DIVERTICULITIS - DIVERTICULOSIS
Many people have small pouches in their colons that
bulge outward through weak spots, like an inner tube that pokes
through weak places in a tire. Each pouch is called a diverticulum.
Pouches (plural) are called diverticula. The condition of having
diverticula is called diverticulosis.
When the pouches become infected or inflamed, the condition
is called diverticulitis. This happens in 10 to 25 percent of
people with diverticulosis. About half of all Americans
age 60 to 80, and almost everyone over age 80, have diverticulosis.
What Causes Diverticular Disease?
Though not proven, the dominant theory is that a low-fiber diet is the main cause of diverticular disease. The disease was first noticed in the United States in the early 1900s. At about the same time, processed foods were introduced to the American diet. Many processed foods contain refined, low-fiber flour. Unlike whole-wheat flour, refined flour has no wheat bran.
Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Some fiber dissolves easily in water (soluble fiber). It takes on a soft, jelly-like texture in the intestines. Some fiber passes almost unchanged through the intestines (insoluble fiber). Both kinds of fiber help make stools soft and easy to pass. Fiber also prevents constipation.
Constipation makes the muscles strain to move stool that is
too hard. It is the main cause of increased pressure in the
colon. The excess pressure might be the cause of the weak spots
in the colon that bulge out and become diverticula.
Diverticulitis occurs when diverticula become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning.
What are the Symptoms of Diverticular Disease?
Diverticulosis
Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other diseases such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis. You should visit your doctor if you have these troubling symptoms.
Diverticulitis
The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.
What is the Treatment for Diverticular Disease?
A high-fiber diet and, occasionally, mild pain medications will help relieve symptoms in most cases. Sometimes an attack of diverticulitis is serious enough to require a hospital stay and possibly surgery.
Increasing the amount of fiber in the diet may reduce symptoms
of diverticulosis and prevent complications such as diverticulitis.
Fiber keeps stool soft and lowers pressure inside the colon
so that bowel contents can move through easily. The American
Dietetic Association recommends 20 to 35 grams of fiber each
day.
When is surgery necessary?
If attacks are severe or frequent, the doctor may advise surgery. The surgeon removes the affected part of the colon and joins the remaining sections. This type of surgery, called colon resection, aims to keep attacks from coming back and to prevent complications. The doctor may also recommend surgery for complications of a fistula or intestinal obstruction.
If antibiotics do not correct an attack, emergency surgery may be required. Other reasons for emergency surgery include a large abscess, perforation, peritonitis, or continued bleeding.
Emergency surgery usually involves two operations. The first surgery
will clear the infected abdominal cavity and remove part of the
colon. Because of infection and sometimes obstruction, it is not
safe to rejoin the colon during the first operation. Instead, the
surgeon creates a temporary hole, or stoma, in the abdomen. The
end of the colon is connected to the hole, a procedure called a
colostomy, to allow normal eating and bowel movements. The stool
goes into a bag attached to the opening in the abdomen. In the second
operation, the surgeon rejoins the ends of the colon.
Points to Remember
- Diverticulosis occurs when small pouches, called diverticula, bulge outward through weak spots in the colon (large intestine).
- The pouches form when pressure inside the colon builds, usually because of constipation.
- Most people with diverticulosis never have any discomfort or symptoms.
- The most likely cause of diverticulosis is a low-fiber diet because it increases constipation and pressure inside the colon.
- For most people with diverticulosis, eating a high-fiber diet is the only treatment needed.
- You can increase your fiber intake by eating these foods: whole
grain breads and cereals; fruit like apples and peaches; vegetables
like broccoli, cabbage, spinach, carrots, asparagus, and squash; and
starchy vegetables like kidney beans and lima beans.
- Diverticulitis occurs when the pouches become infected or inflamed and cause pain and tenderness around the left side of the lower abdomen.
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