DIVERTICULOSIS & DIVERTICULITIS
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
and having this is called diverticulosis. When pouches become
infected or inflamed, the condition is diverticulitis.
Causes & Symptoms
Diverticular diseases common in developed or industrialised
countries, particularly the United States, England and Australia
where low fibre diets are common. The disease is in countries
of Asia and Africa, where people eat hight fibre vegetable
diets. Some fibres dissolves easily in water (soluble fibre).
It takes on a soft jelly-like texture in the intestines.
Some fibre passes almost unchanged through the intestines
(insoluble fibre). Both kinds of fibre help make stools
soft and easy to pass. Fibre 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.
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.
Diverticulitis
The most common symptoms 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 depend on the extent
of the infection and complications.
Diagnosis
To diagnose diverticular disease, the doctor asks about
medical history, does a physical exam, and may perform one
or more diagnostic tests. Because most people do not have
symptoms, diverticulosis is often through tests ordered
for another ailment.
When taking medical history, the doctor may ask about bowel
habits, symptoms, pain, diet and medications. the physical
exam usually involves a digital rectal exam. To perform
this test, the doctor inserts a gloved lubricated
finger into the rectum to detect tenderness, blockage or
blood. The doctor may check stool for signs of bleeding
and test blood for signs of infection.
Treatment
Increasing the amount of fibre in the diet may reduce symptoms
of diverticulosis and prevent complication such as diverticulitis.
Fibre keeps stool soft and lowers pressure inside the colon
so that the bowel contents can move through easily.
The doctor may also recommend taking a fibre product such
as Metamucil once a day. These products are mixed with water
and provide about 2 to 3.5 grams of fibre per tablespoon,
mixed with 8 ounces of water.
Until recently, many doctors suggested avoiding foods with
small seeds such as tomatoes or strawberries because they
believed that particles could lodge in the diverticula and
cause inflammation. However, this is now a controversial
point and no evidence supports this recommendation. Individuals
differ in the amounts and types of foods they can
eat. If cramps, bloating and constipation are problems,
the doctors may prescribe a short course of pain medication.
However, many medications affect emptying of the colon,
an undesirable side effect for people with diverticulosis.
Treatment for diverticulitis focuses on clearing up the
infection and inflammation, resting the colon and preventing
or minimizing complications. An attack of diverticulitis
without complications may respond to antibiotics within
a few days if treated early. To help the colon rest, the
doctor may recommend bed rest and a liquid diet, along with
a pain reliever.
An acute attack with severe pain or severe infection may
require a hospital stay. Most acute cases of diverticulitis
are treated with antibiotics and a liquid diet. The antibiotics
are given by injection into a vein. In some cases, however
surgery may be necessary.
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