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Harvard Medical School
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General Medical Questions
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Question : In the last five years or so, I’ve occasionally had an intense pain on my left side. The doctors tell me that I have diverticulitis and should think about surgery. I hate the idea. Is it necessary?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 01, 2013
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A:

Diverticulitis is inflammation of small pouches that can bulge off the large intestine. These small pouches are called diverticula.

Diverticula are very common. They happen more often in people with irritable bowel syndrome (IBS) and chronic constipation. The risk of developing them increases with age.

Diverticula don’t cause any symptoms unless one bleeds or gets inflamed (diverticulitis).

Diverticulitis starts when there is increased pressure within the pouch. The pressure creates small holes in the lining. Bacteria that live in the colon seep through the holes. The bacteria are now in a place they shouldn’t be. An infection starts. This leads to the inflammation.

Doctors treat diverticulitis with antibiotics. In most cases, this all that needs to be done.

After a first attack of diverticulitis, about a third of patients will have no more symptoms. Another third will have occasional abdominal cramps. The other third will go on to have more attacks.

If you had two or more definite bouts of diverticulitis in the same part of the colon within a couple years, your doctor may advise surgery. Here, the surgeon would remove that part of the colon.

But if you only have cramps that come and go, you may not need surgery. The symptoms could be caused by IBS. Your doctor can prescribe medicine to help ease the symptoms.

A CAT scan of the abdomen will likely help you and your doctor decide on surgery. If there is persistent inflammation in and around a diverticula, your doctor will likely recommend surgery.

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