Most people don’t have much in common with Pope Francis. But each year, about 200,000 Americans have the same experience as the leaders of the Catholic Church. That means I had surgery for diverticulitis.
Pope Francis has recovered well from surgery in July, which revealed this potentially serious condition in his colon. If you have questions about why diverticulitis occurs, the most common signs of this condition, and how to treat it, keep reading.
What is diverticulitis?
Diverticulitis results from a condition called diverticulosis, which occurs when weak areas in the lining of the colon bulge outward, forming small pouches. Many people develop diverticulosis as they age. In fact, approximately 58% of U.S. adults over the age of 60 have diverticulosis. Getting enough fiber in your diet can help prevent diverticulosis.
Most people don’t even realize they have this condition. The diagnosis of diverticulosis often first appears on a report when a person has a colonoscopy or an abdominal CT scan for another reason. Although diverticulosis does not cause symptoms, people with irritable bowel syndrome or who are prone to constipation, bloating, or abdominal discomfort after eating are more likely to develop diverticulosis.
“Although diverticulosis is very common, only a small percentage of people with diverticulosis develop diverticulitis, which is caused by inflammation or infection of one of the sacs,” says the Harvard Brigham & Co., Ltd. Dr. Matthew Hamilton, a gastroenterologist at Women’s Hospital, says:
Know the signs of diverticulitis
The most common symptoms of diverticulitis are abdominal pain (usually in the lower left) and fever. The pain is distinct and sharp and may last for several hours. Other symptoms may include loss of appetite, nausea, vomiting, bloating and cramping, and inability to pass gas or stool.
Mild cases of diverticulitis that cause minimal pain in the lower abdomen will resolve on their own within 1 to 2 days. However, if your symptoms do not go away or if you start to feel unwell, such as increased pain, fever, bloody stools, or abdominal distension with vomiting, you should see your doctor right away.
Treatment depends on whether you have simple or complicated diverticulitis. Doctors can determine this using a combination of blood tests and imaging tests, such as her CT scan.
How is simple diverticulitis treated?
As the name suggests, simple diverticulitis is the less serious of the two. This means that the inflammation or infection is limited to one part of the colon and there are no signs of complications.
Uncomplicated diverticulitis is usually treated at home with oral antibiotics. A few days of “bowel rest” is also prescribed, which often includes a clear liquid diet. This gives your intestines a chance to rest and heal, which may reduce pain. Additionally, continue a low-fiber diet (about 10 to 15 grams of fiber per day) until your symptoms improve.
Some people may need to be hospitalized to receive intravenous (IV) antibiotics. If you are over 65 or have other medical conditions, such as heart disease, diabetes, or chronic obstructive pulmonary disease, you are more likely to need hospitalization.
You will usually begin to feel improvement from treatment after about 3 days. If you feel better and your symptoms have subsided, you can gradually return to your normal diet.
If your symptoms don’t respond to antibiotics after a week, you’ll probably want to have a CT scan or other tests to see if you have complicated diverticulitis.
How is complicated diverticulitis treated?
Complicated diverticulitis means you have certain complications that require long-term IV antibiotics and possibly surgery.
Pope Francis had scarring in part of his colon from a previous bout with diverticulitis, causing a narrowing of the colon called stricture. In these cases, the abnormal part of the colon is removed and the remaining colon is reattached.
Other types of complications that can occur during an active diverticulitis infection include:
- abscess. A diverticular abscess is a collection of pus (fluid that forms at the site of an infection) on the outside of the intestinal wall. If the abscess does not improve with antibiotics, your doctor may need to use a needle to drain the pus under the guidance of a CT scan.
- pierced. Diverticulitis can cause holes in the colon, allowing intestinal contents to spill into the abdominal cavity. If there is a perforation, the abdomen may feel tender to the touch, hard, or dilated. Surgery will repair the hole. In some cases, a portion of the colon around the hole must be removed.
- Fistula. A fistula is an abnormal connection between an inflamed and infected part of the colon and an adjacent organ, such as another part of the intestine or the bladder. Surgery consists of colectomy and removal of the fistula.
Can diverticulitis be prevented?
Eating a high-fiber diet and managing stress may reduce your risk of developing pouches known as diverticula in your colon. Therefore, it makes sense that these lifestyle interventions may help reduce the incidence of diverticulitis. However, once diverticulosis develops, there is no proven way to prevent diverticulum infection and inflammation.