Diverticulitis and Diverticular Disease, Rupture and Incidents
Fiber helps to soften stool and relieve constipation allowing smooth movement through the colon
What Is Diverticulitis and Diverticular Disease?
Diverticular disease and diverticulitis are related digestive disorders of the large bowel or colon.
Let's begin our discussion by examining the colon.
The colon is the last part of the digestive system, also known as the large intestine. It consists of a layer of flexible tissue on the inside covered by a tougher layer of muscle. It is approximately six feet long.
The colon plays a significant role in the absorption of water and some electrolytes into the circulation before elimination. It helps to move waste material from the small intestine into the rectum and out through the anus as feces.
Meaning of "Diverticular"
Diverticular is a medical term used to describe pouches or sacs that can form in the colon that protrude and bulge out through the muscle wall. Diverticular disease is rare in parts of the world where the diet is characterized by a large intake of fruits and vegetables, and a low intake of red meat.
Diverticular disease is related to aging. It occurs in approximately 70% of people by the age of 80.
The cause of the formation of pouches or sacs are unknown. However, according to experts, eating a low-fiber diet is one of the most likely causes. Diverticular disease is common in the United States and Europe, where a high percentage of the food consumed is processed and low in fibre. The result is the formation of hard stool and constipation that increases the pressure in the colon, leading to the formation of pouches.
In certain conditions such as multiple sclerosis, where constipation is a common complication, the bowel function needs to be managed to prevent diverticulitis in cases with diverticular disease.
However, with education, people have become much more aware and are making informed choices about the right diet and lifestyle to reduce the incidence of diverticular disease and diverticulitis.
The majority of people with diverticula will not exhibit symptoms, but 1 in 4 will experience abdominal pain and diarrhoea. These are said to have diverticular disease.
The pouches in the colon can become infected and inflamed, forming areas of empyema. When this occurs, the condition is known as diverticulitis.
- Low-fiber diet
- Alcohol. Excessive consumption may increase the possibility of diverticulitis by 2-3 times higher when compared to the general population.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may increase the risk of diverticular disease.
- Suppressed Immune system
- Age. Under the age of 30, approximately 1 to 2% of people will have diverticula disease. However, the condition is found in more than 40% of the population over the age of 60. The total number of diverticula increases with age.
- Gender. Women appear to experience complications from diverticula disease at an older age than men.
The symptoms of diverticulitis are more severe than that of diverticular disease, which usually presents symptoms of lower abdominal pain and a feeling of bloating. With diverticulitis, the stomach pain is severe and is accompanied by a high fever with temperature more than 38 degree Celsius, nausea, vomiting and loss of appetite.
There is a risk that the infection may cause the colon to rupture and spread fecal matter into the sterile area of the abdomen, resulting in peritonitis. Infection can lead to the formation of a fistula, which is an abnormal channel, connecting to other regions causing a wider spread of the infection and further complications that will require surgical intervention.
Diverticulitis can be simple or complicated:
Simple diverticulitis occurs in around 75% of cases with no complications and responds to medical treatment without the need for surgery.
Complicated diverticulitis occurs in 25% of cases and often requires surgery. Complication such as abscess, fistula, obstruction, peritonitis and sepsis can occur.
Recent studies demonstrate a lesser role for aggressive antibiotics or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary.— Journal of the American Medical Association, January 15, 2014
The treatment for diverticulitis largely depends on the severity of the symptoms; treatment can be in a hospital or at home.
- To reduce the pain, the doctor may suggest bed rest and the use of heat pads, applied to the abdomen.
- Pain medication may be indicated and prescribe by your doctor or health care provider; this may include paracetamol and antispasmodics, avoid aspirin and ibuprofen as they may cause internal bleeding. Your doctor will be aware of your medical history and can give advice appropriate to your individual need. Always read the information leaflet that comes with the medication and if in doubt, discuss with your pharmacists.
- Take only fluids for the first twenty-four to forty-eight hours. In a hospital, fluids and energy may be given through an intravenous drip, this allows the bowel to rest and recover, before moving on to thicker liquids then progressing to solid foods.
- Your doctor may prescribe antibiotics.
When the condition has sufficiently improved, more fiber may be consumed to prevent further attacks. If bloating and gas persist, the amount of fiber can be reduced for a day or two.
Once formed, diverticula pouches remain for life, but by making a few dietary and lifestyle changes, diverticulitis may be kept at bay and prevented from returning. Some foods, however, can worsen the symptoms and should be avoided.
Food to Avoid
Avoid. Beans and peas, dried fruits, coconut, popcorn, strawberries and coarse grains. Also, vegetables and fruits with skin on, tomatoes, pickles and cucumbers.
Doctors can advise individuals about eating nuts and seeds. Medical opinion on eating nuts and seeds are changing; some experts say it can complicate the condition of diverticular disease and increase the incidence of diverticulitis. Others say not.
Too much tea, coffee and alcohol can cause constipation that can aggravate the condition and worsen the symptoms. Eat five portions of fruits and vegetables per day; this will help to form soft, bulky stool.