Diverticular disease surgery

An operation to remove the diseased part of the large bowel (usually the sigmoid colon) when diverticular disease causes serious or repeated problems that other treatments cannot control.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Surgery is for serious complications of diverticular disease, or for repeated severe attacks that affect quality of life — not for symptom-free pouches found by chance.
The usual operation removes the diseased part of the bowel; the ends are then rejoined or brought out as a stoma (which may be temporary or permanent).
It is major surgery with a real risk of complications, including a leak where the bowel is rejoined; emergency operations carry higher risks than planned ones.
Removing one segment does not remove every pouch or guarantee an end to all tummy symptoms — discuss realistic aims with a colorectal surgeon.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMajor bowel operation

AnaestheticGeneral anaesthetic

How long it takesOften around 2–4 hours, depending on complexity

Hospital stayUsually inpatient, often several days; longer after emergency surgery

Time off workCommonly 4–8 weeks or more before full activity

When you'll see resultsAim is to settle symptoms or treat a complication; recovery builds over weeks to months

On the NHS?Commonly done on the NHS, both planned and as an emergency, when clinically indicated

A general guide. Your surgeon will give you advice for your situation.

Best fit

Can treat or prevent a serious complication such as a burst bowel, abscess, fistula or blockage

Pause if

Your diverticula cause no symptoms or only mild ones that respond to diet and medical treatment — surgery is not usually advised.

Main recovery point

You are cared for on a ward, encouraged to drink, eat lightly and walk early. Pain is managed with regular relief. Your bowel may be slow to start...

Good aftercare

Clear written advice on wounds, diet, activity, lifting and when to drive and return to work.

First few days

You are cared for on a ward, encouraged to drink, eat lightly and walk early. Pain is managed with regular relief...

Around the time you go home (often several days)

You go home once you can eat and drink, your pain is controlled, you are passing wind or stool (or your stoma is...

Weeks 1–3

Energy slowly returns and pain settles. Walk a little and often, avoid heavy lifting, and build activity...

Weeks 3–6

Most people are doing more around the house and may return to light or part-time work, depending on the job. Avoid...

Medical line illustration of lower gi colonoscopy for Diverticular disease surgery. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is diverticular disease surgery?

Diverticula are small pouches that can form in the wall of the large bowel, most often in the lower left part called the sigmoid colon. Having these pouches is very common with age and usually causes no symptoms (diverticulosis). When the pouches cause tummy pain or a change in bowel habit it is called diverticular disease, and when one becomes inflamed or infected it is called diverticulitis.

Most people with diverticular disease never need an operation. Symptoms are usually managed with diet, fluids, fibre, pain relief and, for some infections, antibiotics. Surgery is considered when there is a serious complication — such as a burst (perforated) bowel, an abscess that will not settle, a connection forming to another organ (fistula), a narrowing that blocks the bowel (stricture), or repeated bleeding — or, much less often, after several severe attacks that badly affect a person's life.

The usual operation removes the affected segment of bowel (most often a sigmoid colectomy). The two healthy ends are then either rejoined (an anastomosis) or, if rejoining is not safe at that moment, one end is brought out onto the tummy wall as a stoma (colostomy) with a bag, which may be temporary or permanent. The choice depends on whether the surgery is planned or an emergency, how inflamed or infected the bowel is, and your overall health.

Surgery is a serious decision with real risks. It can remove or repair the diseased segment, but it cannot guarantee that all tummy symptoms will disappear, because the rest of the bowel still has pouches and other conditions (such as irritable bowel) can cause similar symptoms.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Elective (planned) sigmoid colectomy

A planned operation to remove the diseased sigmoid colon, usually with the two healthy ends rejoined in the same operation. Done when complications or repeated severe attacks justify surgery and you are well enough to prepare for it.

Keyhole (laparoscopic) resection

The bowel is removed through several small cuts using a camera and instruments, often with a slightly larger cut to take the specimen out. Where suitable it can mean less pain and a quicker recovery, but it is not always possible and may be converted to open surgery for safety.

Open resection

The bowel is removed through one larger cut in the tummy. Used when keyhole is not safe or possible — for example with heavy inflammation, scarring from previous surgery, or in some emergencies.

