Talking with the Doctor
Howard
Ross, MD, specializes in colon and rectal
surgery at Penn Presbyterian Medical Center of
the University of Pennsylvania Health System.
Question: What is diverticulitis and how
is it treated?
 Answer:
Diverticulitis is a common disease of the colon.
As we age, soft outpouchings called diverticuli
can develop in the wall of the large intestine.
The formation of diverticuli is associated with
diets that are low in fiber. By the time people
living in the United States reach 70 years of
age, two thirds develop diverticuli. These outpouchings
usually do not cause any problems; occasionally,
however, they can become infected. This infection
is called diverticulitis. No one knows why infection
develops. Unproven, but popular, traditional beliefs
have incriminated popcorn, seeds, and nuts.
When someone has diverticulitis they usually
experience pain in the left side of their abdomen.
The pain can be mild or severe. If a person were
to experience pain in their abdomen they should
visit a physician. The treatment of mild diverticulitis
can be only a short course of antibiotics. More
intense or repeat attacks can require surgery.
Traditionally, the type of surgery required to
remove the diseased portion of colon required
a large incision, a hospital stay of more than
a week, and a recovery at home which did not permit
full activity for six weeks.
Advances in laparoscopic surgery, also called
minimally invasive surgery or keyhole surgery,
now enable specially trained surgeons to remove
the affected portion of colon without a large
incision in the center of the abdomen. In the
newer laparoscopic approach, the surgeon uses
a very small telescope called a laparoscope,
to see inside the patient's abdomen. The surgeon
makes several small incisions and inserts both
the laparoscope and miniaturized surgical instruments.
All
the necessary operative steps are made through
these small holes, using the image on the
video monitor as a guide. When a colon operation
is performed laparoscopically, the patient has
less pain, a shorter hospital stay, a better
cosmetic result, and a more rapid return to
the activities they enjoy. Patients have left
the hospital in as short a time as two days
and have played golf within a month after
surgery. After hospital discharge, the patients
are encouraged to return to an active
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