Diverticulosis/Divericulitis


Your diagnosis is diverticulosis. You may have been bothered for some time with abdominal cramps, gas, and diarrhea alternating with constipation. After waiting for this distress to "go away", you finally undergo a series of tests and are told that you have diverticular disease.

What Is It?

Diverticulosis, coming from the Latin word diverticulum, means a small pouch or a weak spot in the colon (large intestine) which yields to pressure from food or gas within the colon. Tiny pockets of the membrane lining of the colon are pushed out from the inside of the intestinal wall to form small sacs or pouches about the size of a rubber tip of a lead pencil.

Diverticula can develop anywhere in the digestive tract but they usually occur in the colon, predominantly in the narrowest part, the sigmoid region.

Is It A Rare Disease?

In persons under 35 it is unusual. But in persons over 40, it is very prevalent, one of the most common of the diseases of the colon. At least one-third of all Americans over 45 years of age, and more than two-thirds of those over 60 have diverticulosis.

How Serious A Disorder Is It?

While it can be uncomfortable and burdensome, diverticulosis is not usually a serious condition. However, it can lead to diverticulitis, in which the pouch perforates and becomes inflamed and infected. Occasionally, the pouches may erode into blood vessels and cause bleeding. Generally, perforation and/or bleeding of diverticulum can be controlled medically. Sometimes, hospitalization and surgical treatment are required to control these complications.

Fortunately, with medical supervision, the complications of diverticulosis can usually be avoided. The condition has no direct relationship to cancer.

What Causes It?

The precise cause of diverticulosis is obscure. The process of ageing and muscle shrinkage may weaken the wall of the colon, allowing the pouches to develop. In most case studies, an abnormal thickening of the muscle wall of the colon producing very high pressures inside the colon has been found and it is thought that this might predispose to the development of the pouches (diverticula).

While constipation has not been shown to be a causative factor, the regular use or abuse of potent laxatives, cathartics and purgatives to cleanse the bowels may be a contributing factor. Repeated trauma to the colon by these agents, instead of correcting the constipation, only makes it worse.

Probably the principal factor responsible for the high incidence of diverticulosis among Americans is a low fiber diet. Africans and Orientals living in rural areas who eat plenty of natural fiber or roughage, rarely get diverticulosis. With the technological revolution, our food is more and more highly refined and processed, and lacking in natural fiber. Fiber is a non-nutrient but it is essential for normal bowel function.

Fiber deficiency, a leading cause of constipation, results in small hard stools that do not fill out the colon. The colon then develops areas of spasm which force the pouches through the muscle wall.

Can A Diet High In Fiber Prevent This?

A high roughage diet will not prevent the development of diverticulosis but will help treat it once it is established. It will also help correct constipation.

How Does One Know He Has Diverticulosis?

Often, the patient doesn't know. Most people, even with widespread diverticulosis, have no symptoms. When there are symptoms, they usually include "gas", stomach cramps, pain and diarrhea alternating with constipation.

Aren't These Symptoms Common In Other Disorders?

Yes, including some serious diseases; that is why you went through all those tests. Before making a diagnosis of diverticulosis, we must first exclude all other serious causes of the symptoms. Barium enema, CT Scan and/or colonoscopy will confirm the diagnosis by distinguishing diverticulosis from other diseases of the colon with similar symptoms.

How Is It Treated?

Treatment of diverticulosis includes regulating the diet. The condition can usually be controlled by diet. The easiest way to do this is by eating bran cereal every day. Bran, the outer coating of whole wheat grain has a high percentage of dietary fiber. Pure bran, which has even a higher percentage of fiber than the bran cereals can be purchased in health food stores.

While pure bran is very dry, it has almost no taste of its own and can be mixed into cottage cheese, yogurt, spaghetti, hamburger and many other foods. It is not only high in fiber but it is also an excellent protein "stretcher".

Psyllium seed preparations (Metamucil, Citrucel, Fibercon, etc.) may be prescribed to supplement the fiber in your diet. Medications to reduce the muscular spasm in your colon may also be prescribed for a limited time.

Fresh fruits and vegetables are also high in roughage. In fact, there are no dietary restrictions - just make sure you get enough fiber.

How Long Should I Remain On A High Fiber Diet?

The fiber you put back into your normal diet will help to keep your digestive machinery operating at high gear. Gradually, the program will become a way of life for you. Most people who go on a high fiber diet experience such a dramatic improvement that they never revert to their old eating habits.

The only time to change this diet is in the event of the development of diverticulitis, with perforation of one of the pouches. Then, treatment with antibiotics and low residue diet is necessary. In some cases, when patients do not respond to these simple measures and complications develop, hospitalization and surgery may be required.

DIVERTICULITIS


What Are My Chances Of Developing Diverticulitis?

Only about 15% of patients with diverticulosis develop diverticulitis - and the percentage is even smaller for those under medical supervision on a high fiber diet. Only about 10% of patients with diverticulitis require surgery. With prompt treatment, the complications of diverticulitis can usually be controlled. So it is important to see your doctor at the first appearance of symptoms - severe abdominal pain and fever.

When the illness is controlled and the patient is able to leave the hospital, one should return to a high residue diet. If constipation occurs, do not return to the futile and harmful practice of subjecting the colon to cathartics. There are safer and more effective methods to overcome this problem.

General Information:

As people get older, small bulging pouches often form at weak points in the wall of the large bowel, (colon). Many people don't even know they have the problem because they have no symptoms. But when bodily wastes get trapped in these pouches, they may become inflamed and cause pain. This is known as diverticulitis. The exact cause of diverticulosis is unknown. It is more common in persons who don't eat enough bulky, high fiber foods.

Instructions:


  1. Applying heat to your abdomen may help relieve pain. Use an electric heating pad set on warm.
  2. Don't strain while having a bowel movement. Check your stool to make sure that it is not black or does not contain blood.
  3. Stay in bed if you have pain and fever. When you feel better, you may begin your normal activities again.
  4. If you have abdominal pain and a fever, take on]y clear liquids, such as ginger ale, juices, broth or gelatin.
  5. You may use medications for constipation that you can buy without a prescription. Take only as directed by your doctor.
    1. Stool sofleners make the stool softer and easier to pass. Follow the directions on the label.
  6. To help prevent attacks.
    1. Eat foods that are high in fiber. Good choices are whole grain breads, oatmeal or bran cereals, and plenty of vegetables and fruits.
    2. Drink plenty of water.
    3. Eat at regular hours.

Call If:


  1. You develop a temperature.
  2. You continue to have severe pain even with treatment.
  3. Your stool is black or contains blood.
  4. You have vomiting or swelling in your abdomen.
  5. You have any problems that may be related to the medicine you are taking.

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