Over the years, many people develop “outpouchings” in their intestinal mucosa. These occur when the intestinal mucosa push out through a hole in muscle, forming a “pouch” (seen from inside the intestine). The medical term for this is “diverticulosis” and it is not itself a disease.
Since the muscle layer is missing in the region of the diverticulosis, the intestinal wall is very thin here and can also tear if damage to the intestinal mucosa occurs.
This enables bacteria to enter the intestinal wall or even leave the gut entirely – this is termed “perforation”. Most perforations occurring from diverticulosis are termed “covered perforations” since the body can cover over these small leaks with other loops in the intestine or what is known as the “greater omentum”. Nonetheless, these inflammations can give rise to pain, fever and make the patient very ill: this is then termed “acute diverticulitis”.
In general, diverticulitis can be cured with antibiotics and by reducing food intake or switching to a diet of lighter meals. Any decision to operate on the affected part of the intestine – an operation that can generally be performed as abdominal (laparoscopic) surgery – depends on whether or not the disease is affecting only the mucosa or the entire intestinal wall. This is because the latter type causes narrowing of the colon and must be operated on when free from inflammation. If a patient suffers from recurrent inflammation of this type, however, then we view this as a surgical indication marker.