A recent letter to medical professionals highlights the ongoing challenges faced by patients after a sigmoidectomy, a surgical procedure commonly performed to treat complications from diverticulitis. The letter details one patient’s experience with persistent diarrhea and cramping following surgery, which has affected both work and home life.
Diverticulitis occurs when small pouches called diverticula form in the colon wall and become inflamed or infected. These pouches can trap fecal waste and bacteria, leading to inflammation or infection. If a diverticulum develops a perforation, it may result in contamination of the abdominal cavity, potentially causing peritonitis—a severe infection that requires prompt intervention. To address this risk, surgeons often remove the damaged section of the colon and reconnect the remaining ends in a procedure known as sigmoidectomy.
While this surgery is considered lifesaving, it can lead to several complications. The colon plays a complex role in digestion involving muscles, neurons, microbes, and specialized cells responsible for absorbing water and signaling immune responses. Even minor removal of colon tissue can disrupt these systems.
Diarrhea is identified as a common side effect after sigmoidectomy because food passes more quickly through the shortened colon segment. There are fewer cells available to absorb liquids, changes occur within the enteric nervous system—the network of neurons managing digestion—and alterations happen within the gut microbiome. As a result, patients may struggle with forming solid stool or controlling bowel urgency.
The symptoms described align with low anterior resection syndrome (LARS), typically associated with rectal surgeries but also observed after lower colon operations like sigmoidectomy. Management approaches include dietary adjustments to reduce inflammation, increasing soluble fiber intake to thicken stool consistency, transanal irrigation procedures, medications that slow intestinal movement, and physical therapy focused on pelvic floor rehabilitation—sometimes incorporating biofeedback techniques.
This multidisciplinary care often involves gastroenterologists or colorectal surgeons overseeing treatment plans that might include registered dietitians and physical therapists. Given how loss of bowel control can impact daily activities and social interactions—potentially leading to isolation—the importance of mental health support is emphasized alongside medical management.
Patients are encouraged to seek guidance from their healthcare providers regarding appropriate therapies and support options for improving quality of life following colorectal surgery.
Questions about post-surgical symptoms or related concerns can be directed via email or mail to UCLA Health Sciences Media Relations at 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA 90024.
