Tuesday, August 18, 2015

Diverticulitis

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.


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.

LIKELY FIRST STEPS
  • 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
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 Take it easy                                           Stay in bed if possible.
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Watch diet                                              Avoid high-fibre foods at first; then eat more. ---------------------------------------------------------------------------------------------------------------------------------
 Exercise                                                   Helps prevent constipation; stay hydrated.

MEDICATIONS
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Antibiotics                                          Clear up inflammation and infection
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 Analgesics                                          For pain; no NSAIDs if you have bleeding.

Procedures
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Colonscopy                                           And/or X-rays to find source of bleeding.
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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.
THE SEED CONTROVERSY For years it has been standard medical wisdom that if you has diverticulits, you should steer clear of nuts, seeds and popcorn because they get trapped in diverticula and cause inflammation. It turns out, however, there is no scientific evidence to support this. Most doctors now tell their patients that they themselves should be the judge of what they can eat. So, if they don't bother you, go ahead and have strawberries, tomatoes, sunflower seeds, cashews and all your favourite dishes that contain seeds and nuts.

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