My mother is 66 years old. She has been diagnosed with diverticular disease, and she's also diabetic. She has had a couple of episodes of diverticulitis and has had to go on a liquid diet along with antibiotics. My mom insists her doctor won't do surgery on her diverticulitis because she is diabetic. But I think she might have misunderstood what the doctor has told her. What are your thoughts?

S.P.

Most Americans over age 60 have small pouches, called diverticula, in the wall of the colon. The presence of these pouches is called diverticulosis. Diverticula usually cause no symptoms. In some patients, they may cause spasms in the colon and abdominal cramps. In a small minority of people, they may cause bleeding, infection and inflammation (diverticulitis), leading to abdominal pain, fever and change in bowel habits.

Most cases of diverticulitis can be treated with antibiotics, and healing soon occurs. However, in some cases hospitalization is needed. Also, an abscess may form in the abdomen, requiring urgent surgery to remove the part of the colon that is causing the infection.

In cases of recurrent diverticulitis, elective surgery is often recommended to remove the segment of colon that contains the diverticula in order to prevent more episodes. Diabetes may make such surgery (and all other types of operations) slightly more risky. However, if the chance of suffering further attacks of diverticulitis is high, your mother and her doctor must weigh the benefits of surgery versus the risks of waiting. It is also best to get diabetes under good control before any elective surgery. Further discussion about all the various options with both a gastroenterologist and a surgeon should help clear up confusion in your mother's case.