Why Choose Cedars-Sinai Marina del Rey Hospital for Diverticulitis Treatment?
At Cedars-Sinai Marina del Rey Hospital, our well-trained surgeons have vast knowledge of and experience in treating intestinal disorders, including diverticulitis. After a thorough evaluation, our doctors will provide a personalized treatment plan.
Diverticulitis is an acute inflammation of the diverticula, which are small, bulging pouches commonly found in the inner lining of the colon or large intestine. These sacs often occur in the sigmoid colon, the lowermost part of your large intestine. Diverticulitis may cause fecal matter to collect in the diverticulum, leading to obstruction and intestinal bacterial overgrowth. Diverticulitis may occur in patients of any age, but it is most common among people over 40 years old. It is especially common in people who take immunosuppressive drugs or corticosteroids. The most common symptom of diverticulitis is a sudden pain in the lower abdominal area, usually felt on the left side. This may be accompanied by fever, chills, nausea, constipation, or rectal bleeding. If diverticulitis is left untreated, complications such as abscesses, fistulas, peritonitis, perforations, and intestinal obstructions may develop. Treatment depends on the severity of the symptoms. Diverticulitis with mild symptoms is commonly treated with rest, dietary changes, and oral antibiotic medication. Severe cases are treated with intravenous antibiotics and surgical procedures. Consuming a fiber-rich diet and drinking plenty of fluids can help lower your chances of diverticulitis.
Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital for Diverticulitis
Surgical treatment may be needed if you have had recurring episodes of diverticulitis, if you do not respond well to medical therapy, or if you have developed severe complications such as perforation, fistula, abscesses, or bowel obstruction. In these cases, surgery is performed to remove the portion of your colon containing the infected diverticulum. The two main surgical techniques used to treat diverticulitis are:
- Primary Bowel Resection: This surgical procedure involves the removal of the affected segment of your intestine, followed by the reconnection of the unaffected, healthy intestine. This technique restores bowel movements to normal. Based on the severity of the inflammation, a surgeon may perform an open procedure or a minimally invasive one.
- Bowel Resection with Colostomy: This technique is generally considered when there is severe inflammation that hinders the reconnection of the colon and rectum. An incision is made in the wall of the abdomen (stoma), which is then attached to the healthy portion of your colon. Fecal waste moves through this opening and is collected in a colostomy bag. The colostomy is reversed and the intestine is reconnected once the inflammation subsides.
Drugs and Other Treatments Needed for Diverticulitis
Diverticulitis treatment varies depending on the severity of the symptoms exhibited. Generally, uncomplicated diverticulitis with mild symptoms is treated at home. A severe attack of diverticulitis with associated health problems requires hospitalization.
Bowel Rest »
Diverticulitis is classified in three types based on the symptoms and presence of complications: asymptomatic diverticulosis, uncomplicated diverticulitis, and complicated diverticulitis. The Hinchey classification categorizes diverticulitis into four clinical stages, which are helpful when choosing the appropriate surgical procedure, especially in complicated cases of diverticulitis. The classification is:
Hinchey I »
Hinchey II »
Hinchey IV »
Hinchey III »
Symptoms of Diverticulitis
The symptoms of diverticulitis often appear suddenly and worsen within a few days. Pain in the lower abdominal area, on the left side, is the most common symptom of diverticulitis. Other symptoms include:
Diagnosis of Diverticulitis
Initially, the diagnosis of diverticulitis is made on the basis of your symptoms, medical history, and a physical examination. During the physical examination, your doctor will check for tenderness in your abdomen. As the pain in the abdomen is associated with several disorders, it becomes necessary to preclude other causes of your condition. For women, a pelvic examination will be done to rule out pelvic diseases. Your doctor may also order certain diagnostic tests such as:
- Blood Tests: A higher white blood cell count (WBC) indicates the presence of an infection.
- Urine Tests: These tests are done to check for infection.
- Stool Tests: This test is done to check for the presence of blood in your stool, and to rule out infection in case you have diarrhea.
- Liver Function Tests: This helps rule out other reasons for abdominal pain.
