In the final part of our review of Diverticular disease and diverticulitis we consider various treatment options

Diverticular disease and diverticulitis Part 3

Treatment

I discussed the importance of fibre last week. Mild diverticulitis can be treated by a GP who will prescribe antibiotics for the infection and paracetamol to ease pain. Sticking to a fluid-only diet for a few days may be recommended until symptoms improve. For severe diverticulitis, hospital treatment may be needed.

Surgery

In the past, surgery was recommended as a preventative measure, but this is no longer the case. However, there are exceptions to this, such as a history of serious complications arising from diverticulitis

Colectomy

Surgery for diverticulitis involves removing the affected section of the large intestine. This is known as a colectomy. There are two types of colectomy:

• an open colectomy: a large incision in the abdomen to remove a section of the large intestine
• laparoscopic colectomy: keyhole surgery where the surgeon makes small incisions in the abdomen and is guided by a camera to remove a section of large intestine

Open colectomies and laparoscopic colectomies are equally effective in treating diverticulitis. Laparoscopic colectomies have the advantage of a faster recovery time and less post-operative pain.

Stoma surgery

In some cases, the surgeon may decide that the large intestine needs to heal before it can be reattached, or that too much of the large intestine has been removed to make reattachment possible.  

In such cases, stoma surgery provides a way of removing waste materials from the body without using all the large intestine. Stoma surgery involves the surgeon making a small hole in the abdomen that is known as a stoma.

There are two types of stoma surgery:

• An ileostomy: stoma is made in the right-hand side of the abdomen. The small intestine is separated from the large intestine and connected to the stoma, and the rest of the large intestine is sealed. The person wears a pouch connected to the stoma to collect waste material.
• A colostomy: a stoma is made in the lower abdomen and a section of the large intestine is removed and connected to the stoma. As with an ileostomy, the person wears a pouch to collect waste material.

In most cases the stoma will be temporary and can be removed once the large intestine has recovered, usually within nine weeks. If a large section of the large intestine is affected by diverticulitis and needs to be removed, a permanent ileostomy or colostomy may be needed.

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