Hartmann's procedure

Often used in an emergency, such as a burst bowel. The diseased segment is removed, the lower end is closed off inside, and the upper end is brought out as a colostomy. A second operation to reverse the stoma may be possible later, but a sizeable proportion of people keep the stoma permanently.

Resection with a temporary protecting stoma

The bowel is rejoined, but a temporary stoma (often a loop ileostomy) is also formed to divert waste and protect the join while it heals. This is usually reversed by a later, smaller operation once healing is confirmed.

Drainage of an abscess

Not bowel surgery itself, but an abscess from diverticulitis can sometimes be drained with a needle or small tube guided by a scan. This can settle an infection and may allow any later operation to be planned rather than done as an emergency.

Planned vs emergency surgery

Planned	Emergency
Time to prepare and optimise health	Done urgently when unwell
Bowel often rejoined in one operation	Stoma more likely (e.g. Hartmann's)
Lower complication and death risk	Higher complication and death risk
Keyhole more often possible	Open surgery more likely
You can discuss options fully	Decisions made quickly to keep you safe

Wherever possible, surgery is planned so risks are lower and the bowel can often be rejoined. Emergency surgery for a burst bowel or severe infection carries higher risks and more often needs a stoma.

Preparing for your surgery

See a colorectal surgeon to confirm the diagnosis with scans (often a CT scan) and to agree that surgery is the right step for you.
Discuss honestly what the operation can and cannot achieve, the chance of needing a stoma, and whether any stoma might be temporary or permanent.
Ask to meet a stoma care nurse beforehand if a stoma is possible, so a site can be marked and you know what to expect.
Tell the team about all medicines, especially blood thinners, and about diabetes, heart or chest problems that may need managing first.
Stop smoking as early as you can, as it raises the risk of chest, wound and healing problems.
Follow instructions on eating, drinking and any bowel preparation before the operation.
Arrange time off work (often several weeks), help at home, and a lift, as you should not drive for a period afterwards.
Ask about an enhanced recovery programme, which uses early eating, drinking and walking to help you recover.

What happens

The operation is done under general anaesthetic, so you are asleep. The surgeon removes the diseased segment of bowel, most often the sigmoid colon, either through several small cuts (keyhole) or one larger cut (open). The amount removed and the approach depend on how much bowel is affected and how inflamed or scarred it is.

The two healthy ends are then either joined back together (an anastomosis) or, if joining is not safe at that moment, one end is brought out as a stoma onto the tummy wall. Sometimes the bowel is joined but a temporary stoma is added to protect the join while it heals.

Afterwards you are looked after on a ward, sometimes initially in a higher-care area after a big or emergency operation. You will be encouraged to drink, eat and walk early. Tubes or drains may be used for a short time. Most people stay in hospital for several days; emergency operations and any complications can mean longer.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Your diverticula cause no symptoms or only mild ones that respond to diet and medical treatment — surgery is not usually advised.
Your symptoms are more likely due to another condition, such as irritable bowel syndrome, so removing bowel may not help.
You are not currently fit enough for major surgery and a general anaesthetic until other health problems are managed.
An abscess or acute infection might first be treated with antibiotics or drainage so that any operation can be planned rather than done as an emergency.

Delay surgery if…

You have an active infection elsewhere or are acutely unwell and could be stabilised first.
Your blood-thinning medicine cannot yet be safely managed around surgery.
You have poorly controlled diabetes, heart or lung disease that needs optimising.
Recent imaging or a colonoscopy to exclude other diagnoses (such as cancer) has not yet been done where advised.
You have not yet had time to discuss stoma possibilities or to be seen by a stoma nurse, where a stoma is likely.

Alternatives to discuss

Continued medical management with diet, fibre, fluids, pain relief and antibiotics for infections, for many people.
Image-guided drainage of an abscess, which can settle infection without immediate bowel surgery.
Watchful waiting after recovery from an attack, reviewing the need for surgery over time.
Treating other causes of symptoms (such as irritable bowel) where these are contributing.
The NHS pathway rather than private care if speed is not the priority.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

You are fully asleep. This is standard for bowel resection, whether keyhole or open.

Epidural or spinal pain relief

An epidural or other regional technique is sometimes added alongside the general anaesthetic to help control pain after the operation.

