Diverticulitis Progression Flow Chart: For Patients, By a Patient.

WOW! this is really helpful. I was in the "yellow stricture legend" I am so glad it did not have to go to red. But, almost there before I elected surgery.
Thank you for the time you put into this!

Thanks! Just what I needed!

What a fantastic resource. Thank you!

UPDATED/IMPROVED VERSION COMING SOON, ADDING SMOLDERING DIVERTICULITIS & MICRO-PERFORATIONS...

For anyone that didn't see the previous version, this is an updated version of a Diverticulitis Progression Flow Chart and guide that I previously posted. Read the Introduction page for details. If you've seen it and want to know what the major changes are, I'll describe them below. Otherwise, here is the updated version of all 7 pages.

UPDATE SYNOPSIS FOR THE 31JAN26 VERSION:

Added “Smoldering Diverticulitis” as a “Complication”: It isn’t a formal Complication of diverticulitis, like Abscess, FIstula, Stricture, etc, but it is a way diverticulitis often presents itself. It is referenced enough by patients that I thought this guide was incomplete if I didn’t find a way to include it. As I worked with AI and the 5 key medical resources on designing a way to integrate it into the Flow Chart it became obvious this was a key missing link in the previous version and the way to effectively weave it in, even with Uncomplicated Diverticulitis, became obvious and just satisfyingly right. I think the way it flows from Uncomplicated, Phlegmon and Abscess and then out to not only Stricture as it did before, but now also to Fistula, will help many of us find where we fit in the Diverticulitis Progression Flow Chart. We may have acute flareups from a specific type of Complicated or even Uncomplicated episodes, but then we have times where we have these longer Smoldering episodes - and the Flow Chart now represents that. It also shows how these Smoldering cases can progress into some chronic, structural Complications.

Added “Micro-Perforation”: Similar to “Smoldering Diverticulitis”, this is a term that is frequently used by patients as well as Docs and CT techs. Although the research work with AI didn’t identify this as needing its own “Complication Box” in the flow chart, it did confirm that it should be used in defining 2 Complications: Phlegmon and Contained Abscess. So you’ll now see that term referenced in those boxes of the Flow Chart and rows of the Data Matrix.
“Planned” vs “Elective” Surgery: The term “Elective Surgery” was changed to “Planned Surgery”. This shift better characterizes surgery as a proactive mechanical fix for structural failures (Fistula/Stricture/Smoldering) rather than an optional lifestyle choice.

97.75%: If you take the mid-point of the percentage ranges for all of the Complications, they add up to 97.75%. You won’t see this quoted anywhere, but it was a nice result to see and I thought it worthy of letting readers know what it means. Using AI to estimate the percentage of cases each one of the Complications represents out of all Complicated cases, and doing so using data from 5 different medical sources, was a challenge. It took a lot of chat questions back and forth asking which sources were used, what denominators were being used, and sometimes using 2 data points from 2 different sources in order to calculate the estimates. On top of that, the studies the sources used were obviously different, and some had completely different cohorts, such as only patients hospitalized versus any patient treated for diverticulitis. That is the main reason you will see that some of the percentage ranges are rather large. Getting the total to or close to 100% was never mentioned in the process, but at the end I had AI do the math. Having it end up at 97.75%, just 2.25% away from 100% is pretty good. Most of you don’t care, you’re not going to get into the weeds on this and you’ll probably never look at any products past the Flow Chart. But for those that are geeks like me, I thought I’d include this comment. (If you’re checking the math, note that the 9.6% for “Smoldering” is NOT included since it is 9.6% of ALL cases, not of Complicated cases; and you can have Smoldering plus a Complication at the same time, and often do.)

“Mandatory Colonoscopy”: You’ll notice the new note at the bottom saying colonoscopies are mandatory 6-8 weeks after a complicated episode. AI was pretty adamant about this so I added it. And yes, I know, AI is not a conscious being so it can’t be “adamant” about anything. What it means and what I mean though, is that the medical sources referenced this as important. And the % given related to cancer made me want to add it for the sake of all of us patients to be aware of.

Very informative, but a bit disheartening. The percentages are a bit confusing because as you move down the chart, it’s a percentage of a percentage and not of the original number. E.g. 15% of 100, then 25% of 15% isn’t 25%, it’s about 4% of the original. Combining percentages of percentages in math is not always a legitimate math usage and it never is when the percentages are derived from two different base numbers of the original populations.

@donbarkman If it is confusing to you then I'll want to address that in the next version to make it less confusing, thanks for that feedback. The math is not percentages of percentages, but I see what you may be referring to. 15% may be referring to the "15-20% develop 1 or more of the following Complications, usually starting with a Phlegmon", that's denoting the start of the 15 to 20% of ALL cases that are Complicated, as described in the Overview. Then from there, the percentages in the colored boxes are the percentage ranges that present with that specific Complication. The percentages between those colored boxes that are overtop of arrows identify percentages that move from 1 complication to another. But not everyone runs completely through every box, some can skip and present with a Complication further "down" the flow-chart. For example, the "Arrow" text between Plegmon and Contained Abscess says "15%-20%¹ progress to Contained Abscess despite antibiotics; others skip Phlegmon & present directly with a Contained Abscess." So 15-20% of those with Phlegmon progress to Contained Abscess, and some patients present with Contained Abscess directly. Now, they probably had a Phlegmon, but when they presented at a facility it was a Contained Abscess. I hope that helps, but I'll ponder a way to explain it more clearly in the next update. Is the confusion on the percentages why this is disheartening for you, or is it something else? Thanks again.

@bc321 - I combined your two posts on this flow chart so members could see it all together in progression.

How are you doing post colectomy this past week, bc321?

Great. So you deleted the original/older chart and files, correct? Thanks for doing that since I can't edit after a few hours. I think I'm doing well for 19 days post-op.

@bc321 I understand how you presented the percentages going down the chart. I did a lot of math work with adults. Percentages are widely misunderstood. You might start with 15 out of 100 people will experience repeated episodes of diverticulitis. Of those 15, 3 will experience xyz and another 2 will experience abc. Of the 3 with xyz, 1 will require rst. Those are all made up conditions and treatments, but you get the drift. Use numbers not percentages and work down from a base of 100. Maybe if I have time, I will print your chart and do the math my way for you.