Diverticulitis: When Is Surgery the Right Choice?

Diverticulitis can range from a mild flare that settles with rest to a serious infection that needs a hospital stay. If you've had more than one episode, you may be wondering whether surgery could end the cycle. Here's what to know.

Diverticulosis vs. diverticulitis

Diverticulosis means small pouches (diverticula) have formed in the wall of the colon. It's very common with age and often causes no symptoms. Diverticulitis is when one or more of those pouches becomes inflamed or infected.

Common symptoms of diverticulitis

• Pain, often in the lower left side of the abdomen
• Fever or chills
• Nausea or loss of appetite
• Constipation or diarrhea
• Tenderness that gets worse over a day or two

How is it treated?

Mild, uncomplicated diverticulitis is often treated at home with a liquid or low-fiber diet for a short time, rest and sometimes antibiotics. More severe cases may need hospital care, IV antibiotics or drainage of an abscess.

When is surgery recommended?

Surgery isn't automatic after a certain number of flares. Today, the decision is personal and based on how diverticulitis affects your health and quality of life. Your surgeon may recommend surgery if you have:

• A perforation (hole) in the colon or a widespread infection, which needs urgent surgery
• An abscess that doesn't improve with other treatment
• A fistula, an abnormal connection between the colon and another organ such as the bladder
• A narrowing (stricture) of the colon from scarring
• Frequent or ongoing flares that interfere with work, travel or daily life
• A weakened immune system that makes future infections riskier

What does surgery involve?

The most common operation removes the diseased section of the colon, usually the sigmoid colon, and reconnects the healthy ends. When planned ahead of time rather than done in an emergency, this surgery can often be done robotically or laparoscopically through small incisions. Most elective patients don't need a colostomy.

This article is for educational purposes and is not a substitute for medical advice. If you have symptoms, please see your healthcare provider.