Benefits

Can treat or prevent a serious complication such as a burst bowel, abscess, fistula or blockage
Removes the most affected segment of bowel, which can reduce or stop repeated severe attacks
May improve quality of life for people whose attacks have been frequent and disabling
Allows a tissue sample to be examined, which can help rule out other conditions such as cancer
Where the bowel is rejoined, many people return to normal bowel function over time

Risks & complications

More common

Pain, tiredness and a reduced appetite for some weeks after major surgery
A temporary change in bowel habit, including looser or more frequent stools while the bowel settles
Wound discomfort and bruising
A slow return of bowel movement after surgery (the bowel can be sluggish for a few days)

Less common

Wound infection or a collection of fluid or pus inside the tummy
Bleeding needing treatment or, rarely, a transfusion
Needing to convert from keyhole to open surgery during the operation
Needing a stoma when one was not planned, or keeping a stoma longer than hoped
Blood clots in the legs or lungs

Rare but serious

A leak where the bowel was rejoined (anastomotic leak), which can be serious and may need a further operation and a stoma
Injury to nearby organs such as the bladder, ureter, blood vessels or other bowel
A serious chest or heart problem around the time of surgery
Serious problems related to the general anaesthetic
Death, which is uncommon for planned surgery but a real and higher risk in emergency operations

The most serious specific risk is a leak where the bowel is rejoined, which can need urgent treatment and a stoma. Risk is higher for emergency surgery, severe infection, older age and other health problems. Ask your surgeon how often they do this operation, whether keyhole is suitable for you, how likely you are to need a stoma and whether it would be temporary or permanent, and what they would do if a leak occurred.

Published figures to discuss

Risk depends heavily on whether surgery is planned or an emergency, on the degree of inflammation and infection, on age and on other health problems. Emergency operations carry substantially higher complication and death rates than planned ones. The figures below are cautious estimates from surgical literature and registries, not guarantees for any one person, and surgeons should give you figures relevant to your situation.

Figure	Reported range	How to interpret it	Source / confidence
Leak where the bowel is rejoined (anastomotic leak)	Reported around 2–3% in large series of elective sigmoid colectomy for diverticular disease; higher in emergency or high-risk surgery	Can be serious and may need a further operation and a stoma. Risk is higher with infection, urgent surgery and other illness.	Hartmann's procedure, reversal and rate of stoma-free survival — Ann R Coll Surg Engl (PMC)pmc.ncbi.nlm.nih.govPublished figure
Permanent stoma after Hartmann's procedure	Large proportion: one Hartmann's series reported only 46% stoma-free at the end of follow-up	Whether a stoma is reversed depends on health, the original reason for surgery and the risks of a second operation.	Hartmann's procedure, reversal and rate of stoma-free survival — Ann R Coll Surg Engl (PMC)pmc.ncbi.nlm.nih.govPublished figure
Conversion from keyhole to open surgery	About 13% in one elective-only diverticulitis cohort and 16.5% overall in a multicentre laparoscopic colectomy cohort; older/smaller series vary more widely	A safety decision, not a failure. Ask your surgeon how likely this is for you.	Hartmann's procedure, reversal and rate of stoma-free survival — Ann R Coll Surg Engl (PMC)pmc.ncbi.nlm.nih.govPublished figure
Reoperation after elective surgery	Reported around 3% in a nationwide cohort, falling in more recent years	Most often for a leak, bleeding or infection. Figures vary between units and over time.	Hartmann's procedure, reversal and rate of stoma-free survival — Ann R Coll Surg Engl (PMC)pmc.ncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

This is major surgery, so recovery takes weeks, not days. Many people feel much better within a few weeks but take a couple of months to feel fully back to normal, and longer after emergency surgery or complications.

First few days

You are cared for on a ward, encouraged to drink, eat lightly and walk early. Pain is managed with regular relief. Your bowel may be slow to start working; this is normal at first.

Around the time you go home (often several days)

You go home once you can eat and drink, your pain is controlled, you are passing wind or stool (or your stoma is working) and you can move safely. You will be given wound, diet and activity advice.

Weeks 1–3

Energy slowly returns and pain settles. Walk a little and often, avoid heavy lifting, and build activity gradually. Bowel habit is often unsettled while things heal.

Weeks 3–6

Most people are doing more around the house and may return to light or part-time work, depending on the job. Avoid heavy lifting and strenuous activity until your surgeon agrees.

