The pain caused by diverticular disease can be so painful that your intestines burst. Just ask one of the approximately 130,000 people in the United States who are hospitalized with this disease each year, or one of the 1.5 million hospital outpatients who come to the hospital each year with a tummy tuck.
The National Institutes of Health reports that diverticular disease is the eighth most common outpatient diagnosis in the United States.
Dr. Francene Martin, a board-certified gastroenterologist with Health First Medical Group, explains the details of this disease and explains the differences between the two main types of diverticular disease: diverticulosis and diverticulitis.
“Diverticulosis is the presence of small pockets (diverticula) that form in the wall of the colon and increases with age,” says Dr. Martin. “Diverticulitis occurs when these pockets become inflamed and swell, which can cause them to tear or become infected.” point out that these pockets form over time.
A Harvard Medical School newsletter explains that diverticula protrude from the normally smooth muscular layer of the colon and tend to occur where the muscle is weakest, where blood vessels that pass through the muscle intersect. . In Western society, the majority of cases occur in the narrowest part of the colon, the sigmoid colon.
The severity of diverticulitis can range from mild to severe to life-threatening, depending on the size of the perforation or tear. Small pinhole-like perforations quickly close on their own and can cause some pain and inflammation, but can be treated with oral antibiotics. At the other end of the spectrum, large perforations that leak air and stool into the surrounding abdominal cavity can be serious enough to require emergency surgery.
In rare cases, an infected diverticulum can rupture and spread infection to the peritoneum, causing peritonitis. Peritonitis can be life-threatening and requires immediate treatment with antibiotics.
The Stanford University Lifestyle Medicine Newsletter recently published a paper stating that the important relationship between colorectal health and diet is more important than ever, given the rise in colorectal disease in Western society.
Dr. Martin agrees, saying refined foods, red meat, low-fiber foods, and genetically modified foods are to blame. Smoking, obesity, and constipation also increase risk.
Diverticulosis was identified in the United States in the early 1900s, coinciding with major technological advances such as fertilizers, preservatives, and large-scale agriculture, all of which caused significant changes in the American diet. Regular consumption of farm-fresh whole foods rich in fiber has been replaced by processed foods lacking essential nutrients.
Diets have also become saturated with meat, fat, sugar, and chemicals, replacing fruits, vegetables, and whole grains.
“We used to tell patients to avoid seeds, nuts, popcorn, and similar foods because they can get into your pocket and increase your risk of diverticulitis, but now we know that this won’t happen. “We know that,” Dr. Martin added.
In addition to the diet already discussed, NYU Langone Health suggests lifestyle changes that can help reduce symptoms of diverticulosis. They include:
- Physical activity – Activity helps keep your bowels moving. Try to incorporate light to moderate exercise like walking, running, and yoga into your daily schedule.
- Quit smoking – Studies have shown that smoking increases the risk of complications of diverticular disease, such as bleeding and diverticulitis.
- Proper hydration – Water, clear liquids, and vegetable juices help keep stools soft. If you’re taking fiber supplements, it’s important to drink plenty of water to prevent constipation.
Use of NSAIDS, aspirin, steroids, and opioids can also increase the risk of developing diverticulosis.
Chronic or long-term inflammation is associated with a growing number of medical conditions, Dr. Martin said, and research is underway to examine its connection to diverticular disease.
Diverticular disease is equally distributed between men and women. Also, like most intestinal diseases, genes and family history are not the main causes of diverticulosis, but genetics can influence its onset and severity. Your risk may be slightly higher if a close family member has diverticulosis.
Most people do not experience symptoms from diverticulosis. If it happens, it’s mild, like a mild cramp.
Common symptoms of diverticulitis include bloating, nausea, and vomiting.
“If you have any of these symptoms, or persistent localized pain, chills, or bleeding, it’s important to seek treatment right away,” says Dr. Marten. “If the pain is severe, go to the ER immediately.”
Diagnosis of diverticular disease usually begins with a physical exam to check for abdominal tenderness. Follow-up tests include:
- A blood test to check for signs of infection, such as an increase in the number of disease-fighting immune cells called white blood cells.
- An abdominal CT scan is the most accurate tool doctors use to diagnose diverticular disease. This provides cross-sectional, two-dimensional and three-dimensional images of structures within the gastrointestinal tract, allowing doctors to identify abnormalities in the colon and surrounding areas.
- A colonoscopy examines the lining of the walls of the colon and rectum for problems such as diverticula.
Dr. Martin says: “Once formed, pockets never disappear. Making healthy choices helps your long-term outlook.”
Dr. Francene Martin is a board-certified gastroenterologist. She earned her bachelor’s degree in biology from the University of St. Thomas and her MD degree from the University of Texas. She completed a gastroenterology fellowship at the University of South Florida, as well as an internal medicine residency and internship. She is board certified in gastroenterology by the American Board of Internal Medicine. Her office at Health First Medical Group is located at 5191 Babcock Street, Palm Bay: 321-434-3131. and 1223 Gateway Drive, Melbourne: 321-576-0647.