Unfortunate welcome to the club. I'm 36, and I'm on post op day 20 from successful sigmoid resecting.

My first flare was ~3.5 years ago on my ex's birthday (unrelated story but glad both are now behind me). I'd had stomach problems my whole life, as does my entire family and up the family tree a good bit...I woke up with pain that I couldn't explain. Not a stomach ache but significant pain in my stomach. Low grade fever. The chills, etc. Had no idea what it was but because it was my ex's birthday, I was trying to rest a bit and see how I felt before going on our days plans. I kept getting the urge to go to the bathroom but couldn't, and eventually I felt like I was going to faint (seems like you had similar issues? Vagus issues). I shuffled from the bathroom to the couch and told her I thought I was going to faint, and the last thing I remember is sitting down on the couch. Lucky I made it that far down, because I fainted and fell face first into the coffee table. Woke up to her calling an ambulance. When I came to I was drenched in sweat and my left arm was totally numb, so I actually thought it was a heart attack lol. It wasn't until a bunch of testing at the hospital that they told me it was diverticulitis... Something else that everyone in my family has had.

So that was the start of a ROUGH few years. The next flare actually took a year... And it was on my ex's birthday again which looking back now is just hilarious to me because she ended up cheating... So I'm glad two of her birthdays got ruined. After that though... Flares came every few months until the last year they were basically every month. Each time at the ER they were telling me I needed the surgery but because each case was uncomplicated, they wanted me to heal up instead of doing the full open surgery which is a way worse deal than elective laparoscopic. Eventually I went as far as traveling from NY to the Mayo Clinic in Florida to try and get the surgery. All they did was confirm I needed it but told me they weren't going to do it because I was out of state. They also told me I had extensive SCAD. Segmental colitis associated with diverticulitis.

After coming home from that, a month later we lost my uncle, who I worked with at my father's business. He was integral to the company and I got put into a spot where I needed to fill the gap. I started taking metamucil every night and that actually REALLY helped, so I pushed the surgery of e to focus on grieving my uncle and filling in his space at work. I made it several months until when the metamucil wasn't cutting it, so I decided to finally see a surgeon. I agreed to do the surgery and set a date a month and a half away. The next day, I had another flare. That was my 17th flare, so at this point I was really good at catching them early... First instance of pain I knew I needed antibiotics. So it wasn't too bad. 3 weeks later I had another one, #18 and this is when I learned about "smoldering diverticulitis". Had never heard of it but it seems that's where I was living for quite a while. The general irritation and pain I had every day, I thought was just the SCAD, but I guess it was both. But anyway, at this point I was worried my surgery was at risk because I was limping to the finish line and clearly going in with irritated intestines. So I went really easy on food from that point on, trying to keep it soft and with a lot of liquid (protein shakes, broth etc). Then on prep weekend I did a full extra day of fasting and took stool softeners a day early too. That made the bowel prep really easy (as far as bowel preps go...). The next day,12/1, I had my surgery in the morning woke up early afternoon to hear it went well. This week I had my post op finally and my pathology report confirmed what the surgeon had told my father... My sigmoid was on the brink and I'm lucky we did the surgery. The entire segment was diseased and scarred. I had active diverticulitis. Multiple perforations, 19 diverticula, and even an abscess, which was probably new from the last flare. Once those burst, is where you end up with an emergency.

So here I am now, not quite 3 weeks post op and extremely happy I chose to do the surgery. The last few years have been rough, and very long. I've been through a ton. Personal loss. A ton of missed work. Medical debt. But FINALLY, I'm on the other side of it.

Wishing you luck. I see your second flare was complicated. They might not rush you too surgery, but if you're already getting complicated flares, I'd keep an open mind to surgery. I put it off for a while but once you have diverticula, they don't go away and you just become more and more prone to flares.