Diverticular Disease Treatment in Melbourne
Diverticular disease refers to the presence of small outpouchings, called diverticula, in the colon, most commonly in the sigmoid colon. While diverticula alone (diverticulosis) are often asymptomatic, some people develop diverticulitis, a condition in which one or more diverticula become inflamed or infected.
Diverticulitis ranges from mild episodes managed at home with antibiotics to complicated presentations requiring hospitalisation or surgery.
At Specialist Surgical Group, our Melbourne-based colorectal surgeon, Dr Thomas Tiang (MBBS, FRACS), offers specialist assessment and treatment of diverticular disease across the full spectrum of care, from guiding conservative management through to performing elective laparoscopic bowel resection for patients with recurrent or complicated disease. Each treatment plan is tailored to the individual based on the frequency and severity of episodes, any complications identified, and the patient’s overall health.
We consult from our Essendon and Bundoora clinics, with surgical procedures performed at accredited hospitals in Melbourne. Diverticular disease treatment is part of our broader colorectal surgery service.
Call us today at (03) 9466 7338 to book a consultation.
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Mon – Fri: 9 AM – 5 PM
We are located in the heart of Essendon and Bundoora.
Is diverticular disease treatment right for you?
A consultation with our colorectal surgeon may be appropriate if you:
- Have been diagnosed with diverticular disease and are experiencing recurrent episodes of lower abdominal pain, particularly in the left lower abdomen
- Have had one or more confirmed episodes of acute diverticulitis and want specialist input to guide your ongoing management
- Have been hospitalised for complicated diverticulitis, including abscess formation, perforation, or colonic fistula
- Are experiencing ongoing symptoms between acute episodes, including bloating, irregular bowel habits, or persistent lower abdominal discomfort
- Have developed a colonic stricture or recurrent partial bowel obstruction related to diverticular disease
- Have been advised by your GP or gastroenterologist to seek a surgical opinion regarding elective bowel resection
- Are concerned about the risk of recurrence following a previous episode and want to discuss your long-term management options
Your suitability for conservative or surgical management will be confirmed during a consultation, where Dr Tiang will review your symptom history, any prior imaging, and your overall health to recommend the most appropriate management plan.
Potential benefits
- Effective resolution of acute episodes with conservative management. Antibiotic therapy combined with dietary modification achieves resolution in 70-80% of uncomplicated first presentations, with most patients avoiding hospitalisation [1].
- Elective surgery eliminates further episodes in the treated segment. Studies report recurrence rates below 5% following laparoscopic sigmoid colectomy, providing durable relief for patients with recurrent or complicated disease [2].
- Minimally invasive surgery with favourable recovery. Laparoscopic resection is associated with shorter hospital stays and a faster return to normal activities than open surgery, with most patients discharged within 3-5 days [3].
- Definitive management of complications. Surgical resection addresses fistulae, chronic strictures, and recurrent abscesses that cannot be controlled with antibiotics or radiological drainage alone [2].
- Lower risk than emergency surgery. Elective resection carries significantly lower morbidity than emergency surgery for perforation or peritonitis, and in most cases allows the procedure to be completed without a stoma [2].
Potential risks
- Anastomotic leak. The join between bowel ends after resection can occasionally break down, causing infection or peritonitis requiring further intervention. The reported rate for elective sigmoid colectomy is approximately 2-4%, and is higher in emergency settings or in patients who are nutritionally compromised [4].
- Temporary or permanent stoma. A temporary ileostomy may be formed to protect the anastomosis while it heals. In emergency surgery for faecal peritonitis (Hartmann’s procedure), a permanent stoma is occasionally necessary if bowel continuity cannot be safely restored [5].
- Injury to adjacent structures. Prior inflammation and adhesions can increase the risk of inadvertent injury to the ureter, bladder, or pelvic nerves during resection. Such injuries are uncommon in elective surgery but are a recognised operative risk in patients with a history of complicated disease [3].
- Conversion to open surgery. Planned laparoscopic resection requires conversion to an open procedure in approximately 5-15% of cases due to adhesions or intraoperative findings, and is associated with a longer hospital stay [3].
- Post-operative infection. Wound infection and intra-abdominal collection occur in approximately 5-10% of elective bowel resections and are usually managed with antibiotics or radiological drainage [4].
