Diverticulitis flareup, smoldering divert., narrowed sigmoid colon?

@bc321
You mention preparing for a January 6 sigmoid colectomy.

You no doubt have discussed detail with your surgeon. As you wait for others to comment it may help to review an overview of the procedure. I particularly like the section about what to expect following.
- Mayo Clinic Colectomy: https://www.mayoclinic.org/tests-procedures/colectomy/about/pac-20384631

How are you feeling about having your sigmoid colon removed?

@jlharsh Ready for it ASAP now that I have these symptoms from a prognosis of a narrowed colon. The goal is to make it 3 weeks to surgery without infection. The last 3 nights indicate even small low-residue meals of any substance cause pain/pressure 23-27 hours later. I'm testing clear liquid + protein shakes in small portions through the day to rest the colon and test if the nightly pains go away from dinner the day before. If that works I'll see if a morning low-residue meal to see if it comes back, but in the morning of the next day. I can do protein shakes and clear liquids for 3 weeks if necessary. Some have described this as what "smoldering diverticulitis" is, but there are no facts that support that it is infection-based. It seems my colon somehow somewhat suddenly narrowed enough to cause all of this and I'm guessing it will not reverse itself. I did have a full flareup 2 months prior to this starting and completely healed and was back to normal in 7-10 days, but I guess the scarring from that recovery could have continued developing and it was just enough to be the straw that broke the camel's back, so to speak. Thanks.

I’ve been dealing with what just diagnosed as smoldering diverticulitis after 6 years. They are talking surgery at my local hospital. Can I ask how your surgery was? They refuse to put me on IV antibiotics and just keep telling me liquid diet over & over. I’m at a loss. Surgery doesn’t sound fun for this at all.

I also had smoldering diverticulitis. After too many trips to the ER and strong antibiotics that made me sick, my GI referred me to a colorectal surgeon. She convinced me to have the surgery while I was healthy. She said if perforated it would require emergency surgery. Having the surgery while I was not having a flare up allowed it to be done robotically. I had the surgery a little over a year ago and have not had diverticulitis since then. You’ve been dealing with this for 6 years so I’d say you might want to give surgery some serious thought. Special diets weren’t really helping me because it just never completely healed. I know there are several of us in this discussion group who have had bowel resections and have shared our experiences. Maybe that will help you in your decision. Good luck to you in whatever you decide to do.

Hello, I've had diverticulitis 4 times in the past year. I'm getting it every 3 months. I've had it a few times in the past, but it's been years.. I'm contributing my flare ups to my cpap machine. A year ago Resmed changed the elbow connection that connect the mask to the tube. I feel like I cannot exhale and the air in my opinion is getting into my colon causing pressure which then turns into diverticulitis. Seems like no one believes me. I've stopped using my cpap machine just to see if I get it again.. so far, so good. good luck..

@help123 surgery was delayed 1 additional week to 14Jan due to OR availability so I am now 6.5 weeks post-op. Surgery went very well and as planned. It was a sigmoidectomy so the entire sigmoid colon was removed (standard/best practice as I understand it rather than removing just a 'bad' section of the sigmoid). It was done laparoscopic, took 2 hours and no other complications were identified. I was in for 4 nights but would have been 3 if I didn't have nausea on day 3 which delayed my transition from full liquid diet to low residue diet, which was a requirement for discharge. I feel like recovery has gone very well. Every week had it's own improvements but I really started feeling 'normal-ish' in that week 5-6 period. Although I've read that is common and is the period most susceptible to hernias because people feel so much better that they start breaking weight lifting and activity guidance. I've learned that the protective lining of the abdomen, called the facia, is only at 50-60% recovery at week 6. So I am doing my best to follow the rules. I still do walks instead of starting back up on running; and I won't return to the gym for weight lifting until week 12. I'm very detailed by nature, and a researcher, so I've created a lot of tools from what I've learned about the disease and recovery. Some of them I've posted here but I haven't posted some recent tools yet as I usually post them on a FB support group. My latest is about "Recovery Nutrients", not just nutrition and food, but key intake guidelines at the Nutrient level, showing which weeks each is "Key" and the recovery amounts vs RDA. I may post it here if anyone wants it once I get the final version. I'm waiting for an admin on the FB group to approve me posting a draft asking for input from fellow patients on that group. Good luck.

@foxj I think this reply is for you @help123

@hollster339 Interesting hypothesis. Caveat: As always, I am not medically trained at all. I'll assume the diverticulitis episodes were confirmed with CT scans and the existence of diverticulum (diverticulosis) has been confirmed by a colonoscopy and/or CT scans. Thinking through the process of your hypothesis, you're thinking that you are swallowing air that is getting to your colon, causing pressure, which is then causing the diverticulum to become inflamed (diverticulitis). Is that your thought process? I could understand a hypothesis of air pressure causing the initial creation of diverticulum by pushing on week spots in the colon; but I can also understand a counter-hypothesis that air in the colon would spread out in length when it reaches resistance of the colon wall unlike a hard bolus piece of feces caused by constipation (the current leading cause of both diverticulosis and diverticulitis at this point, from what I've read). Although maybe the air behind a bolus would cause it to have more pressure against the colon wall? Again, interesting hypothesis. Go to an AI and ask it something like this: "What do reputable medical entities say regarding air in the colon via swallowing air during sleep due to a CPAP machine causing diverticulosis and/or diverticulitis?" When I did it in Gemini it had useful info, the most useful being this:

Why You Might See a Connection
While a direct "cause-and-effect" link hasn't been proven, there are several reasons why they are often discussed together:

Pressure in the Colon: Diverticulosis is caused by high pressure within the colon that pushes the lining out through weak spots in the muscle wall. While medical literature usually attributes this to straining (constipation), patients often wonder if the "internal pressure" from swallowed air adds to this stress.

Symptom Mimicry: The bloating and "trapped gas" pain from CPAP can feel very similar to a mild diverticulitis flare-up, leading to confusion during diagnosis.

Shared Risk Factors: Both sleep apnea (requiring CPAP) and diverticular disease share common risk factors like obesity and aging, meaning many people naturally have both conditions simultaneously.

@bc321 hi, yes my diverticulitis was confirmed w a ct scan each time. Also keep in mind that I had colon cancer years ago and 1/2 my colon was removed and a re connection was done. So the length of my colon is very small. I'm also never constipated, and as far as my eating habits, I generally eat the same things all the time. I do not believe its from something i'm eating. The only thing I can contribute this to is my cpap machine.

@bc321 yes, please post here or let me know what fb group this would be in! If I go ahead with the surgery, I want any advice that will help recovery. I’m so hesitant to have surgery again, because medically I was misdiagnosed & have had 3 surgeries already, starting with a hysterectomy, appendectomy that weren’t needed. Unfortunately my pain has gotten out of control at this point, I’ve lost 55lbs so I need some quality of life back.