Diverticulitis: Will I Have a Colostomy

Medically reviewed by: Gary H. Hoffman, MD

Diverticulitis.  What Is It?

Everyone knows about diverticulitis.  Everyone has heard the old wives’ tales that eating corn and nuts or seeds will cause an inflammation of the colon because these foods “get stuck” in the diverticulosis sacs (this is not true).  And then there is the dreaded colostomy. Many people know someone who had an operation for diverticulitis and ended up having a colostomy.  In most cases of surgery for diverticulitis, a colostomy is not required. However, sometimes this is not the case.

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To understand the operation and the why and why not of a colostomy, the anatomy and physics of the colon must be understood. The colon is a six foot long muscular tube which removes water from stool and moves stool into the rectum for storage and eventual release. A proctologist, also known as a colon and rectal surgeon, can teach you about the colon, rectum and anal canal during an appointment.

The Physics Of Your Colon.

To move the stool (peristalsis), the colon muscles generate high pressures to squeeze the colon and the stool in a propulsive forward direction.  The highest pressures are generated in the sigmoid colon, next to the rectum.  At points in the sigmoid where blood vessels and nerves enter, the outward pressure can create outpouchings of the colon and these are called diverticular openings, or diverticulosis.

Inflammation And Surgery.

When a diverticular pocket becomes repeatedly inflamed, an operation, a colectomy is needed to remove the diseased area and reconnect the ends of the remaining colon.  Under most circumstances, patients recover without difficulty.  However, when the operation is performed as an emergency, because of a perforation (a hole in the colon), or infection, there is no time to electively cleanse the colon.

A Colostomy.  What Is It And Why Is It Needed?

In these cases, a temporary colostomy may be needed.  A colostomy is an exteriorization of the colon upstream from the surgically removed segment.  After the surgeon ahs reconnected the ends of the bowel, a colostomy is fashioned so that stool can be routed into a bag on the side of the abdomen, and away from the fresh colon connection, allowing the connection (anastomosis) to heal.  The colostomy is eventually closed.

Think of the colostomy as life saving rather than life altering.  Over many years, surgeons have learned about the value of the colostomy and its importance in emergency situations. There are modern appliances (bags) that fit over the colostomy, eliminating any odor from stool in the bag.  Specially trained ostomy nurses can instruct patients in the care and changing of the colostomy bag.  Again, a colostomy can be life saving.

Los Angeles Colon and Rectal Surgical Associates.

Board certified and trained surgeons are available at Los Angeles Colon and Rectal Surgical Associates to educate you and treat you for all diseases of the colon, rectum and anus. They will help you through a difficult time and will aid you in a return to health.  You cam make an appointment by calling (310)273-2310.  There is much literature and pre-appointment forms on the office website.

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