General, Thoracic and Vascular Surgery

Diverticulitis: Battling a Fierce Opponent

Diverticulitis: Battling a Fierce Opponent

There’s not much that slows Nancy Fauls down. She was one of the first female skippers to race schooners in the Pacific Northwest and knows how to stay calm and keep everything moving forward. Then in January 2019, the Port Townsend resident experienced a lower abdominal pain that was overpowering. “I’d never felt anything like it before,” she remembers. “I could hardly breathe or move. I was doubled over.”

Nancy went to the local emergency room and then to her general practitioner who prescribed antibiotics to curb bacteria growth. The medication didn’t have much impact on her symptoms and she spent several days lying flat on her back. A month later she experienced the intense pain again and her doctor referred her to Virginia Mason. Because of the distance from Port Townsend to the hospital and the severity of her pain, she was transported by ambulance and ferry boat to Virginia Mason Seattle. Diagnostic blood tests and a CT scan, indicated her pain was caused by diverticulitis.

Nancy FaulsNancy Fauls

Diverticulitis occurs when a diverticulum (a bulging sac that can form on the colon wall and push outward) becomes inflamed or infected. The condition is most common in people whose diets are lower in fiber and higher in processed carbohydrates.

“Diverticulitis used to commonly be seen in patients who are 50 to 70 years old,” Virginia Mason colorectal surgeon Vlad Simianu, MD, MPH, says, “but now we’re seeing younger patients. The culprits, he adds, “often are obesity, smoking and a diet of highly processed and packaged foods.”

As part of Virginia Mason’s commitment to continually improve the patient experience, Vlad Simianu, MD, is the site principal investigator of a national study comparing outcomes and quality of life for diverticulitis patients who choose surgery versus those who choose medical management.

High fiber diets can prevent the colon diverticula from forming, he says, because the fiber results in smoother elimination without the damage that can occur with the pressure on the colon that is caused by constipation. And as Nancy experienced, damaged sections of the colon wall can thin and burst.

“Once the disease occurs, diet changes may help the symptoms but they are no longer the cure,” says Dr. Simianu. “The truth is once you have diverticula we don’t really know what drives them to become inflamed and infected, and therefore can’t be sure whether a specific medicine or lifestyle change will prevent a flare.” Often the diseased portion of the colon must be surgically removed.

“These days the surgery is much easier on patients. It is minimally invasive, usually requiring three to five small cuts in the abdomen, as opposed to traditional surgery which involves one large incision.” He adds, “Patients heal faster and their stay in the hospital is reduced.”

In Nancy’s case, the nine inches of her colon with the disease were removed using robotic technology. She was back home three days following her surgery. She’s made some lifestyle adjustments, lost 50 pounds and is enjoying trips with friends and an active life in the beautiful town she calls home.

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