Diverticular Disease

Surgery is indicated if you have repeated attacks of diverticulitis, if you have a partial or complete blockage in your intestines, if there is evidence of a bowel perforation causing a widespread infection in the abdomen, or if a communication (fistula) develops between the affected bowel and any surrounding structures such as bladder, uterus, or skin.

• In Emergent Situations, when there has been perforation in the intestine, two operations are usually involved.

The first operation involves removing the infected bowel. Due to local inflammation and infection, the bowel is usually not healthy enough to reattach and the patient is left with a colostomy. A colostomy is a temporary situation in which the colon is brought up to the skin. The stool will pass through the colon, through this stoma, and into an attached bag. The colostomy is typically left in place for three to six months to allow the infection and inflammation to heal inside.

The second part of the operation is when the colostomy is reversed and reconnected to the remaining colon so that you can resume going to the bathroom normally.

• In an Elective Situation, the segment of the chronically affected bowel will be surgically removed, with the two remaining ends reattached during the same operation.

You will be admitted to the hospital for about two to four days but may require up to eight days, depending on how you are responding to the effects of surgery. During your stay, you’ll be monitored carefully to make sure you’re healing well and that your colon has started working again.

A nasogastric (NG) tube, which goes through your nose and into your stomach, may be used to keep your stomach empty for the first few days because the surgery can cause a postoperative ileus. This is a temporary paralysis of a portion of the intestines preventing food or drinks from moving forward, which is why it’s important to slowly begin your diet pre-surgery to help prevent complications. You’ll receive the fluids you need intravenously during that time. 

When you start to pass gas, that is a sign that your colon is working again, and you will be placed on a liquid diet. If you don’t experience nausea or increased abdominal pain with your liquid diet after a day or so, you will then progress to a soft diet. You should continue the soft diet for two to eight weeks after surgery, depending on your healing and what your doctor instructs. We will provide a list of foods to help you choose a soft diet when you have returned home.

You should be up and walking within a day or two after surgery. This will encourage your circulation and bowel function to return to normal and may prevent complications.

Do your breathing exercises to make sure you are inflating your lungs completely. It may be painful for your abdomen at first but it is important to do these exercises to clear any fluid that may be in your lungs from surgery, and prevent pneumonia.