This painful intestinal condition is widely believed to the 'lifesytle-related', the unhappy result of too little fibre in your diet. Most cases can be treated with medication and rest, and future flare-ups, prevented by making healthier lifestyle choices.
If your diet is heavy in highly refined processed foods and light in fruit, vegies and whole grains, you're missing a vital ingredient for a healthy colon: fibre, the indigestible part of food. Without fibre--a natural stool softener-constipation is often the order of the day, causing pressure to build up inside your colon (large intestine). Over time, the colon walls weaken and a lot of little pouches, called diverticula, start bulging out like weak spots in an inner tube (see illustration); This is called diverticulosis; it's quite common, occurring in about a third of Australian and New Zealanders over age 50 and in 50 percent of those between ages 60 and 80. Diverticulosis rarely causes problems; infact, most people don't even know they have it unless it's found during testing for another ailment.
Diverticulosis can become serious, however, if food particles get trapped in the pouches and bacteria build up. The inflammation and infection that results is the basis of a condition called diverticulitis. Characterised by an intense abdonimal pain that's hard to ignore, diverticulitis often comes on suddenly, producing tenderness in your lower left abdomen. The infection may also give you a high temperature, chills, vomiting, cramping and constipation.
Although diverticulitis is simple to treat, in rare cases people develop complications. In the most severe cases, diverticula become filled with pus and develop into abscesses. Sometimes these will perforate, allowing the infected pus to leak into your abdominal cavity. This is called peritonitis, a life-threatening condition requiring emergency surgery. An infection that spreads outside your colon can also lead to another problem, a fistula, which occurs when the tissue of one organ--in this instance, your colon--sticks to another organ, and the infection burrows into it. With diverticulitis, the other organ is often the bladder and the result can be a severe urinary tract infection. Sometimes an infection can leave scarring, resulting in blockages of the intestine called adhesions.
LIKELY FIRST STEPS
If caught early, a mild case of diverticulitis often clears up after two or three days with oral anitbiotics, bed rest, a clear liquid diet to allow your colon to heal and analgesic for the discomfort. Over 70 percent of patients treated in
this way will make a full recovery. If you have severe pain or a serious infection, you may need to be hospitalised so that medications and fluids can be delivered intravenously. About 20 percent of those who suffer repeated diverticulitis flare-ups will require surgery to recover from intestinal complications. If you have any of the following symptoms you should get emergency medical treatment right away: bloody stools, a persistent high fever, inability to have a bowel movement or severe abdominal pain or tenderness.
What is happening
If your diet is heavy in highly refined processed foods and light in fruit, vegies and whole grains, you're missing a vital ingredient for a healthy colon: fibre, the indigestible part of food. Without fibre--a natural stool softener-constipation is often the order of the day, causing pressure to build up inside your colon (large intestine). Over time, the colon walls weaken and a lot of little pouches, called diverticula, start bulging out like weak spots in an inner tube (see illustration); This is called diverticulosis; it's quite common, occurring in about a third of Australian and New Zealanders over age 50 and in 50 percent of those between ages 60 and 80. Diverticulosis rarely causes problems; infact, most people don't even know they have it unless it's found during testing for another ailment.
Diverticulosis can become serious, however, if food particles get trapped in the pouches and bacteria build up. The inflammation and infection that results is the basis of a condition called diverticulitis. Characterised by an intense abdonimal pain that's hard to ignore, diverticulitis often comes on suddenly, producing tenderness in your lower left abdomen. The infection may also give you a high temperature, chills, vomiting, cramping and constipation.
Although diverticulitis is simple to treat, in rare cases people develop complications. In the most severe cases, diverticula become filled with pus and develop into abscesses. Sometimes these will perforate, allowing the infected pus to leak into your abdominal cavity. This is called peritonitis, a life-threatening condition requiring emergency surgery. An infection that spreads outside your colon can also lead to another problem, a fistula, which occurs when the tissue of one organ--in this instance, your colon--sticks to another organ, and the infection burrows into it. With diverticulitis, the other organ is often the bladder and the result can be a severe urinary tract infection. Sometimes an infection can leave scarring, resulting in blockages of the intestine called adhesions.
- Antibiotics to battle inflammation and infection.
- Analgesics for pain and bed rest until symptoms ease up.
- Liquid diet to let colon heal, then increased fibre to prevent recurrences.
- If necessary, surgery to deal with complications.
QUESTIONS TO ASK
- How long before I can resume my normal activities?
- What are the chances that I'll need surgery?
- If I can't tolerate a high-fibre diet, are there other ways to help my digestive tract?
Treatments
If caught early, a mild case of diverticulitis often clears up after two or three days with oral anitbiotics, bed rest, a clear liquid diet to allow your colon to heal and analgesic for the discomfort. Over 70 percent of patients treated in
this way will make a full recovery. If you have severe pain or a serious infection, you may need to be hospitalised so that medications and fluids can be delivered intravenously. About 20 percent of those who suffer repeated diverticulitis flare-ups will require surgery to recover from intestinal complications. If you have any of the following symptoms you should get emergency medical treatment right away: bloody stools, a persistent high fever, inability to have a bowel movement or severe abdominal pain or tenderness.
Treatment Options
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Take it easy Stay in bed if possible.
-------------------------------------------------------------------------------------------------------------------------------
Watch diet Avoid high-fibre foods at first; then eat more. ---------------------------------------------------------------------------------------------------------------------------------
Exercise Helps prevent constipation; stay hydrated.
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------
Antibiotics Clear up inflammation and infection
------------------------------------------------------------------------------------------------------------------------------
Analgesics For pain; no NSAIDs if you have bleeding.
Procedures
------------------------------------------------------------------------------------------------------------------------------
Colonscopy And/or X-rays to find source of bleeding.
------------------------------------------------------------------------------------------------------------------------------
Surgery To remove abscess, fistula or diseased colon.
TAKING CONTROL
LIFESTYLE CHANGES
--------------------------------------------------------------------------------------------------------------------------------
Take it easy Stay in bed if possible.
-------------------------------------------------------------------------------------------------------------------------------
Watch diet Avoid high-fibre foods at first; then eat more. ---------------------------------------------------------------------------------------------------------------------------------
Exercise Helps prevent constipation; stay hydrated.
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------
Antibiotics Clear up inflammation and infection
------------------------------------------------------------------------------------------------------------------------------
Analgesics For pain; no NSAIDs if you have bleeding.
Procedures
------------------------------------------------------------------------------------------------------------------------------
Colonscopy And/or X-rays to find source of bleeding.
------------------------------------------------------------------------------------------------------------------------------
Surgery To remove abscess, fistula or diseased colon.
TAKING CONTROL
- See a gastroenterologist if you have recurrent symptoms. In a recent study by Loyala University Medical Center in Illinois, people with diverticulitis who were treated by gastroenterologists had a shorter hospital stay and were less likely to need readmission.
- Avoid enemas. Even though they may seem like a good solution for a problem that results from constipation, they can actually aggravate diverticulitis symptoms.
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