- Recurrence in residual colon. Resection eliminates disease in the treated segment, but diverticula elsewhere in the colon may cause future symptoms, particularly in patients with extensive diverticulosis [2].
Book a consultation today
(03) 9466 7338Meet our team
Our colorectal surgeon is FRACS-qualified with specialist training at leading medical institutions in Australia. The procedures are performed at accredited Melbourne hospitals with full nursing and anaesthetic support.
Your diverticular disease treatment journey
The following steps provide a brief overview of your haemorrhoid treatment journey. Individual experiences will vary based on your specific health circumstances.
1. Initial consultation and health assessment
Dr Tiang will review your symptom history, any prior episodes of diverticulitis, previous investigations, and treatments received.
A physical examination will be performed, and prior CT scans, colonoscopy reports, or hospital discharge summaries will be reviewed.
A colonoscopy is typically recommended 6-8 weeks after resolution of an acute episode to assess the extent of disease and exclude other colorectal pathology.
2. Conservative management
For patients with uncomplicated diverticulitis or symptomatic diverticulosis, the initial focus is on conservative management. A high-fibre diet (25-30 grams per day) with adequate fluid intake is the most important long-term measure for reducing recurrent episodes.¹
For an acute, uncomplicated episode managed in the outpatient setting, a short course of oral antibiotics is prescribed, along with a temporary low-residue diet.
Patients who do not improve, develop a high fever, or cannot tolerate oral intake are assessed in the hospital for intravenous antibiotics. For confirmed diverticular abscesses, CT-guided percutaneous drainage may be arranged before definitive elective surgery is planned.
3. Elective laparoscopic sigmoid colectomy
Elective surgery is recommended for patients with recurrent diverticulitis (generally 2 or more confirmed episodes), complicated disease including fistula or chronic stricture, or persistent symptoms significantly affecting quality of life [2].
The procedure is performed laparoscopically under general anaesthesia at an accredited Melbourne hospital. Through 3-5 small incisions, the affected sigmoid colon is mobilised and removed along with its mesentery.
The descending colon is then joined to the upper rectum to restore bowel continuity. In the majority of elective cases, this is completed without a stoma. Operating time is typically 2-3 hours.
4. Hospital recovery
Most patients are admitted for 3-5 days following surgery. An enhanced recovery pathway is followed, encouraging mobilisation on the day of surgery or the day after, early resumption of oral diet as tolerated, and regular oral analgesia.
Bowel function typically returns within 2-4 days. Written discharge instructions covering wound care, diet, medications, and activity restrictions are provided before you leave the hospital.
5. Results and follow-up
Light activities and desk-based work can usually be resumed within 2-3 weeks. Strenuous activity and heavy lifting are restricted for 4-6 weeks, with full recovery typically achieved within 4-8 weeks.
A follow-up appointment is scheduled at 2-4 weeks after discharge to review wound healing, bowel function, and any pathology results from the resected specimen.
Long-term dietary advice, including maintaining a high-fibre diet, will be reinforced to support ongoing colorectal health.
Book a consultation today
(03) 9466 7338Diverticular disease treatment FAQ
The cost of elective sigmoid colectomy depends on your private health insurance, the hospital facility used, and the complexity of your procedure. Laparoscopic sigmoid colectomy is a Medicare-eligible procedure, and private health insurance with appropriate hospital cover typically covers the hospital and anaesthesia components.
Out-of-pocket costs after Medicare and insurer rebates vary by fund and policy level, but, as a general guide, patients with private health insurance may expect out-of-pocket costs of $1,000-$4,000, depending on their specific circumstances. Self-funded patients should request a detailed cost estimate prior to confirming their booking. Your estimated out-of-pocket costs will always be provided to you in writing before any procedure.
Diverticulosis refers to the presence of diverticula in the colon wall without active inflammation. It is extremely common, affecting an estimated 50-70% of people over 60, and is usually detected incidentally during colonoscopy [1].
Diverticulitis occurs when one or more of these pouches become inflamed or infected, leading to symptoms such as left lower abdominal pain, fever, nausea, and changes in bowel habits. Only a minority of people with diverticulosis ever develop diverticulitis.
