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 high 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 bulging out to become diverticulae.
Diverticulitis occurs when diverticulae become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticulae. An attack of diverticulitis can develop suddenly and without warning.
Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating and constipation when they do occur. Other diseases such as irritable bowel syndrome (IBS) c cause similar problems, so these symptoms do not always mean a person has diverticulosis.
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.
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.
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 tablespoons, mixed with a glass 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 diverticulae 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 prevent recurrent Diverticulitis doctors at CDD now use 5ASA compounds long term with good success
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. Another method of aborting diverticulitis is to use standard pre-colonoscopy preparation such as Glycoprep or Picoprep. This has been shown in a trial to shorten diverticulitis considerably and prevent admission to hospital.