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Diverticulosis is the inflammation of an abnormally-formed pouch in the intestinal wall and is usually found in the colon (large intestine). Although this condition can be treated at home, with doctor's instructions, untreated it could become quite serious, requiring surgery. These pouches, or diverticulae, occur with increasing frequency in individuals after the age of forty and are present in almost half of individuals over the age of fifty. Diverticulae are not serious in themselves and may not present symptoms other than a slight tenderness or occasional mild abdominal cramp or gas. The elderly are especially prone to this condition as well as anyone who has suffered an attack previously. Recurrence is frequent.
The major cause of diverticulosis is a low fiber diet along with a diet consisting of too many processed foods. Contributing factors can be diets too high in red meats or high-fat foods. When a diet contains adequate fiber, stools pass easily through the intestines because they are large and soft. A diet lacking in fiber tends to produce small, hard stools which can strain the colon and produce the diverticulae along the muscular wall of the intestines. Heredity, obesity, history of gallbladder disease may also be factors in this condition.
Getting enough fiber through diet is very important for the control as well as prevention of diverticulosis. Several servings of fresh fruit, vegetables, whole-grain cereals and breads daily will provide the fiber needed to maintain intestinal good health and reduce symptoms of diverticulosis, if already present. Fiber should not be increased suddenly, however, since this may produce painful gas and bloating. More fiber should be introduced gradually to allow the body to adjust to its presence.
Insoluble fiber, which can be found mainly in the skin of apples, etc., can do much to prevent diverticulosis. Insoluble fiber, which is very absorbent, leaves the digestive system in much the same form as it entered. As a result, this type of fiber aids in the passage of firmer stools during bowel movements. The fact that insoluble fiber moves food through the digestive system faster also helps by sweeping many harmful substances from the colon faster, reducing the risk for diseases such as colo-rectal cancer.
Soluble fiber also passes through the intestines without being absorbed. In doing so, food is eliminated from the body easier. Even though soluble fiber forms a protective gel coating for the intestines against harmful substances, it is less important for prevention of this disease than insoluble fiber. The consumption of set amounts of insoluble or soluble fiber is not of great importance since a diet adequate in fresh fruit, vegetables, whole grains and legumes will supply all the necessary healing benefits of both.
Water intake is also an important factor in reducing the symptoms and frequency of diverticulosis attacks. Drinking at least eight glasses of water daily will help fiber to pass through the intestinal system and keep stools soft and firm for easy elimination.
When diverticulae become infected, bleed or perforate, they can cause abdominal pain, fever, and bleeding from the rectum. Other symptoms include:
---nausea
---constipation and/or diarrhea
---abdominal and/or back pain
---loss of appetite
---change in the appearance of stools
---swollen abdomen
---a lump in the area where the pain is present
---pain in the lower left abdomen relieved by the passing of gas
If any of the symptoms of diverticulosis are experienced, a physician should be consulted. If chills, fever, severe pain, vomiting blood, or rectal bleeding are present, medical attention should be sought immediately. In severe cases, diverticulae may bleed profusely and perforate the intestinal wall, causing peritonitis. In these instances surgery is indicated. Surgery may also be used to remove the affected portion of the colon when attacks become increasingly severe or frequent.
A physician may diagnose diverticulosis on the basis of symptoms alone but can also use sigmoidoscopy. This is a procedure in which a flexible tube with a lighted tip is inserted into the rectum and lower colon to detect any abnormalities. A CT scan can determine the leakage of any air into the stomach. Barium enemas are used as a diagnostic tool when an x-ray of the lower intestinal tract is needed. However, a barium enema may not be done in cases where the colon is greatly inflamed. Normally, hospital treatment consists of a short stay in which intravenous antibiotics and a mild or liquid diet are administered. This treatment serves to rest the bowel and treat any existing infection.
Mild cases of diverticulitis may be treated at home by the patient under doctor's instruction. Home treatment may include:
---pain relievers for abdominal discomfort
---antibiotics, if any infection is present
---anti-spasmodic drugs for the bowels
---bed rest
---low-fiber diet to prevent further irritation while experiencing an attack
---stool softeners to reduce discomfort of bowel movements
---herbal remedies to reduce bowel spasms
If any other health conditions are present, a physician should be made aware of these before medications are taken.
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