Beyond 6 weeks

Many people are back to most normal activities by 6–8 weeks, though full recovery of energy and bowel habit can take a few months. Heavy or physical jobs and exercise are built up gradually.

What's normal — and not a worry

Tiredness and a smaller appetite for several weeks
Looser, more frequent or unpredictable bowel motions that usually settle over weeks to months
Some soreness and numbness around the wounds
Trapped wind and bloating in the first days, easing as the bowel wakes up
Learning to manage a stoma if you have one, with help from a stoma nurse

Aftercare

Take pain relief as advised and reduce it as the pain settles.
Keep wounds clean and dry and follow advice on showering and dressings.
Walk a little and often to aid recovery and lower the risk of clots.
Build up to a normal, balanced diet and keep well hydrated; ask for dietitian or stoma-nurse advice if needed.
Avoid heavy lifting and strenuous activity for the period your surgeon advises, to reduce the risk of a hernia at the wound.
Do not drive until you can perform an emergency stop comfortably and your insurer agrees.
If you have a stoma, follow the stoma nurse's advice and know who to contact for problems.
Watch for warning signs such as worsening pain, fever or wound problems, and keep your follow-up appointments.

Before-surgery checklist

Pain relief in stock and a plan for taking it
Loose, comfortable clothing that does not press on wounds or a stoma
Easy, balanced meals and plenty of fluids ready at home
Help arranged for shopping, lifting and chores for a few weeks
Stoma supplies and the stoma nurse's contact details, if relevant
Time off work booked (often several weeks)
Someone to drive you home and stay for the first day or two
The clinic's contact number and a list of warning signs saved

Scars and how they heal

Keyhole surgery leaves several small scars plus, usually, one slightly larger scar where the bowel is removed. Open surgery leaves a longer scar down or across the tummy. If you have a stoma, there is a separate small wound where it sits, and a further scar later if it is reversed. Scars are pink and firm at first and fade over months; the wound area can stay numb for a while.

⚠ Get urgent help if…

Severe or worsening tummy pain, or a hard, swollen, very tender tummy
A high temperature, shivering or feeling very unwell (possible infection or leak)
Spreading redness, heat, swelling or discharge from a wound
Persistent vomiting, or being unable to eat, drink or pass wind or stool
Heavy or fresh bleeding from the back passage or a wound
A swollen, hot or painful calf, or breathlessness or chest pain (possible clot — call 999)
A stoma that stops working, turns dark, bleeds heavily or pulls in

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means the complication has been treated or the diseased segment removed, the wounds and any join heal well, and bowel function gradually settles. Where the bowel is rejoined, many people return to a near-normal bowel habit over weeks to months, though some notice lasting changes such as looser or more frequent motions.

Surgery cannot promise that every tummy symptom will go, because the rest of the bowel still contains pouches and other conditions can cause similar symptoms. A careful surgeon checks that surgery is likely to help your particular problem, and is honest that the main aim is often to treat or prevent a complication rather than to cure all symptoms.

How long it lasts

Removing the most affected segment can greatly reduce the chance of further severe attacks in that area, but diverticula can still be present elsewhere in the bowel and new symptoms can occasionally occur. A further operation specifically for diverticular disease is uncommon after a planned resection, but is not impossible. Keeping a good fibre intake, staying hydrated and not smoking support long-term bowel health.

Combining with other procedures

Surgery for diverticular disease is sometimes combined with repair of a related problem found at operation, such as a fistula to the bladder or vagina. It is not usually combined with unrelated procedures, and you should be cautious about add-on operations you did not come for. If a stoma is formed, a separate planned operation may later be needed to reverse it.

Follow-up & long-term care

You will usually be reviewed after the operation to check healing, discuss the results of any tissue examined, and plan reversal of a stoma if one was formed. You should be told who to contact for wound problems, pain, fever or stoma difficulties, and have a clear route back to the team if symptoms persist or a complication develops.

Build activity and lifting back up gradually to reduce the risk of a hernia at the wound.
Eat a balanced diet with adequate fibre and fluids once recovered, as advised by your team.
If you have a stoma, keep regular contact with the stoma care service and attend planned reviews.
Seek review if you develop new or worsening tummy pain, bleeding, or a marked change in bowel habit.
Stop smoking and keep to a healthy weight to support healing and bowel health.

