Diverticular Disease

Is a condition found primarily in the large intestine. They are small pouches or a weak spots in the colon or large intestine which yields to pressure from food or gas within the colon. These tiny pockets are called diverticula. Diverticula can develop anywhere but are mostly located in the sigmoid colon.

While it can be uncomfortable in itself, is not a serious condition. However, it can lead to inflammation known as diverticulitis, they can also perforate or rupture, this is very uncommon, only 10 to 15% of patients will develop such complication. Occasionally the pouches may erode into blood vessels causing bleeding. Generally, perforation and bleeding of diverticula can be controlled medically. Sometimes, hospitalization and surgical treatment are required to control these complications. Only about 10% of patients with diverticulitis require surgery. This condition has no direct relation to cancer.

CAUSE
The precise cause of diverticulosis is obscure. The process of aging and muscle shrinkage may weaken the wall of the colon, allowing the pouches to develop. Fiber deficiency, a leading cause of constipation, results in small hard stools that do not fill out the colon. The colon then develops areas of spasm which force the pouches through the muscle wall.

Probably the principle factor in the high incidence of diverticulosis among Americans is the low residue, low fiber diet consumed in western countries. Africans and Orientals living in rural areas that eat plenty of natural fiber or roughage, rarely get diverticulosis. Fiber is a non-nutrient but it is essential for normal bowel function.

Can diet high in fiber prevent it?
Yes. A high roughage diet will not only prevent the development of diverticulosis but will not, once it is established. It will also help correct constipation due to improper diet.

SYMPTOMS
The symptoms most commonly are non-specific they usually include "gas", stomach cramps, pain and diarrhea alternating with constipation. Aren't these symptoms common in other disorders? Yes, including some serious diseases; that is why you go through all those tests. Before making a diagnosis of diverticulosis, we must first exclude all other possible causes of the symptoms. X-ray test and colonoscopy will confirm diagnosis distinguishing diverticulosis from other diseases of the colon with similar symptoms. If a complication of diverticulosis appears, this is typically pain, fever or bleeding.

Management of diverticulosis is mainly dietary. Twenty-five or more grams of fiber is recommended daily. While pure bran is very dry, it has almost no taste of its own and can be mixed into cottage cheese, yogurt, spaghetti, hamburger and many other foods. It is not only high in fiber but it is also an excellent "stretcher". Psyllium seed commercial preparations, (Metamucil or Citrucel) may be prescribed in your case to supplement the fiber in your diet. Medications to reduce the muscular spasm in your colon may also be prescribed for a limited time. Fresh fruits and vegetables are also high in roughage, and you can have all you want. In fact, there are no dietary restrictions.

The only time to change this diet is in the event of the development of diverticulitis, with perforation of one of the pouches. Then, treatment with antibiotics and low residue diet is necessary. When patients do not respond to these simple measures and complications develop hospitalization and surely may be needed.