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Please refer me to a colorectal surgeon if there is one.

Hello, Please refer me to a...
Hello,
Please refer me to a colorectal surgeon if there is one. Thank You
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Answered in 9 hours by:
11/28/2017
Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 59,714
Experience: Medical Doctor Trained at a Top Academic Institution
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Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

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can I help?

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Customer reply replied 7 months ago
Hello, I have to leave so will have to follow up later. I am wondering if my condition, which has improved, would necessitate resection surgery to remove diverticulitis with prior abscess.9-20-17 - low grade fever no appetite, pelvic pain. Seen at Urgent care prescribed 5 day prednisone+cipro (eating all foods)
10-5-17 - symptoms improved not gone - prescribed 7 day cipro+ 10 day flagyl both 500mg x2 (still eating all types of foods)
11-1-17 - admitted to ER due to right side pain at night in ascending colon - 1.5 cm x 1.1cm diverticulitis abcess found near sigmoid. left ER with more oral cipro+flagyl (7 days) bacteria seem resistant to cipro+flagyl
11-9-17 PCP prescribes augmentin500+flagyl both 10 days 500mg x 3. (diet changed to soft foods)
11-18-17 symptoms improved pain level on scale of 1 to 10 averaging about 1
11-20-17 follow up ct w/contrast shows abscess gone but mild wall thickening with inflamed appearing diverticula within the proximal sigmoid (diet soft foods)
11-23 to current: symptoms still improved with soft diet10-7-17 - symptoms improved more but not gone - prescribed 10 day augmentin+flagyl both 500mg x3
Customer reply replied 7 months ago
Note: The above 10-7-17 is a typo

How old are you?

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Customer reply replied 7 months ago
51 years old

So how many discrete episodes have you had?

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Customer reply replied 7 months ago
There has been only 1 episode of fever, with moderate pelvic pain & no appetite on 9/20/17. We have no idea what size the abscess was at that time, but we know it was 1.5 x 1.1 cm on 11/1/17 after the 2 rounds of antibiotics which the pathogen became, or was already resistant to. The subsequent higher dosage of flagyl 1500 mg/day, combined with the augmentin500 1500 mg/day was more effective. There still exists some inflammation. Is there a way to reduce the risk of the abscess returning, and shrink the diverticuli pocket other than surgery & eating fiber?

are they suggesting removal of the abscess or part of the colon?

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Customer reply replied 7 months ago
I had one doctor refer me to a colo rectal surgeon who i cant see (out of network) mentioning a resection (remove the section of colon with diverticulitis) by robotics and to follow up with colonoscopy after surgery
Customer reply replied 7 months ago
He said if I don't do it there's a good risk of perforation leading to my having to wear a bag. I have no idea why he thinks a reinfection would lead to perforation

I don't agree with this at all

If it were me, I would have interventional radiology drain the abscess and stay on antibiotics

then do a scope

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Customer reply replied 7 months ago
well its too late for that now, as I mentioned the latest ct scan showed the abscess is gone
Customer reply replied 7 months ago
yet I'm still being referred to a colorectal surgeon

Ok I misunderstood then

maybe because the plan makes so little sense!

Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 59,714
Experience: Medical Doctor Trained at a Top Academic Institution
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Dr. Phil, MD and 87 other Medical Specialists are ready to help you
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Customer reply replied 2 months ago
Hello, I'm still having issues with colon. I've taken antibiotics several times since we last spoke for what i assumed was diverticulitis flaring up. The symptoms usually start with stabbing chest pain followed by brain fog/dizziness and some colon pain. I took antibiotics i while out of town and ran out after 4 days but felt better for around 3 weeks then felt miserable again so restarted around 5/1 however, this time they didnt seem to work, and when i switched from cipro/flagyl to augmentin/flagil I got extremely sick with colon pains in new areas, and extreme dizzy/brain fog. Went to ER blood/temp/urine/ct all negative, however i understand this infection doesn't always show these signs. How can I tell if this is Dysbiosis or bacterial resistance to antibiotics?

Did they drain it and do a scope?

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Customer reply replied 2 months ago
The one, and only abscess was last year resolved with oral cipro/flagyl/augment. A follow up CT showed the abscess was gone. I've not had a scope due to being out of town, and frequent flares (GI doc won't do scope until 6 weeks after antibiotics finished/inflammation cleared) I've not had 6 consecutive weeks symptom free, presumably because diet has been incorrect. Also maybe these "flare ups" (extreme fatigue/dizziness) are something else such as excess bile production by gall bladder (my endoscopy revealed gastric erosions last Sept.) There's never a fever, blood & urine always normal. Last Thursday I had increasing pain in the sigmoid area while on the 10th day of antibiotics, but also pains in several areas of colon which is abnormal. This is the first time I've had pains around colon area at the end of a course of antibiotics. I've had no diarrhea so it can't be Dysbiosis related correct?
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