Revision and secondary surgery reality

If the bowel was brought out as a stoma, a separate planned operation may be needed later to reverse it, and reversal is not always possible or advisable.
A leak or infection may need a return to theatre, drainage or a stoma that was not originally planned.
A small number of people develop a narrowing at the join or a hernia at the wound, which can need further treatment.
Surgery removes one segment but does not remove every pouch, so new symptoms can occasionally arise elsewhere.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear written advice on wounds, diet, activity, lifting and when to drive and return to work.
Specific warning signs (worsening pain, fever, wound problems, stoma trouble) and what to do.
A named contact and out-of-hours number, plus stoma nurse support where relevant.
Explanation of any tissue results and a clear plan for any later stoma reversal.
A defined route back to the surgical team for complications or persistent symptoms.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether the operation is planned or an emergency (emergency care is usually NHS-led)
Surgeon's and anaesthetist's fees
Theatre/facility time and the length of hospital stay, including any high-dependency or intensive care
Whether surgery is keyhole or open, and the complexity of the disease
Whether a stoma is formed, including stoma supplies and stoma nurse support
Any later operation to reverse a stoma
Follow-up, imaging, tissue examination and the policy if a complication occurs

Make sure your written quote includes

The surgeon's fee and the anaesthetist's fee
The hospital/facility and theatre fee, and expected length of stay
Whether higher-care (HDU/ICU) costs are covered if needed
Stoma supplies and stoma nurse support, if a stoma is likely
Whether a later stoma-reversal operation is covered
Follow-up appointments, imaging and examination of any tissue removed
The cancellation policy and what happens, and who pays, if a complication such as a leak occurs

On the NHS? Surgery for diverticular disease is widely available on the NHS, both as planned and emergency surgery, when it is clinically indicated; private care is sometimes chosen for speed or choice of surgeon.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Why do you recommend surgery for me now rather than continuing other treatment?
How likely am I to need a stoma, and would it be temporary or permanent?
Is keyhole surgery suitable for me, and how likely is conversion to open surgery?
How often do you do this operation, and what is your approach if the bowel is very inflamed?
What would you do if the join leaked, and how would I know?
What realistic change in my symptoms and bowel habit should I expect afterwards?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Will I definitely need a stoma (bag)?

Not always. In planned surgery the bowel can often be rejoined without a stoma. A stoma is more likely in an emergency, when the bowel is very inflamed or infected, or when the surgeon judges that joining is not safe at that moment. Any stoma may be temporary or permanent — ask your surgeon what is likely in your case.

Can this be done on the NHS?

Yes. Surgery for diverticular disease, both planned and emergency, is commonly done on the NHS when it is clinically needed. Private care may be chosen for speed or choice of surgeon, but emergencies are managed wherever you present.

Do I need surgery just because I keep getting diverticulitis?

Not necessarily. Many people manage repeated mild attacks without surgery. An operation is usually reserved for complications or for attacks that are frequent and severe enough to badly affect your life. The decision should be shared with a colorectal surgeon.

Is keyhole surgery always possible?

No. Keyhole (laparoscopic) surgery suits many planned cases and can mean a quicker recovery, but it is not always safe or possible — for example with heavy inflammation, scarring or in some emergencies. A keyhole operation may also be converted to open surgery for safety, which is a sensible decision, not a failure.

How long until I am back to normal?

Many people are back to most everyday activities by around 6–8 weeks, with energy and bowel habit settling over a few months. Recovery is slower after emergency surgery, open surgery or if a complication occurs.

Will surgery cure all my tummy symptoms?

Not always. It can treat a complication and reduce severe attacks, but the rest of the bowel still has pouches and other conditions (such as irritable bowel) can cause similar symptoms. Be wary of any promise that surgery will end every symptom.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Diverticular disease and diverticulitis NICE NG147 — Diverticular disease: diagnosis and management NICE CKS — Diverticular disease ACPGBI Position Statement on Elective Resection for Diverticulitis (PDF) Hartmann's procedure, reversal and rate of stoma-free survival — Ann R Coll Surg Engl (PMC) Reoperation and mortality after elective surgery for chronic/recurrent diverticular disease — nationwide cohort (PMC) NHS — Colostomy Conversion after elective laparoscopic colectomy for diverticulitis — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.