Cure Diverticulitis

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Diverticulitis – An Overview

Diverticulitis is a condition in which diverticulitis in the colon rupture.  The rupture results in infection in the tissues which surround the colon.  The colon is the large intestine and is a long tube like striation that stores and then eliminates waste material.  As a person gets older, pressure within the colon causes bulging pockets of tissue, or sacs, that push out from the colon walls.  A small bulging sac pushing outward from the colon wall is called a diverticulum.  More than one bulging sac is referred to as diverticula.  Diverticula can occur throughout the colon, but most are common near the end of the left colon.  This is referred to as the sigmoid colon.  The condition of having these diverticula in the colon is called diverticulosis.

As a person gets older, pressure within the colon causes bulging pockets of tissue, or sacs, that push out from the colon walls.  A small bulging sac pushing outward from the colon wall is called a diverticulum.  More than one bulging sac is referred to as diverticula.  Diverticula can occur throughout the colon, but most are common near the end of the left colon.  This is referred to as the sigmoid colon.  The condition of having these diverticula in the colon is called diverticulosis

Diverticulitis occurs when bacteria get trapped in the pouches.  This leads to infection or inflammation.  No screening is available at this time for diverticulitis.  Starting at age 40, a procedure called a flexible sigmoidoscopy may be recommended every 3 to 5 years or a colonoscopy every 10 years as a screening exam for cancers of the colon and rectum.  Both flexible sigmoidoscopy and colonoscopy involve using a flexible tube with a lighted viewing instrument to see inside the large intestine.  These exams are often able to reveal diverticula if they are present.  Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack. 

More serious complications include diverticulitis, abscess in the pelvis, colon obstruction, and bacterial peritonitis, plus bleeding in the colon.  A diverticulum can become infected with bacteria and ruptures, causing diverticulitis.  Fever, tenderness, and pain of the lower left abdomen are common symptoms.  Constipation or diarrhea may also occur.  A collection of pus can develop around the inflamed diverticulum, which leads to the formation of an abscess, usually in the pelvis.  On rare occasions, the inflamed diverticula can erode into the urinary bladder, which causes a bladder infection and passing of gas during urination.  Inflammation of the colon may also lead to bowel obstruction.  On rare occasions, a diverticulum ruptures freely into the abdominal cavity causing life threatening infection caused peritonitis. 

No screening is available at this time for diverticulitis.  Starting at age 40, a procedure called a flexible sigmoidoscopy may be recommended every 3 to 5 years or a colonoscopy every 10 years as a screening exam for cancers of the colon and rectum.  Both flexible sigmoidoscopy and colonoscopy involve using a flexible tube with a lighted viewing instrument to see inside the large intestine.  These exams are often able to reveal diverticula if they are present.  Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack.  This treatment may include getting plenty of fluids daily, gradually increasing the amount of fiber in the diet through fruits, vegetables, wheat bran, and the regular use of a fiber supplement.  It is also highly recommended that regular doctor visits are conducted to monitor the condition.

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Defining Diverticulitis

Diverticulitis is a common disease found in the digestive area, particularly in the large intestine.  Diverticulitis develops from diverticulosis, which involves the formation of pouches on the outside of the colon. These pouches are called diverticula and diverticulitis results of one of these diverticula become inflamed.  Small protruding sacs of the inner lining of the intestine can develop in any part of the intestine.  They are most commonly found in the colon, specifically in the sigmoid colon.  The diverticula increase in frequency after the age of 40.  Symptoms of diverticulitis may include alternating diarrhea and constipation, and severe, intermittent cramps in the lower left side of the abdomen. 

Diverticulosis is very common, being found in more than half of Americans over the age of 60.  Only a small percentage of these people will develop the complication of diverticulitis.  Diverticulitis is caused by inflammation or a small perforation with a diverticulum.  Direct risk factors for diverticulitis are not known, but they may include older age or a low fiber diet.  To prevent diverticulitis, eat regular, nutritious meals containing high fiber foods, such as fruits and vegetables.  It is also vital to drink plenty of water and to watch for changes in bowel movements, get enough rest and sleep, and to avoid foods such as popcorn. 

Diverticulitis typically causes pain, tenderness, and fever, but unlike diverticulosis, diverticulitis does not generally cause gastrointestinal bleeding.  If a doctor has diagnosed diverticulosis, a diagnosis of diverticulitis may be based almost entirely on the symptoms.  Many other conditions involving the large intestine and other organs in the abdomen and pelvis can cause symptoms similar to diverticulitis.  These symptoms are similar to appendicitis, colon or ovarian cancer, an abscess, which is a pus filled pocket of infection, and non-cancerous growths on the wall of the uterus. 

