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DIVERTICULAR DISEASE OF INTESTINE

UNDERSTANDING THE PROBLEM

Diverticular disease and diverticulitis are related digestive conditions that affect the large intestine (colon).
In diverticular disease, small bulges or pockets (diverticula) develop in the lining of the intestine. Diverticulitis is when these pockets become inflamed or infected.

UNDERSTANDING WHO SUFFERS
  • Diverticular disease is one of the most common digestive conditions.
  • Age is a major risk factor for diverticulosis although not very common before people reach the age of 40. Research has shown that at least 33% of all Americans will develop this condition by the time they reach the age of 60.
  • Both sexes are equally affected by diverticular disease and diverticulitis, although the condition is more likely to appear at a younger age (under 50) in men than in women. Overall, symptoms of diverticulitis are most likely to occur in people over 70 years old.
  • Diverticular disease is often described as a "Western disease" because the rates are high in European and North American countries, and low in African and Asian countries.
  • A combination of genetics and diet is thought to be the reason for this and the fact that people in Western countries tend to eat less fibre.
  • People aged 50-70 who eat a high-fibre diet (25g a day) have a 40% lower chance of admission to hospital with complications of diverticular disease – compared to others in their age range with the lowest amount of dietary fibre.
POTENTIAL SIGNS AND SYMPTOMS

Symptoms of diverticular disease and diverticulitis include abdominal pain, bloating and a change in normal bowel habits. The most common symptom of diverticular disease is intermittent (stop-start) pain in the lower abdomen (stomach), usually in the lower left-hand side. The pain is often worse when eating, or shortly afterwards. Passing stools and breaking wind (flatulence) may help relieve the pain.

Other long-term symptoms of diverticular disease include:

  • a change in the normal bowel habits, such as constipation or diarrhoea, or episodes of constipation that are followed by diarrhoea – a classic pattern is multiple trips to the toilet in the morning to pass stools like "rabbit pellets"
  • bloating

Another possible symptom of diverticular disease is bleeding dark purple blood from the rectum (back passage). This usually occurs after diarrhoea-like cramping pain, and often leads to hospital admission, but fortunately this is an uncommon complication.

Diverticular disease does not cause weight loss, so if symptoms include losing weight, seeing blood in the stools or experiencing frequent bowel changes, a doctor need to be consulted.

Diverticulitis shares most of the symptoms of diverticular disease. However, the pain associated with diverticulitis is constant and severe, rather than intermittent. It is most likely to occur if symptoms of diverticular disease were experienced, and develops over a day or two.

Other symptoms of diverticulitis can include:

  • a high temperature (fever) of 38oC (100.4F) or above
  • a general feeling of being tired and unwell
  • feeling sick (nausea) or being sick (vomiting)

The pain usually starts below the belly button, before moving to the lower left-hand side of the abdomen.

In Asian people, the pain may move to the lower right-hand side of the abdomen. This is because East Asian people tend to develop diverticula in a different part of their colon for genetic reasons.

EXAMINATIONS USUALLY REQUIRED

Diverticular disease can be difficult to diagnose from the symptoms alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome (IBS). Tests will normally include:

  • Medical history: Health and Symptoms experienced, including: Pain, Bowel habits, Diet, Current medications. and Blood tests which help to rule out other conditions such as coeliac disease (a condition caused by an abnormal immune response to gluten) or bowel cancer.
  • Colonoscopy.
  • Computerised tomography (CT scan).
PROPOSING TREATMENT AND WHY AIMIS

Surgery for diverticulitis, in which the infected part of the colon is removed, may be required if there are complications, these can include:

  • Infected pouch (diverticulum): that has ruptured into the abdominal cavity, especially if a pocket of infection (abscess) has formed.
  • Perforation: surgery may be needed to repair the tear or hole. Additional surgery may be needed to remove a small part of the colon if the surgeon cannot repair the perforation.
  • Peritonitis: requires immediate surgery to clean the abdominal cavity. A colon resection at a later date after a course of antibiotics.
  • Fistula: Surgeons can correct a fistula by performing a colon resection and removing the fistula.
  • Intestinal obstruction: If the large intestine is partially or completely blocked, surgery is required with possible colon resection. In the case of complete blockage immediate surgery is required.

