Half of Americans over 50 years old have pea-sized bubbles that push through weak spots along their large intestine’s wall. In fact, people can have hundreds of them. The bubbles form little pouches, and though the pouches themselves aren’t a problem (it’s called diverticulosis), if the pouches become inflamed or infected with bits of stool, trouble can fester (that’s called diverticulitis). These bulges can form anywhere along the 5-foot-long large intestine, yet they most commonly take shape within the colon’s lower left quadrant. 

The condition’s impact can range from uncomfortable to intolerable.  

“Diverticulitis has a wide spectrum in terms of severity. Most episodes are managed by a primary care physician who can prescribe antibiotics in an outpatient setting. On the other end of the spectrum, diverticulitis can lead to severe problems, including a ruptured colon that requires emergency surgery. There’s also everything in between,” said Adam Rothermel, M.D., Board-certified General Surgeon and Director of the Genesis Center of Surgical Excellence.   

Common symptoms associated with diverticulitis include: 

• Abdominal pain on the lower left side – which can come on suddenly or start mildly and increase over days 

• Fever 

• Chills 

• Nausea/vomiting 

• Constipation  

• Bloating 

Why do so many Americans get diverticulosis?    

Research shows that people most at risk for diverticulosis and diverticular disease, like diverticulitis  

• Are males 

• Are over 50 years old 

• Are obese and don’t exercise enough 

• Eat low-fiber diets (meaning, not enough leafy green vegetables, beans and legumes, grains or nuts)  

• Eat a diet high in fat and red meat 

• Take nonsteroidal anti-inflammatory drugs (like aspirin, ibuprofen, steroids or opioids)   

• Smoke 

Dr. Rothermel said: “In America, because of our low fiber diet, our colon has to work harder to poop. Just like when you roll over the curb in your car and create a bubble on your tire because of the pressure, you can develop bubbles on your colon because of extra pressure. The best thing we can do is eat a lot of fiber (25 grams a day) and drink 6 to 8 glasses of water a day.”  

How is diverticulitis treated?  

People who experience symptoms of diverticulitis should see their primary care physician, as many mild cases can be treated with prescribed antibiotics. People who experience multiple episodes of mild attacks, or those who experience one or two episodes of more severe attacks, may consider talking with their physician about surgery. 

If surgery is elected, a colonoscopy is performed first to confirm diverticulitis and rule out other possible diagnoses.   

“The expectation with minimally invasive surgery for diverticulitis is that things will only get better, and the previous bowel problems should improve,” Dr. Rothermel said. “I love seeing people get back to enjoying their lives. It’s why I do what I do.”

Can problematic diverticulitis be treated with minimally invasive surgery? 

Surgically treating diverticulitis includes removing the involved portion of the colon, usually a 6-to-10-inch segment. Surgeons can use either minimally invasive or traditional techniques for the procedure, depending on the physician’s skillsets and what is best for the patient.  

“When patients are a good candidate for minimally invasive surgery, that is my preferred method,” said Dr. Rothermel, who uses the DaVinci Robotic Platform when performing minimally invasive surgeries at Genesis Hospital. “Patients who undergo minimally invasive surgery for diverticulitis receive a long list of benefits, including significantly less risk of developing a hernia from surgery. Approximately 20 percent of people who have the traditional surgery will develop a hernia – that’s 1 in 5 people. Thankfully, it’s very rare with the minimally invasive technique.”  

Other benefits of minimally invasive surgery for treating diverticulitis include:  

• Shortened length of hospital stay (generally two nights, as opposed to four or five nights)  

• Less pain and therefore less need for narcotic pain medication  

• Smaller incision sites 

• Less chance of infection at incision sites 

• Faster recovery (with a return to full activity in 1 month, compared to 6 to 8 weeks)  

“The expectation with minimally invasive surgery for diverticulitis is that things will only get better, and the previous bowel problems should improve,” Dr. Rothermel said. “I love seeing people get back to enjoying their lives. It’s why I do what I do.”