Persisting Symptoms after Elective Sigmoid Resection for Sigmoid Diverticulitis

Persisting Symptoms after Elective Sigmoid Resection for Sigmoid Diverticulitis In the past, sigmoid resection in patients with recurrent sigmoid diverticulitis was typically recommended after the second episode. In recent years, this practice has been questioned as well as abandoned in favor of a more individual decision making. After elective sigmoid resection for diverticulitis, however, approximately a quarter of all patients report persistent or new-onset symptoms. In the minority of cases, actually genuine recurrent diverticulitis plays a role, in which the height of the anastomosis is a determining factor. Often patients report about symptoms suggestive of irritable bowel syndrome, and studies in the recent years also show an overlap of irritable bowel syndrome and diverticular disease. Recent studies suggest that visceral hypersensitivity and markers of inflammation are correlated in patients with symptomatic diverticular disease. In conjunction with predisposing factors such as obesity, these conditions may be a key reason for persistent complaints. Therefore, on the one hand, it will be up to the physician to identify those patients who are at high risk for complications and have a high probability of remaining symptom-free postoperatively. On the other hand, patients who will most likely not benefit from surgery should be directed towards other treatment modalities.