A doctor may perform a colonoscopy once inflammation has subsided or the infection has been treated.  A colonoscopy is an examination of the large intestine using a flexible viewing tube.  These tests are performed to either confirm the presence of assess the severity of diverticula and to rule out the possibility of colon cancer.  Colonoscopy or barium enema x-rays usually need to be delayed for several weeks after treatment as they may damage or rupture an inflamed intestine.  Exploratory surgery is rarely required to confirm or deny the diagnosis.

For uncomplicated divertusulosis, the primary physician may recommend a high fiber diet and the use of stool softeners.  An attack of acute diverticulitis may require hospitalization which will include a treatment regimen of antibiotics, intravenous fluids, and nasogastric suction, which is a procedure that relieves pressure in the intestine.  In most cases which require surgery, the surgeon will remove the diseased section of the intestine and joins the remaining sections together.  Some patients may require a temporary colostomy.  A colostomy is an operation to bring part of the large intestine to the abdominal surface to form a new opening for bowel movements.  Diverticulitis is usually mild and should respond well to antibiotics and changes in diet.  

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Help! What Can I Eat After An Attack Of Diverticulitis?

You have just received the diagnosis of diverticulitis and have been given antibiotics to take, great! Make sure that you take the antibiotics as prescribed taking all of the medication. If your attack was mild you doctor sent you home with strict instructions to rest, which may include bed-rest and either a clear liquid diet or a low-fiber one. What if you are unsure of what exactly is allowed on a clear liquid diet or what makes up a low-fiber one? Don't panic, this article will list for you the items that you can safely consume on both of these diets. The important thing is not to stress out and to rest. Take good care of yourself so your colon can heal.

What is allowed on a clear liquid diet?

You may drink water, fruit juices WITHOUT pulp, broth, which includes bouillon or consommé (chicken or beef), unflavored or flavored gelatin, Popsicles WITHOUT those bits of fruit or fruit pulp, and tea or coffee but WITHOUT cream or milk.

Basically a clear liquid is a liquid that when placed in a glass can be seen through. It is very important not to consume and milk or cream in beverages or to have any fruit or fruit pulp when on a clear liquid diet.

What foods are you allowed to have on a low-fiber diet?

When you have been placed on a low-fiber diet as you recuperate from diverticulitis you will want to consume a diet that will allow your colon to function but to not over-exert it. Foods that will not tax your colon are those that do not have skins, seeds or roughage.

Enriched white bread, white rice or plain pasta, noodles or macaroni all can be eaten when you are on a low-fiber diet. You can also eat any cereal that is labeled as a low-fiber cereal. You can also eat most raw, canned or cooked fruits without the skins. It is very important to skin all fruits and vegetables before eating them. There is a lot of fiber contained in the skins of fruits and vegetables. Make sure that there are no seeds or hulls in these canned items. You can eat meat, poultry and fish if they are TENDER. You can eat eggs, and SMOOTH peanut butter; crunchy peanut butter is a huge NO-NO when on a low-fiber diet. You can have milk and milk products while on a low-fiber diet, you can also have yogurt, and cheese. You CANNOT have seeds or nuts with your cheese. You can eat desserts when on a low-fiber diet as long as the desserts do not contain any seeds or nuts of any kind and in any form.

Within a few days you will be able to start increasing the fiber in your diet. Your doctor or dietician will instruct you on how to do this. Typically, you add about 5 to 15 grams of additional fiber a day to the low-fiber diet. This gradual increase in fiber allows your digestive system and your colon to become adjusted to the increase in fiber.

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Diverticulitis Treatment

Diverticulitis is an infection or inflammation of the pouches in the digestive tract, most commonly affecting the sigmoid colon, which is part of the large intestine.  It typically affects people over the age of 40, but it is not uncommon for a younger person to experience diverticulitis. 

Complications of diverticulitis could affect nearby organs and emergency surgery is sometimes required if the intestine has ruptured.  The most common symptom of diverticulitis is abdominal pain.  The most common sign is tenderness around the left side of the lower abdomen.  If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well.  The severity of symptoms depends on the extent of the infections and complications. 

Most people who suffer from diverticulosis do not have any discomfort or symptoms, however, symptoms may include mild cramps, bloating, and constipation.  Other diseases, such as irritable bowel syndrome, and ulcers cause similar problems.  These symptoms are not indicative of diverticulosis.  The differential diagnosis of diverticulosis includes colon cancer, inflammatory bowel disease, colitis, and irritable bowel syndrome.  It also includes a number of urological and gynecological processes.  Bleeding from the rectum is also common.  Patients are commonly studied with a CT scan, but also barium enema and colonoscopy tests

The colon is a long tube like structure that stores and then eliminates waste material.  As a person gets older, pressure within the colon causes bulging pockets of tissues. This pushes the walls out from the colon walls.  A small bulging sac pushing outward from the colon wall is called a diverticulum.  More than one bulging sac is referred to as diverticula.  Diverticula can occur throughout the colon but are most common near the end of the left colon called the sigmoid colon.  The condition of having these diverticula in the colon is called diverticulosis.  A patient with diverticulosis may have few or no symptoms.  When a diverticulum becomes infected and ruptures, the condition is called diverticulitis.