A total colectomy involves removing the entire colon. Subtotal colectomy is a term to describe a procedure removing part of the colon. Segmental colectomy is a term describing the removal of a segment of the colon and could also be labelled a hemicolectomy to differentiate between the right or left halves of the large intestine. When using the prefix “procto” it indicates a procedure that involves the removal of the rectum as well as the colon. Rectum removal is called proctectomy. Other terms such as low anterior resection, indicating the removal of the sigmoid colon as well as the upper part of the rectum. Although the rectum is distinct from the colon it is a fact that many pathologic conditions and procedures normally related to the colon will involve the rectum.

If a surgeon recommends surgery to treat Diverticulitis, these are potential surgery types for minimally invasive da Vinci Surgery.

AIMIS is an expert in all da Vinci Robotic surgeries related to Diverticulitis and provides advanced techniques offering many advantages over standard laparoscopy such as:

  • Greater precision
  • Lower blood loss
  • Quicker return of bowel function
  • Lower rate of complications
  • Shorter hospital stay
  • Small incisions for minimal scarring

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AFFORDABILITY

AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

Complications of diverticulitis affect one in five people with the condition. Those most at risk are aged under 50.

Some complications associated with diverticulitis are:

  • Bleeding (Around 15% of people with diverticular disease or diverticulitis experience bleeding, which is usually painless, quick and resolves itself in 70-80% of cases.)
  • Urinary problems (pain when urinating (dysuria), needing to urinate more often than usual, in rare cases, air in the urine
  • Abscess (pus-filled cavity or lump in the tissue. Abscesses are usually treated with a technique known as percutaneous abscess drainage (PAD).
  • Fistula (abnormal tunnels that connect two parts of the body together, such as the intestine and the abdominal wall or bladder)
  • Peritonitis (infection of the lining of the abdomen)
  • Intestinal obstruction (If the infection has badly scarred the large intestine, it may become partially or totally blocked. A totally blocked large intestine is a medical emergency because the tissue of the large intestine will start to decay and eventually split, leading to peritonitis)
FURTHER INFORMATION ON INCREASED RISK GROUPS

Factors that appear to increase the risk of developing diverticular disease include:

  • smoking
  • being overweight or obese
  • having a history of constipation
  • use of non-steroidal anti-inflammatory drugs (NSAIDs) painkillers
  • having a close relative with diverticular disease, especially if they developed it under the age of 50 but not necessarily because of genetics but shared factors potential diet, being overweight, etc.
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Diverticular disease can be difficult to diagnose from the symptoms alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome (IBS).

In addition to the test mentioned above, further testing could involve:

  • Stool sample. This test may show bleeding in the digestive tract.
  • Digital rectal exam. The doctor will insert a gloved finger into the rectum to check for pain, bleeding, or a blockage.
  • X ray and barium enema. The doctor will insert liquid called barium in the large intestine through the anus.
  • Colonoscopy. The doctor will insert a small tube through the anus. A tiny video camera is in the tube and will show if there are any pouches.
WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery for Lower Gastrointestinal Problems including:

Right & Left Hemicolectomy, Subtotal Colectomy, Total Colectomy, Total Proctocolectomy with pouch, Anterior Resection of the Rectum, Total Mesorectal Excision, Abdominoperineal Excision and other minimal invasive procedures involving the best American and International surgeons who are experts in the field

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for Lower Gastrointestinal problem and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Lower blood loss
  • Greater precision
  • Few small incisions - Minimal Scarring
  • Better margins with potential less disruption to surrounding tissue
  • Shorter hospital stays
  • Return to normal activities quicker.

Over the past few years this innovative system has given millions of patients worldwide the benefit of minimal invasive surgery. The da Vinci Xi system has changed technology and the experience of surgery to patients around the world.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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