Before surgery, conservative therapy should always be exhausted
If the presence of intestinal wall protuberances (diverticulosis) is known, a high-fiber diet should be eaten, drunk a lot and exercised a lot. Otherwise, no further therapy for diverticulitis is needed.
Nutrition and antibiotics
If the diverticula are inflamed, treatment can be either conservative or surgical. Conservative treatment is used for highly acute or mild inflammation. If the inflammation is severe, the patient should stay in hospital for possible surgery.
He is not allowed to eat (nutrition via blood by infusion) and is treated with a broad-spectrum antibiotic. If pus has accumulated, it must be drained. Painkillers and those which reduce the tension of the intestinal muscles are then administered additionally. Such antibiotics are also used to treat mild inflammation. Mostly, however, the treatment is carried out on an outpatient basis, i.e. at home.
How long are you sick after an operation?
The acute inflammation of an intestinal wall bulge, i.e. a diverticulum, usually requires rapid surgery to prevent further spread of the inflamed material in the abdomen. Nowadays, the procedure is often performed laparoscopically, i.e. only a few small incisions are made in the abdominal wall, through which the surgical instruments are inserted under camera view. If this surgical technique is used, recovery is usually faster and the hospital stay is usually limited to about ten days, provided that no further complications occur. After that, patients are usually put on sick leave for another two to three weeks before they can resume their usual activities. However, this information refers to an uncomplicated course of treatment, in which everything proceeds as planned and the patient has no more pain or discomfort after this time.
Indication for surgery
Diverticula are only operated on to eliminate or generally avoid the consequences of complications of diverticulosis or diverticulitis. Surgical intervention is therefore necessary in less than 5% of diverticulitis carriers. If there is no improvement after 24-48 hours of conservative therapy in case of a diverticulitis relapse, surgery can be decided upon depending on the patient’s condition.
This should be performed promptly, but not as an emergency operation. In case of repeated inflammatory attacks, but at the earliest after the second attack, surgery in a state as free of inflammation as possible is conceivable. The same applies in the case of a narrowing (obstruction) of the inflamed intestinal loop without completely obstructing the intestinal passage.
In case of a complete intestinal obstruction or an intestinal rupture due to a ruptured diverticulum (perforation), immediate surgery is inevitable. As a consequence of the inflammation in diverticula, bleeding of the colon may occur, which can manifest itself by blood loss through the anus. Depending on the extent of the bleeding, this too is a sign justifying surgery. Depending on the extent of bleeding, the urgency of the operation may also depend. With a probability of 80%, however, the sources of bleeding will close without surgery.
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