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

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Hello, Please refer me to a...
Hello,
Please refer me to a colorectal surgeon if there is one. Thank You
Submitted: 4 months ago.Category: Medical
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Answered in 9 hours by:
11/28/2017
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago
Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 58,762
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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Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

can I help?

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Customer reply replied 4 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 4 months ago
Note: The above 10-7-17 is a typo
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

How old are you?

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Customer reply replied 4 months ago
51 years old
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

So how many discrete episodes have you had?

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Customer reply replied 4 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?
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

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

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Customer reply replied 4 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 4 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
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

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 4 months ago
well its too late for that now, as I mentioned the latest ct scan showed the abscess is gone
Customer reply replied 4 months ago
yet I'm still being referred to a colorectal surgeon
Doctor: Dr. Phil, MD, Medical Doctor replied 4 months ago

Ok I misunderstood then

maybe because the plan makes so little sense!

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