Diverticulitis and now going to have a Sigmoid colon resection

Posted by linda82 @linda82, Jan 16, 2024

I have had 4 occurrences this past year treated with antibiotics and Mesalamine ER and now getting ready for surgery. This last occurrence I ended up in the ER and was lucky the abscess was small enough to treat with antibiotics and liquid diet.
I have been on low fiber diet and Mesalamine. The Mesalamine has been great but very hard to find and go form one CVS to another to find stock. (it is not being manufactured right now and insurance will not pay for it) I also to do not want to be on this the rest of my life or until another occurrence when it will be an emergency surgery. Right now all my blood work is great and back to normal and MRI and CT scans have been completed.
I just can't handle another episode of this and will be 60 yrs old this year. I am retired and all episodes happened after vacation and do not want to live in fear of going anywhere! I am in good health and do not take any other meds.
I am curious of others that have gone through this surgery and get helpful insight on what to expect.
Surgery will be in March and will be robotic.
Thanks in advance.

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Profile picture for bc321 @bc321

@gerryp I am working on a detailed diverticulitis guide with a flow chart of complications, data matrix, reference list, glossary, etc. It is not ready for publishing yet but one data point that came up over and over was that about 75% of Free Perforations (open flow of feces into the abdominal cavity) happen on the patient's first episode of diverticulitis. The synopsis is basically that you either have a spot/spots of weakness in the colon that is susceptible to this, or you don't. So if you've had multiple episodes with no Free Perforation, you are less likely to have one. Plus they think the scaring from healing of previous episodes makes it harder to have a Free Perforation. It came from what they reference as: "The Chapman Study" - Transition rates from Phlegmon to Perforation; "First-Episode" paradox data (75%); long-term recurrence of free air. https://pubmed.ncbi.nlm.nih.gov/16192818/ (Complicated diverticulitis: is it time to rethink the rules?)

FYI.

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@bc321 ok. That’s interesting. I read your history in your profile. Sounds like it’s been a long haul. My diverticulitis attack was perforated on my first episode, so I guess I fall into that 75% cohort. I don’t recall having any symptoms of any significance until I was doubled-over in intense pain. My surgery was done on an emergency basis after about 5 days of IV antibiotics - and no improvement. This was in 2004. I have had no other episodes since.

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Profile picture for Lisa Lucier, Moderator @lisalucier

@linda82 - are you by chance referring to a specific post you've made before on Mayo Clinic Connect? If so, will you provide the link to the post to which you're referring?

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@lisalucier There was the first post when I was deciding on the surgery. This site helped me with that decision. Just reading of other people's journeys.
But, I have had so many responses and answers to other people's questions after the surgery.
I will have to search to see if I can find some of them

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Profile picture for linda82 @linda82

@lisalucier There was the first post when I was deciding on the surgery. This site helped me with that decision. Just reading of other people's journeys.
But, I have had so many responses and answers to other people's questions after the surgery.
I will have to search to see if I can find some of them

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@linda82 I did find if you go to my profile and click on comments. It will show all of them.

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Profile picture for bc321 @bc321

I'm interested in recovery experiences specifically from common colectomy patients. Is there anyone out there fitting these conditions that can give me a description of their recovery?

- Entire Sigmoid Colon removed, and nothing else.
- Laparoscopic or Robotic Laparoscopic with no issues during surgery.
- 45-65 years old.
- No other health issues (diabetes, heart disease, obesity, fistulas, etc.)

This may be too specific to get enough input but I thought I'd try. I'm on day 1 of post-op and everything went well. I have reasonable pain but nothing too bad. However I know it is early. I'm looking for similar patients' recovery timelines and any other details you use to describe your recovery: 80%, 100%, start eating fiber, start running and/or weight lifting again, pain levels timeline, just for some examples of what I'm thinking. Thanks.

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@bc321 - I moved your post over to the discussion to which @linda82 referred, simply because there are a lot of members here talking about sigmoid colon discussion you may wish to chat with.

