- Repeated attacks of diverticulitis. Surgery to remove the diseased part of the colon often is recommended if you have two or more severe attacks.
- A high risk of repeated attacks (such as in people younger than age 40, or people with an impaired immune system).
- An abnormal opening (fistula) that has formed between the colon and an adjacent organ, most commonly the bladder, uterus, or vagina.
Surgery for diverticulitis, in which the infected part of the colon is removed, may be required if you have complications, including:
- An infected pouch (diverticulum ) that has ruptured into the abdominal cavity, especially if a pocket of infection (abscess) has formed. In some cases, an abscess can be drained without surgery. (See Other Treatment.)
- An infection that has spread into the abdominal cavity (peritonitis).
- A blocked colon (bowel obstruction) or a narrow spot in the colon (stricture).
- Infection that has spread through the blood to other parts of the body (sepsis).
- Repeated problems with bleeding or severe bleeding that does not stop with other treatments.
Overall, fewer than 6 out of 100 people who have diverticulitis need surgery.3
Surgical treatment involves removing the diseased part of the large intestine (partial colectomy ) and reconnecting the remaining parts. Depending on the severity and nature of the symptoms, more than one surgery may be needed to correct the problem. When multiple surgeries are needed, the person usually has a colostomy during the time between surgeries. A colostomy is a surgical procedure in which the upper part of the intestine is sewn to an opening made in the skin of the abdomen. Stool passes out of the body at this opening and into a disposable bag. Usually the colostomy is removed at a later time and the intestine is reconnected.
Surgical treatment of diverticulitis, called bowel resection, involves the removal of the diseased part of the large intestine.
What to think about
People who have mild, brief attacks and who are willing to try long-term dietary changes may be able to avoid surgery. See the Prevention section of this topic for more information on diet.
If you have multiple attacks of diverticulitis, surgery may be appropriate.