Diverticular Disease

Diverticular disease occurs when small pouches (diverticula) form in the wall of the colon. While many people never develop symptoms, these pouches can become inflamed or infected, causing diverticulitis, which may lead to abdominal pain, fever, or more serious complications. Although many cases respond to medical treatment, recurrent or complicated diverticulitis may require surgery.

At The Medical Group of New Jersey, our general surgeons provide expert evaluation and minimally invasive surgical treatment when needed, working closely with gastroenterologists and primary care physicians to achieve the best possible outcomes.

Symptoms & Initial Evaluation

Many people with diverticular disease never develop symptoms. Others experience mild digestive discomfort, while patients with diverticulitis often develop symptoms that appear suddenly and progressively worsen over one or two days.

Common symptoms include:

Pain in the lower left abdomen
Abdominal tenderness
Fever or chills
Nausea or vomiting
Constipation or diarrhea
Abdominal bloating
Loss of appetite

Most episodes of diverticulitis involve the lower left side of the abdomen, although symptoms may vary depending on the location of the inflamed diverticula.

Patients should seek immediate medical attention if they experience:

Severe or worsening abdominal pain
Persistent fever
Inability to eat or drink
Persistent vomiting
Blood in the stool
Marked abdominal swelling
Dizziness or fainting

These symptoms may indicate a more serious complication requiring urgent treatment.

Comprehensive Evaluation

During your consultation, your surgeon will review your symptoms, previous episodes of diverticulitis, imaging studies, and overall medical history. A careful abdominal examination helps determine whether additional testing is needed and whether surgery should be considered.

Diagnosis & Risk Assessment

The evaluation of diverticular disease focuses on confirming the diagnosis, identifying complications, and determining whether continued medical treatment or elective surgery is the best long-term approach.

CT Scan

A CT scan of the abdomen and pelvis is the preferred imaging study during an episode of diverticulitis. It helps identify:

Inflamed diverticula
Thickening of the colon wall
Abscess formation
Perforation
Fistulas
Bowel obstruction

CT imaging also helps determine whether diverticulitis is uncomplicated or complicated, which significantly influences treatment decisions.

Laboratory Testing

Blood tests commonly include:

Complete blood count (CBC)
Electrolytes
Kidney function tests
C-reactive protein (CRP)
Other inflammatory markers when appropriate

These studies help assess the severity of infection and overall health.

Colonoscopy

Because acute inflammation increases the risk of complications during colonoscopy, the procedure is typically performed after recovery, usually several weeks following an episode of diverticulitis. Colonoscopy helps:

Confirm the diagnosis
Exclude colorectal cancer
Identify colon polyps
Evaluate the extent of diverticular disease

Risk Assessment

Not every patient with diverticulitis requires surgery. Your surgeon will consider:

The frequency of recurrent attacks
Severity of previous episodes
Development of abscesses, fistulas, or perforation
Persistent symptoms between episodes
Age and overall health
Immune system disorders
Previous abdominal operations
Impact on work and quality of life

These factors help determine whether elective surgery offers the greatest long-term benefit.

Treatment & Management

Treatment depends on the severity of the disease and whether complications have developed. Many patients recover completely with nonsurgical treatment, while others benefit from elective surgery after recurrent or complicated disease.

Conservative Management

For uncomplicated diverticulitis, treatment often includes:

Temporary dietary modifications
Adequate hydration
Antibiotics when appropriate
Pain management
Gradual return to a regular diet as symptoms improve

Following recovery, your physician may recommend increasing dietary fiber and making other lifestyle changes to support long-term colon health.

Management of Complicated Diverticulitis

Patients with abscesses or more severe infections may require:

Hospitalization
Intravenous antibiotics
Image-guided drainage of an abscess
Close monitoring

These treatments may control the acute infection and allow surgery to be performed later under safer conditions if needed.

Elective Colon Surgery

Elective surgery may be recommended for patients who experience:

Recurrent episodes of diverticulitis
Persistent symptoms despite medical therapy
Large abscesses
Fistulas
Narrowing (stricture) of the colon
Recurrent bowel obstruction

The most common procedure is removal of the affected portion of the colon (colectomy) with reconnection of the healthy ends of the intestine. Whenever appropriate, our surgeons perform laparoscopic or robotic-assisted surgery, which may provide smaller incisions, less postoperative discomfort, shorter hospital stay, and faster recovery.

Recovery & Follow-Up

Recovery depends on the severity of the disease and whether surgery is performed. Patients recovering from an uncomplicated episode of diverticulitis often resume normal activities within several days.

After surgery, your care team will provide individualized guidance regarding:

Diet progression
Pain management
Activity restrictions
Incision care
Bowel function
Returning to work and exercise

Follow-up appointments allow your surgeon to monitor healing, review pathology findings when applicable, and coordinate ongoing care with your gastroenterologist or primary care physician.

Prognosis & Long-Term Care

Most patients recover completely from uncomplicated diverticulitis with appropriate treatment. For patients who undergo elective surgery because of recurrent or complicated disease, long-term outcomes are generally excellent, with significant reduction in future episodes and improved quality of life.

At The Medical Group of New Jersey, our surgeons provide individualized, evidence-based care for diverticular disease, helping patients understand when surgery is beneficial while supporting safe recovery and long-term digestive health.

Related Services & Internal Links

Related Specialties

General Surgery