- Imaging Tests: A computed tomography (CT) scan is helpful in confirming a diagnosis of diverticulitis, as well as grading the severity of the disease. X-rays and ultrasound examinations of the abdomen may also be advised.
Risk Factors for Diverticulitis
Various factors can increase your risk of developing diverticulitis, including:
- Advancing Age: Elderly people are more susceptible to diverticulitis, likely because bowels become weaker as a person gets older.
- Obesity: A higher body mass index (BMI) and bigger waist circumference increase the risk of developing diverticulitis.
- Intake of Large Amounts of Animal Fat and/or Less Fiber: Not consuming enough fibrous food can increase your risk of developing diverticulitis.
- Smoking: People who smoke cigarettes are at a higher risk of developing diverticulitis.
- Lack of Regular Physical Exercise: A sedentary lifestyle increases your chances of developing diverticulitis.
- Family History: A history of diverticulitis in your first-degree relatives puts you at an increased risk of developing diverticulitis.
- Use of Certain Medications: Long-term use of certain drugs, such as corticosteroids, opiate analgesics, and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, is associated with a higher risk of developing diverticulitis.
- Chronic Constipation: Chronic constipation causes constant muscle straining while passing hard stools that, in turn, increases your risk of getting diverticula in your colon, which may become inflamed if stool becomes trapped inside it.
Causes of Diverticulitis
The exact reason why sacs (diverticula) form on the walls of the large intestine is not clear, but a diet comprised of processed foods and deficient in fiber—and resultant chronic constipation—is thought to be a potential cause. Constant straining while passing hard stools causes pressure within your colon, which can lead to the formation of diverticula. Diverticulitis generally happens when stool is entrapped, causing a bacterial infection in these diverticula.
Alternative medicine may be helpful in reducing the frequency of diverticulitis attacks, and in improving the results of your treatment. Nutritional supplements, herbal remedies, homeopathic medicines, and acupuncture may help you achieve symptomatic relief, but it is necessary to consult your doctor before taking up any of these treatments.
Nutritional Supplements: As much as 25-35 grams of fiber should be included in your daily diet. Whole grain bread, and vegetables such as cucumber, spinach, and lettuce are rich in fiber and decrease your risk of developing diverticular disease. The use of insoluble fiber supplements, such as psyllium and Glucomannan, and soluble fiber supplements, such as oat bran and flaxseed, can help increase your daily fiber intake. Fish oil is quite rich in omega-3 fatty acids, which can help fight against inflammation. Probiotics also help people with diverticulitis to cope with the symptoms and maintain good intestinal health.
Herbal remedies: Herbs are a natural way to strengthen gastrointestinal health. The following herbal remedies may be helpful for patients with diverticulitis:
- Flaxseed: Rich in fiber and acts as a laxative. Taking about 15 grams of ground flaxseed each day is recommended.
- Slippery elm: This herb facilitates healing by protecting irritated tissue.
- Marshmallow: This herb is an emollient and can sooth inflamed tissue.
- Licorice: This herb helps in controlling spasms and inflammation in the gastrointestinal tract.
Homeopathy: After taking into consideration your physical, emotional, and intellectual type, your homeopath will suggest the most suitable remedies for you. Belladonna, Bryonia, and Colocynthis are some of the homeopathic remedies useful in relieving abdominal cramps associated with constipation.
Acupuncture: Acupuncture is an ancient Chinese treatment method that involves the insertion of fine needles into specific points of the body. It can help promote gastrointestinal health and relieve pain.
You can prevent diverticulitis by making the following lifestyle modifications:
- Dietary Changes: Include at least 25-35 grams of fiber in your diet every day. Eat fresh fruits and vegetables such as apples, oranges, bananas, raspberries, spinach, carrots, broccoli, whole grains and cereals to get the optimum fiber for your body. It is also important to avoid the excessive intake of red meat and high-fat foods. Drinking plenty of fluids, particularly water, helps soften feces and prevent constipation.
- Regular Physical Exercise: Performing exercises for at least 30 minutes every day helps relieve pressure within your colon and keep bowel movements regular.
Are you experiencing symptoms of diverticulitis? You can learn more about diverticulitis and its treatment by getting in touch with our specially-trained general surgeons at Cedars-Sinai Marina del Rey Hospital.