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On Sunday evening, Pope Francis underwent surgery for a colon condition called “symptomatic stenotic diverticulitis.” The elective surgery, performed at the Gemelli hospital in Rome, took about three hours. Declaration by the Papal press office.

Francis, 84, is generally healthy and has been hospitalized for the first time since. become pope in 2013. He is alert and breathing on his own and is expected to stay in the hospital for seven days, according to a Vatican spokesperson.

Doctors said that for a man his age, the illness, surgery, and expected recovery were reasonable and should be able to make a full recovery.

Professor of surgery at Weill Cornell College of Medicine, Dr. “I was in the hospital for about seven days, a little surprised but not worried,” said Philip S. Barie. “Probably because he was very careful and the fact that he was 84 years old.”

What is diverticulitis?

Despite its daunting name, symptomatic stenotic diverticulitis is a relatively common and treatable disease.

It starts out as a mild condition called diverticulosis, which is essentially a collection of sacs in the colon wall, usually on the left side. Diverticulosis is extremely common: About two out of three people have pouches by the time they reach their 60s or 70s.

For most people, the bags do not cause any problems, except for occasional blood in the stool. But in about 10 percent to 15 percent of people with diverticulosis, the sacs become blocked and inflamed, which can drive patients to the emergency room.

This inflammation, called diverticulitis, is “incredibly common,” said Dr. David R. Flum, Professor of surgery at the University of Washington in Seattle.

Diverticulitis affects between 3 million and 5 million people each year in the United States alone and is usually treated with antibiotics alone. However, some severe cases may require surgery – which is not uncommon.

Dr. “Diverticulitis is one of the most common causes of colon surgery in the United States,” Flum said.

What causes diverticulitis?

Diverticulosis is believed to be the result of a Western diet low in fiber and high in processed foods. It is common in the United States and some countries such as Scotland, and much rarer in African countries, for example.

Dr. Barie recalled a senior United Nations official from Africa who had been assigned to New York for more than 20 years. Dr. Barie said the change in the man’s diet during this time was enough for him to “develop a disease he probably wouldn’t have developed if he stayed in his hometown.”

A low-fiber diet can cause constipation, especially when combined with not drinking enough water. Dr. “Stools get smaller, harder, and harder to pass, and so you have to create more pressure in your colon and squeeze harder to pass them,” Barie said.

The pressure causes the lining of the colon to come out. When food particles such as cucumber or tomato seeds get stuck in the bags, it can inflame the lining.

Each episode of diverticulitis can progressively scar and thicken the colon wall, eventually shrinking the passage about 90 percent from its typical width, narrowing it to just a quarter of an inch, the diameter of the #2 pencil.

If there is no movement, the patient may develop a large bowel obstruction requiring emergency surgery. But more often, people like Francis experience enough debilitating symptoms to consider elective surgery.

What are the symptoms of diverticulitis?

Diverticulosis causes few symptoms and may go unnoticed. Symptoms become evident in the case of inflammatory diverticulitis.

The range of symptoms varies depending on the severity of the stenosis and its location in the colon. If symptoms are bad enough, doctors may order a colonoscopy to identify the stenosis.

Dr. Barie said Francis may have experienced bloating or abdominal cramps and may have suffered enough to consider elective surgery.

Is surgery the only option?

In its milder stages, diverticulitis can be treated as an outpatient with oral antibiotics. More serious cases may require hospitalization and intravenous antibiotics.

Some severe cases can only be managed long-term with medical-grade fiber, probiotics to replace bacteria in the gut, and an aspirin-like drug that suppresses inflammation in the colon. Dr. flum lead a great trial will compare medical management with surgery. The start of the trial has been delayed by the pandemic, but is expected to be completed by 2025.

If a patient has had multiple episodes of diverticulitis, surgery often becomes the only option. Dr. “Once it gets to the point where it’s scarred and very narrow, we don’t have many medical options,” Flum said.

In surgeries like the one Francis likely had, doctors cut a section of the colon called the sigmoid colon, where diverticulitis is most common. They can take a few inches up to one foot of the column and sew up the cut ends.

What could recovery be like for Francis?

The Pope’s surgery was most likely performed using laparoscopy, which requires much less cutting than traditional methods. Still, one in five people who have this surgery can develop an infection, so Dr. “Preventing infection is an important thing,” Barie said.

For the first month, Francis can follow a low-residue diet designed to avoid large stools. She may then be advised to eat a high-fiber diet to prevent diverticulitis elsewhere in the colon – but this is unlikely at this age because it takes time to develop.

It’s also a good sign that he’s in good health overall. In 1957, he had the upper lobe of his lung removed due to complications from tuberculosis. And in recent years, it has seemed difficult for him to breathe during speeches. He had his cataract removed in 2019. In January, he was vaccinated against the coronavirus.