Diverticular bleeding occurs when stool erodes into a blood vessel at the base of a diverticulum.  Rectal passage of red, dark, or maroon colored blood and clots occur without any associated abdominal pain.  Rarely, blood may be black in those bleeding from a diverticulum of the right colon.  Bleeding may be continuous or intermittent, lasting several days.  Patients with active bleeding are usually hospitalized for monitoring.  Intravenous fluids are given to support the blood pressure.  Blood transfusions are necessary for those with moderate to severe blood loss.  Patients with persistent, severe bleeding require surgical removal of the bleeding diverticula. 

Serious complications can occur as a result of diverticulitis.  Most of them are the result of the development of a tear or perforation of the intestinal wall.  If this occurs, intestinal waste material can leak out of the intestines and into the surrounding abdominal cavity.  Peritonitis, abscesses, and obstructions are some of the results caused by diverticulitis.  It is important to maintain good bowel habits to help prevent diverticular disease or reduce the complications from it.  Symptoms include abdominal pain, abdominal cramps, constipation, diarrhea and bloating.

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Treating Mild, Complicated or Recurring Diverticulitis

The treatments are different for mild diverticulitis than it is for complicated or recurring diverticulitis. The treatment is also different depending on the age of the individual as well as if there are other medical conditions involved. Diverticulitis can range from mild pain to a life-threatening infection.

Not every individual who has diverticulosis develops diverticulitis. Only approximately 15 to 20% of those with diverticulosis go on to present with symptoms of diverticulitis. The diverticula are infected or inflamed when the individual has diverticulitis. Those who do develop the condition often have the following factors:

Advanced age (over 50)

Lack of dietary fiber

Sedentary lifestyle

Countries where citizens consume diets that are high in refined carbohydrates and low in fiber have higher rates of diverticulitis. Countries such as the United States where Americans seldom eat enough fiber in their daily diet. The small, harder stools often found in the individual with a low-fiber diet are what contributes to the presence of increased pressure in the colon leading to weakened colon walls and the formation of diverticula.

The treatment for diverticulitis is tailored to the severity of the symptoms as well as how many acute episodes of diverticulitis the individual has experienced.

Mild:

Mild diverticulitis can be treated at home with a clear liquid diet or with a low-fiber diet and oral antibiotics. Resting is also advised for a few days. Once they start eating again, they should be on a low-fiber diet including avoidance of all whole grains, fruits and vegetables, so that the colon can further rest and heal from the attack. They should after a few days slowly increase the fiber in their diet.

Doctors will typically be more aggressive with individuals who are younger than 50 because they are at higher risk for recurrent attacks and for complications to occur such as a perforated or abscessed colon.

Complicated:

Approximately 50% of individuals with diverticulitis will require hospitalization in order to have intravenous antibiotics or intravenous fluids administered. These are typically the individuals with fever greater than 100 degrees Fahrenheit, or who have a high white blood cell count, or who present with symptoms of a bowel obstruction, peritonitis or other bowel complications.

There are two surgical procedures, which may be included in the treatment plan for individuals who have incurred colon damage. The two procedures are "primary bowel resection and bowel resection with colostomy.

Surgery is usually done on individuals who have had two or more recurrent attacks of diverticulitis or who have not been successfully treated medically for their diverticulitis. Another indication for surgery is when an individual who is under 40 years of age is hospitalized or has evidence of having inflammatory involvement of the urinary tract, has a colonic obstruction or may have suffered a perforation of the bowel.

Individuals who present with diffuse peritonitis or pneumoperitoneum will need to have quick fluid resuscitation, a immediate course of intravenous antibiotics, and emergency surgical exploration.

To Prevent Recurring Diverticulitis:

It is advised that individuals prevent further diverticulitis by eating more fiber, drinking lots of water, to avoid constipation and to absorb the fiber. It is important to learn to respond to bowel urges and do not delay having a movement. Delaying moving the bowels leads to harder stools that than requires the individual to use more force to pass the harder stool which increases the colonic pressure. Regular exercise is also recommended in order to promote normal bowel function and to help to reduce the amount of pressure inside the colon. Individuals should strive to exercise for at least 30 minutes each day or at least 3 to 4 times a week.