It does not appear that everyone who posted in this discussion talked about things like their age, other health issues and type of sigmoid colon removal they had. However, I'm sure that some of them will have things in common with you that you were looking for, such as laparoscopic or robotic removal of the entire sigmoid colon with no other surgery performed or issues during surgery, age 45-65, and no other chronic health issues.

Perhaps members here can self-select if they match with you in these criteria and then can tell you about how their recoveries went, including timeline, what percentage recovered they are today, pain timelines, and when they could resume consuming fiber, running or weightlifting postsurgically. It's highly likely some have factors in common with you. I'd also love for you to meet @jlharsh.

How are you feeling today, bc321? How would you rate your pain right now?

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Profile picture for bc321 @bc321

I'm interested in recovery experiences specifically from common colectomy patients. Is there anyone out there fitting these conditions that can give me a description of their recovery?

- Entire Sigmoid Colon removed, and nothing else.
- Laparoscopic or Robotic Laparoscopic with no issues during surgery.
- 45-65 years old.
- No other health issues (diabetes, heart disease, obesity, fistulas, etc.)

This may be too specific to get enough input but I thought I'd try. I'm on day 1 of post-op and everything went well. I have reasonable pain but nothing too bad. However I know it is early. I'm looking for similar patients' recovery timelines and any other details you use to describe your recovery: 80%, 100%, start eating fiber, start running and/or weight lifting again, pain levels timeline, just for some examples of what I'm thinking. Thanks.

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@bc321
HI, yo estoy dentro de los requisitos que menciona. Cirugia robotica-me quitaron el colon sigmoideo-tuve varios episodios de diverticulitis sin complicaciones en el transcurso de 7 anios. El dia 3 despues de la cirugia me dijeron que ya podia ir a casa. El mayor dolor que tuve fueron los cortes de la cirugia, en el transcurso de 45 dias desaparecieron por completo. Estoy a 3 meses y medio de la cirugia. Actualmente camino hora y media por dia sin inconvenientes, hago gimnasia. El medico me dijo que podia levantar cualquier peso, que estoy bien. El problema especifico con el que me sigo encontrando despues de tres meses y medio es la coordinacion entre el deseo de defecar, y poder hacerlo. Siento deseos de defecar, y cuando voy al banio no defeco, por ahi lo hago a la media hora, o a las 6 horas, lo que me limita algo en cuanto a salir de casa, el segundo problema es que mi materia fecal es ahora muy ancha (el medico me explico que se debia a que no tengo el colon sigmoideo), y a veces muy dura, con las consecuencias que ello implica. Espero que le sea de utilidad .

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Profile picture for ajica @ajica

@bc321
HI, yo estoy dentro de los requisitos que menciona. Cirugia robotica-me quitaron el colon sigmoideo-tuve varios episodios de diverticulitis sin complicaciones en el transcurso de 7 anios. El dia 3 despues de la cirugia me dijeron que ya podia ir a casa. El mayor dolor que tuve fueron los cortes de la cirugia, en el transcurso de 45 dias desaparecieron por completo. Estoy a 3 meses y medio de la cirugia. Actualmente camino hora y media por dia sin inconvenientes, hago gimnasia. El medico me dijo que podia levantar cualquier peso, que estoy bien. El problema especifico con el que me sigo encontrando despues de tres meses y medio es la coordinacion entre el deseo de defecar, y poder hacerlo. Siento deseos de defecar, y cuando voy al banio no defeco, por ahi lo hago a la media hora, o a las 6 horas, lo que me limita algo en cuanto a salir de casa, el segundo problema es que mi materia fecal es ahora muy ancha (el medico me explico que se debia a que no tengo el colon sigmoideo), y a veces muy dura, con las consecuencias que ello implica. Espero que le sea de utilidad .

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@ajica Gracias por compartir su experiencia. Le deseo lo mejor en el resto de su recuperación.

