View Single Post
  #10  
Old 05-01-2017, 08:34 PM
Corporal Lance Boil's Avatar
Corporal Lance Boil Corporal Lance Boil is offline
Tony Colacino
member
 
Join Date: Mar 2016
Location: New Hampshire
Posts: 42
Default Here goes!

To answer your specific questions:

The combination of a fluoroquinolone (either levofloxacin (Levaquin) or Cipro (Ciprofloxacin) with the addition of metronidazole (Flagyl) is a broad-spectrum antibiotic regimen, with good activity against a majority of bacteria that would be causative in diverticulitis. I absolutely agree to not use these unless you need them. Why? They will suppress your normal colonic flora and perhaps you might wind up with an overgrowth of a different bacteria which normally inhabits your bowels, Clostridium Difficile come to mind (C diff). Plus, we are poor antibiotic stewards in general and by indiscriminate use we promote resistance.

Can it come back? Yes, and no. Bear in mind I have not examined you, and do not know the location of your disease. It is not uncommon to have disease "upstream" of the resected area which can become problematic, though this is rare. Some people have pan-colonic disease, i.e. disease all over there colon which make resection problematic, but most resections take place along known anatomic vascular supplies, and the colon is rich in arcades which co-distribute blood. Plus, this is not a cancer operation so the dividing of vessels takes place much closer to the colon, thus providing accessory blood supply. There are tenets to the operation which any surgeon would adhere to (Where are you Frank?) but generally I would resect the area in question and perform primary anastomosis, without diversion (think temporary bag.) My own pathology report shows they reconnected my bowels through a diverticula...I am fine.

Do you need another colonoscopy? No. Unless you like the prep, in which case I question your sanity. Colonoscopies, which I do, will not fix your issue, but maybe confirm it, and rule out malignancy as a cause.

Should you have an operation? Well, that's up to you. The body wants to get stool away from the site of inflammation and irritation, and if you want to try and avoid surgery I would recommend switching to clear liquid diet, something high in electrolytes like Gatorade when you experience significant symptoms like (I assume) serious left lower abdominal pain, and considering antibiotics if you run a fever or you think this may be serious. It would not be unusual to consider a CT scan at this point. Constipation I like to manage with Docusate Sodium (Colace), and over-the-counter stool softener. I usually prescribe 100 mg (2 50 mg pills) twice daily WITH water, as a stool softener doesn't work if there's no water to put into stool. I do not love laxatives in this situation, but would lean towards Senna as opposed to Miralax if forced. Cook all your vegetable well if you are experiencing symptoms, as you want things absorbed before they hit the colon. And for god's sake don't eat mushrooms, as the body does not absorb them, period, and they will irritate the hell out of your colon.

By the way, nuts/seeds/corn being bad for diverticula is a wive's tale. Bank on that.

OK, so long winded reply in a public place but there it is. I wish you health, good collecting, and if you have any issues feel free to contact me.

Tony
Reply With Quote