowel join)
Injury to surrounding organs such as bladder, ureter, or bowel
Bowel obstruction or ileus
Stoma complications (if applicable)
Hernia formation
Recurrence of symptoms
Unintended damage to surrounding structures
Please contact the rooms urgently if you develop: Fever, Increasing abdominal pain, Vomiting, Wound redness or discharge, Abdominal swelling, Inability to pass stool or gas

Duration of Hospital Stay

Hospital stay is usually between 4–7 days, depending on:
The severity of disease
The type of surgery performed
Return of bowel function
Presence of complications
Complicated cases may require longer admission.

Discharge Instructions

Keep wounds clean and dry
Take prescribed pain medication and antibiotics as directed
Eat small, light meals initially and gradually progress to a normal diet
Avoid constipation and straining
Drink plenty of fluids
Walk regularly to reduce the risk of clots and improve bowel recovery
Monitor for fever, worsening pain, vomiting, or wound complications
If a stoma was created, stoma care instructions will be provided before discharge.

Return to Activities

Light walking is encouraged from early after surgery
Avoid heavy lifting or strenuous activity for at least 4–6 weeks
Avoid abdominal strain while healing
Resume driving only once comfortable and no longer requiring strong pain medication

Diverticular disease

What to expect

Before Your Surgery

Day of Surgery

Procedure

Procedure Length

Possible Complications

Duration of Hospital Stay

Discharge Instructions

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