Diverticular diseaseof the colon(diverticula) is a typical lifestyle-related disease that affects up to one-third of the population in older age groups, and as many as 50% of those over 70. There are often multiple diverticula in the colon. The disease is usually asymptomatic. However, in about one-third of those with diverticula in the colon (in our country typically on the left side of the colon, in the sigmoid colon), inflammation of one of the diverticula develops, leading to acute abdominal pain in the left lower abdomen, which we classify as a so-called acute abdominal emergency. At that point, inflammatory markers in the blood (white blood cell count, CRP) rise, and typical findings are visible on ultrasound and sometimes on X-ray. Sometimes a CT scan of the abdomen is also necessary, especially if a complicated course of the inflammation is suspected.
Inflammation can usually be managed with conservative treatment without surgery (infusion therapy, antibiotics); however, in about 5–10% of affected individuals, the inflammation is severe and requires either emergency surgery or elective surgery once the inflammation has subsided.
In 15% of patients, diverticular inflammation recurs over time. In fact, according to a California study of approximately 210,000 patients, the probability of recurrence within one year after the first episode is about 9%, but the probability of another episode after the fourth episode is already 65% within one year, meaning that with each subsequent episode, the probability of another episode within the next 12 months increases exponentially.
If the inflammation recurs frequently—even if the episodes are mild—and causes the patient discomfort or impairs their quality of life, we recommend elective surgery in such cases as well.
Between flare-ups, patients are usually either asymptomatic or experience vague pain in the lower left abdomen, bloating, abdominal discomfort and cramps, constipation, and sometimes urgent diarrhea and perineal pain.
The treatment of diverticular disease of the colon involves dietary and lifestyle measures, antibiotics, intravenous fluids, probiotics, and intestinal chemotherapeutics. Patients must undergo a colonoscopy. Conservative therapy is the domain of gastroenterologists; if conservative therapy fails and symptoms persist, consultation with a surgeon specializing in this condition is warranted.
The planned procedure can be performed laparoscopically; these surgeries yield good functional and cosmetic results and are associated with a low incidence of complications.
In contrast, emergency surgeries are often performed via an incision and frequently result in the creation of a stoma (an opening) in the intestine.
Appointments
Ostomy Clinic
We provide specialized services through our ostomy clinic for patients with colorectal cancer and patients with diverticular disease who have undergone surgery to create a stoma (intestinal opening). Here, you can discuss with a doctor the possibility of stoma reversal, stoma modification in cases of poor function, or treatment for parastomal hernias. You can visit the clinic without an appointment during the listed office hours. It is open to patients who have undergone surgery not only at our hospital but also at other healthcare facilities.
Outpatient Department