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Profile picture for ajica @ajica

@bc321
HI, yo estoy dentro de los requisitos que menciona. Cirugia robotica-me quitaron el colon sigmoideo-tuve varios episodios de diverticulitis sin complicaciones en el transcurso de 7 anios. El dia 3 despues de la cirugia me dijeron que ya podia ir a casa. El mayor dolor que tuve fueron los cortes de la cirugia, en el transcurso de 45 dias desaparecieron por completo. Estoy a 3 meses y medio de la cirugia. Actualmente camino hora y media por dia sin inconvenientes, hago gimnasia. El medico me dijo que podia levantar cualquier peso, que estoy bien. El problema especifico con el que me sigo encontrando despues de tres meses y medio es la coordinacion entre el deseo de defecar, y poder hacerlo. Siento deseos de defecar, y cuando voy al banio no defeco, por ahi lo hago a la media hora, o a las 6 horas, lo que me limita algo en cuanto a salir de casa, el segundo problema es que mi materia fecal es ahora muy ancha (el medico me explico que se debia a que no tengo el colon sigmoideo), y a veces muy dura, con las consecuencias que ello implica. Espero que le sea de utilidad .

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@ajica I had the same for a while. You think you need to go but, you do not. You feel the pressure but, it is not ready yet. I would get scared and think it was stuck.
It will go away. I would suggest a potty squatty. It will help tremendously. Never "sit there" and never "strain"
Also, even though it is the morning. When you get up drink a full glass of liquid and just walk around. It will help move it!
With surgery everything moves around, and it is like a reposition. I also, did tummy massage.

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Profile picture for linda82 @linda82

@ajica I had the same for a while. You think you need to go but, you do not. You feel the pressure but, it is not ready yet. I would get scared and think it was stuck.
It will go away. I would suggest a potty squatty. It will help tremendously. Never "sit there" and never "strain"
Also, even though it is the morning. When you get up drink a full glass of liquid and just walk around. It will help move it!
With surgery everything moves around, and it is like a reposition. I also, did tummy massage.

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@linda82
Muchas gracias por el comentario! Yo tambien uso el banquito para ir al banio, sin eso me resulta imposible. A la maniana tomo magnesio, agua tibia con limon y camino + hago ejercicios de taichi para el intestino. Luego tomo el desayuno. Consultando en chat gpt me comentaba de hacer fisioterapia del suelo pelvico. Por el momento esperare a ver como evoluciono.
Podria preguntarle cuanto tiempo tardo en recuperarse 100%?

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I had the robotic sigmoidectomy surgery in June of 25. While the surgery went extremely well, there was much the surgeon did not educate me about that I can share with you. 1) It may take a long time for your bowels to recover. By long, I mean it can take up to a year and in between that time, when the bowel finally calms down and settles into a new routine because the anatomy has changed, you will find that you go through various stages. 2) Where they remove the sigmoid section is suprapubic, just above your pubic bone. (Think bikini line.) The incision is not long, maybe 3 inches or so. However, it is common to have an area of numbness that does not resolve. I learned this at my follow up appointment six weeks later. My surgeon stated that is a common side effect of the surgery due to the dissection of nerves in the area. I think the most important thing to do is to ask questions, not just about short term recovery, but also long term. Listen to the surgeon regarding recovery, diet, fluid intake, etc., and how to manage constipation should that be an issue. I am a 70 y.o. woman who is active, and eats a healthy diet. I was home after 2 days. Positive thoughts your way and let us know how it goes for you!

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Profile picture for linda82 @linda82

@ajica I had the same for a while. You think you need to go but, you do not. You feel the pressure but, it is not ready yet. I would get scared and think it was stuck.
It will go away. I would suggest a potty squatty. It will help tremendously. Never "sit there" and never "strain"
Also, even though it is the morning. When you get up drink a full glass of liquid and just walk around. It will help move it!
With surgery everything moves around, and it is like a reposition. I also, did tummy massage.

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@linda82 Interested in the "tummy massage" you mention. Did you do a self massage (not usually effective for me), or did you see a therapist for visceral massage. I am interested in massage that might help with adhesions. thanks!

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