What is Diverticulitis?

A friend of mine recent­ly had a brush with death. She was unknow­ing­ly car­ry­ing a time bomb in her large intes­tine, and when it went off, it near­ly took her with it. She had a diver­tic­u­lar abscess, which burst and thus allowed the bac­te­ria to get into her abdom­i­nal cav­i­ty. That caused a prob­lem called peri­toni­tis.

All things con­sid­ered, she got off easy. She had to have emer­gency surgery to remove the dam­aged por­tion of her large intes­tine and clean up the mess in her abdomen. She may have a fierce-look­ing scar, but she’s alive, and she can still go to the bath­room nor­mal­ly, instead of into a colosto­my bag on her side.

The prob­lem start­ed when part of the wall of her large intes­tine “bal­looned out” to form a lit­tle pouch called a diver­tic­u­lum. When you have these diver­tic­u­la, the con­di­tion is called diver­tic­u­lo­sis. Here’s what diver­tic­u­lo­sis looks like, from inside the large intes­tine:

About half of Amer­i­cans over 50 years of age have diver­tic­u­lo­sis and don’t even know it. Diver­tic­u­lo­sis may cause mild, inter­mit­tent symp­toms of pain and bloat­ing in the low­er left side of the bel­ly. It may cause bouts of diar­rhea and con­sti­pa­tion. It is a com­mon cause of rec­tal bleed­ing in peo­ple over 40 years of age. Or it may cause no symp­toms at all. If one of the diver­tic­u­la gets infect­ed, the con­di­tion is called diver­ti­c­uli­tis. It’s just like appen­dici­tis, except that the symp­toms are worse on the low­er left, rather than the low­er right, side of the bel­ly. If the inflamed diver­tic­u­lum bursts, you can end up with life-threat­en­ing peri­toni­tis.

Diver­tic­u­lar dis­ease is com­mon in the Unit­ed States. How­ev­er, it’s rare in places like Africa and Asia, where peo­ple eat a high-fiber, plant-based diet. Accord­ing to the Nation­al Insti­tute of Dia­betes and Diges­tive and Kid­ney Dis­eases (NIDDK), the best treat­ment for most cas­es of diver­tic­u­lo­sis is a high-fiber diet. Both sol­u­ble and insol­u­ble fiber are help­ful, because they retain water and make the stool soft­er and eas­i­er to pass. If the mus­cles of the large intes­tine don’t have to strain so hard, they won’t gen­er­ate the high pres­sure that can cause a diver­tic­u­lum to form.

Some doc­tors say that peo­ple with diver­tic­u­lo­sis should avoid eat­ing small seeds, such as those in toma­toes or rasp­ber­ries. How­ev­er, the NIDDK says that there is no sci­en­tif­ic infor­ma­tion to sup­port that rec­om­men­da­tion.

Dairy prod­ucts increase the risk for diver­tic­u­lo­sis by caus­ing con­sti­pa­tion. When dairy pro­tein is digest­ed, it can pro­duce mor­phine-like com­pounds that slow down the mus­cles that are sup­posed to push food through the intestines.

To pre­vent diver­tic­u­lo­sis, pre­vent con­sti­pa­tion. Eat lots and lots of unre­fined starch­es and veg­eta­bles. Avoid dairy prod­ucts. A diet like that is also good for main­tain­ing a healthy weight, con­trol­ling your cho­les­terol and blood sug­ar, and pre­vent­ing osteo­poro­sis.

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