Hi. Our friend was diagnosed with this and was very miserable. He is scheduled for surgery in February for it. My husband had a mild case and he got antibiotics. He also was very miserable but he over reacts when sick so it's hard to say. lol Just being honest there. But you are probably quite uncomfortable.
That's not really helpful but just other's experience. I think Chin_C has advised you very well to follow up as soon as possible. I'm sure you are very scared. That this could be a malignant situation is frightening. But you need to know in order to begin treatment.
They are proposing surgery?
By doctor, I meant you should see a GI surgeon, not PCP.
Patients with uncomplicated diverticulitis without perforation can be treated with oral antibiotics. On the other hand, patients with complicated diverticulitis with perforation are usually sent to the hospital for intravenous antibiotics, drainage of abscess, etc. Surgery may be considered if there are complications, such as abscess, fistula, or obstruction. Surgery may also be considered if a patient has multiple episodes of uncomplicated diverticulitis.
Bowel wall thickening can be caused by infection, inflammation, or cancer. Because bowel thickening/fat stranding in diverticulitis can mask other pathology, lower endoscopy is typically performed after resolution of the acute process to rule out underlying cancer. In your case, it sounds like sigmoidoscopy was performed but was indeterminate/inconclusive.
Lymph nodes can be reactive or metastatic in etiology. For example, if you had sigmoid diverticulitis, you may have tiny lymph nodes around the sigmoid colon. However, it is uncommon to have presacral/perirectal lymph nodes, as lymph nodes are not typically seen in this region, even small ones. This is why the MRI report suggested possible metastasis.
Taking everything into account, having persistent bowel wall thickening, having indeterminate/inconclusive endoscopy, and having a lymph node in a place where you should not have a lymph node, your situation is suspicious for cancer. You should have a frank discussion with your doctor and weigh pros, cons, and alternatives of treatment options.