Ditching Diverticulosis and Diverticulitis
You have a pain in your abdomen. It is hard to pass a stool, it comes out dry. Great force is needed to propel it along its way. You could have diverticulosis or diverticulitis.
Diverticulosis is a common condition in countries where people have grown used to refined grains in their diet.
Discarding the outer covering of grains—the bran—deprives us of nature’s best laxative: fiber. Without fiber, the residue of undigested food dries up in its passage through the intestinal tract.
Diverticulosis is a colon with many diverticula. Diverticula are grape-sized bulges of the intestinal lining that protrude through its muscle walls. Fiber can hold water in undigested food, keeping it soft and easily eliminated, and preventing diverticula.
By the age of 50, half of us have diverticulosis. However, if diverticula becomes inflamed then diverticulosis becomes diverticulitis, which is often painful and could require hospitalization. Although, most people with diverticulosis do not progress to diverticulitis. In fact, less than 5 percent of people with diverticulosis develop diverticulitis.
The reason why diverticulosis is so prevalent in our society is our overly refined diet. The fiber that is removed from grains has a dietary purpose. It keeps waste material moist in its passage through the colon. To propel dry, rock hard waste, the colon has to generate great force and that force is responsible for the colon lining’s herniation through the colon wall. Diverticulosis rarely creates problems.
Diverticulitis is inflammation of the diverticula due to plugging where they open into the colon. When that happens, bacteria in the diverticula multiply, distend the diverticula and cause abdominal pain, often felt in the lower left section of the abdomen. Diarrhea or constipation also occurs. Severe pain lands people in the hospital, where intravenous feedings allow them to rest their colons and intravenous antibiotics can eradicate the bacteria.
Most people with diverticulosis never know they have it. For the remainder, diverticulosis can turn into diverticulitis. And therein lies the big trouble.
With diverticulitis, the openings of the diverticula have been plugged up. That, in turn, interferes with their blood supply. The diverticula become inflamed.
But the mildest end of the spectrum of diverticular disease is diverticulosis. Diverticulosis is simply a collection of outpouchings or diverticula in the wall of the colon. Aside from being an occasional source of blood in the stool, diverticulosis usually doesn’t cause any symptoms.
Diverticulitis—the suffix “itis” indicates inflammation—typically occurs when a diverticulum becomes blocked by a piece of hard stool, called a fecalith. This localized blockage leads to bacterial overgrowth, followed by inflammation, infection and abscess formation. At the most severe end of the spectrum, the abscess could rupture and stool may enter the abdominal cavity, which may result in sepsis, a dangerous blood infection.
But severe disease is not the norm. Most people with diverticulosis don’t progress to diverticulitis.
Even among those who do develop diverticulitis, most recover uneventfully, typically after seven to 10 days of oral antibiotics. And fewer than one in five experience a reoccurrence.
Complications tend to arise in people who have suppressed immune systems or have other serious conditions, such as kidney failure. They will likely require more aggressive treatment and will be at a higher risk for reoccurrences.
In some instances, an undetected medical problem may cause a reoccurrence of diverticulitis. For this reason, the American Gastroenterological Association recommends that a colonoscopy be performed after the resolution of diverticulitis, unless a colonoscopy was performed recently.
Prevention and treatment involves increasing the amount of fiber in our diet. Diverticulosis patients need to get in the habit of eating whole-bran grains, cereals and breads. Fruits with their skins are another source of fiber. So are vegetables. Beans contain lots of fiber. Patients can also add bran to their food—sprinkling on cereals and adding it to recipes.