Surgery is generally recommended for patients with 2 or more confirmed episodes of acute diverticulitis, complicated diverticular disease (including fistula, stricture, or abscess not controlled by antibiotics or drainage), or persistent symptoms that significantly affect quality of life despite conservative management.
It may also be discussed for younger patients after a first complicated episode, given their higher cumulative lifetime risk of further episodes. We will weigh the risks of surgery against the probability and consequences of future episodes based on your individual history [2].
The most common symptom is pain in the left lower abdomen, which may be constant or cramp-like. Associated symptoms include fever, nausea, vomiting, loss of appetite, constipation, or, less commonly, diarrhoea.
If you develop severe or worsening abdominal pain, high fever, or signs of peritonitis such as a rigid or board-like abdomen, you should seek urgent medical assessment, as these features may indicate a perforation requiring emergency treatment.
Many patients with diverticular disease are managed successfully without surgery. Uncomplicated acute diverticulitis responds to antibiotics and dietary modification in most cases, and a high-fibre diet significantly reduces the frequency of future episodes.
Surgery is reserved for patients with recurrent or complicated disease, or for those whose quality of life is significantly affected by ongoing symptoms. If surgery has been recommended for you, Dr Tiang will explain the specific clinical reasons and discuss the risks and benefits in the context of your overall health.
Elective sigmoid colectomy for diverticular disease is listed on the Medicare Benefits Schedule (MBS) and attracts a Medicare rebate when performed for an appropriate clinical indication. Private health insurance with hospital cover typically covers hospital and anaesthesia costs, subject to your level of cover and any applicable waiting periods.
We recommend contacting your health fund before your consultation to confirm your entitlements [6].
Most patients are discharged from the hospital within 3-5 days following laparoscopic sigmoid colectomy. Light activities and desk-based work can usually be resumed within 2-3 weeks, with strenuous activity and heavy lifting restricted for 4-6 weeks.
Full recovery to pre-operative activity levels typically takes 4-8 weeks. Recovery following open or emergency surgery is generally longer, with hospital stays of 5-10 days or more and a return to full activity taking 8-12 weeks or more.
A high-fibre diet is the most effective lifestyle measure for reducing the risk of diverticulitis in people with known diverticulosis. Aim for 25-30g/day of fibre from wholegrain cereals, vegetables, legumes, and fruit, alongside 6-8 glasses of water daily to maintain soft stools and reduce intraluminal colonic pressure.
Regular physical activity, maintaining a healthy body weight, and avoiding smoking are also associated with a lower risk of diverticular complications. The historical advice to avoid nuts, seeds, and popcorn is not supported by current evidence [1].
Medical disclaimer
The information on this page is for general educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations, and does not create a doctor-patient relationship. Individual circumstances vary significantly, and nothing on this page should be used as a substitute for personalised advice from a qualified medical professional.
If you have concerns about your health, please seek medical attention promptly. To discuss your specific condition and treatment options with our team, please book a consultation by calling us at (03) 9466 7338.
References
[1] Feuerstein JD, Falchuk KR. (2016). Diverticulosis and Diverticulitis. Mayo Clin Proc. 2016;91(8):1094–1104. https://doi.org/10.1016/j.mayocp.2016.03.012
[2] Strate LL, Morris AM. (2019). Epidemiology, Pathophysiology, and Treatment of Diverticulitis. Gastroenterology. 2019;156(5):1282–1298. https://doi.org/10.1053/j.gastro.2018.12.033
[3] Vennix S, et al. (2011). Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: short-term results of the Sigma trial. Ann Surg. 2011;254(1):39–47. https://doi.org/10.1097/SLA.0b013e31821ed7bc
[4] Hall J, et al. (2020). The American Society of Colon and Rectal Surgeons Clinical Practice Guideline for the Treatment of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020;63(6):728–747. https://doi.org/10.1097/DCR.0000000000001679
[5] Oberkofler CE, et al. (2012). A multicenter randomized clinical trial of primary anastomosis or Hartmann’s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg. 2012;256(5):819–827. https://doi.org/10.1097/SLA.0b013e31827324ba
[6] Medicare Benefits Schedule. (2024). MBS Online – Item Search. Australian Government Department of Health and Aged Care. http://www.mbsonline.gov.au