Thursday, May 19, 2005

Diverticulitis: Info & Alternative Treatments


Info & Alternative Treatments

You should consult your Doctor if you are taking any medication.

Diverticulitis : High Fiber Diet for Diverticular Disease

A byproduct of our refined eating habits (04.07.98)

Originally published in Mayo Clinic Health Letter , March 1998

Pain in your abdomen. Nausea. Fever. You'd swear this was an attack of appendicitis - except the pain is on the wrong side.

Diverticulitis can feel like appendicitis and be just as serious. That's because the conditions involve similar problems - inflammation of a pocket on your large intestine (although with diverticulitis the pain is usually on the left side rather than the right, as with appendicitis).

As you get older, you're at increased risk for diverticulitis. But the good news is that you may be able to prevent the condition simply by eating a high-fiber diet.

Pressure problem

Your large intestine is a long cylinder of muscles designed to remove water from its contents while moving waste out of your body.

The first part of your large intestine - the cecum and ascending colon - is widest. Contents in this portion are mainly liquid. Next comes the transverse section, followed by the descending colon and sigmoid colon.

The sigmoid section connects to the rectum. By the time material reaches the sigmoid colon, much of the water has been removed and the material is mainly solid.

Diverticular disease develops when weak points in your colon's wall give way under pressure. Small pouches or pockets (diverticula) protrude through the colon wall. This is called diverticulosis.

Diverticula are most common in the sigmoid and descending sections of your large intestine, where more force is required to move stool out of your body.

When one of these pockets becomes inflamed or infected, you have diverticulitis - a painful and potentially serious problem that requires immediate medical care.

Nearly half of Americans older than 60 have diverticulosis. Fortunately, only 15 percent to 20 percent of people with diverticulosis ever develop diverticulitis. Research suggests that one reason older people are more likely to develop diverticula is that as you age, the outer wall of your large intestine thickens, and more pressure is required to move waste out of your body.

What's the cause?

Originally published in Mayo Clinic Health Letter , March 1998

No one can say for sure why or how diverticula become inflamed.

The most accepted explanation is that high pressure causes a tiny rupture in one of the pockets, allowing bacteria normally found in your colon to infect the tissue. That may lead to an abscess.

A commonly held myth is that eating grape seeds, popcorn or even tomatoes can lead to diverticulitis because the seeds may become lodged in one of the diverticula. While seeds aren't the cause, diet does appear to play a role.

Your chance of developing diverticular disease - which can escalate to diverticulitis - seems directly related to the amount of fiber you eat.

Diverticular disease is uncommon in parts of the world where fiber intake is high. It's more widely seen in Western societies where diets typically are lower in fiber and include more meats and refined grain products

When diverticulitis strikes

Diverticulitis can come on rather abruptly. First-time attacks may occur in your 40s or 50s.

Symptoms can vary. You may experience severe cramping and possibly tenderness, usually more so in the lower left side of your abdomen. Or, you may just have persistent mild abdominal pain. Symptoms also commonly include fever and nausea.

Diverticulitis can range from a minor inflammation on your colon to a massive infection or an intestinal wall perforation that requires immediate surgery. For that reason, see your doctor right away if you suspect you have diverticulitis.

Your doctor will likely examine your abdomen for tenderness and get a blood test to determine your white blood cell count (an indicator for infection). Treatment may range from a course of antibiotics at home to hospitalization.

If you undergo treatment at home, expect to remain quiet for a few days. In addition to taking antibiotics, you'll need to restrict your diet to low-fiber foods and avoid whole-grain products and all fruits and vegetables. That's so your colon can rest (reduce its contractions) and heal. Once you're better, you can gradually move toward a high-fiber diet.

Diverticulitis requires hospitalization about half the time. Your doctor may recommend this if there's concern about a possible bowel obstruction or if the risk for peritonitis (per-i-to-NI-tis) seems high. Peritonitis - an inflammation of the lining of your abdominal cavity - can occur when a diverticulum ruptures and allows intestinal contents into your abdomen. Peritonitis may require emergency surgery. Surgery may also be required if antibiotic treatment isn't effective.

Once the infection or inflammation is under control, your doctor may talk with you about elective surgery to prevent another bout of diverticulitis, particularly if you've had more than one episode. Surgery involves removing the portion of your large intestine affected by diverticula. That usually means removing some or all of the sigmoid colon to connect healthy segments.

Diverticulosis is the development of small pockets (diverticula) on your large intestine. When one of these pockets becomes inflamed or infected, you have diverticulitis.



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