Diverticulosis and Diverticulitis: Knowing the Difference
Most people don’t pay much attention to their colon health. Until there’s trouble.
That’s unfortunate because one of the most common and preventable colon health conditions—diverticulosis—can erupt into a much more serious one—diverticulitis. The latter can include unpredictable bouts of infection or abdominal pain. So, taking steps to keep your colon healthy, and prevent diverticulosis, is a smart move.
What Is Diverticulosis and Who Gets It?
Diverticula are little pockets that form along weakened points in the wall of your colon. They’re especially common in the lower, narrower sections, where the colon’s muscular layers have to work harder to push the contents passing through. Hard stool can force these layers to work that much harder. It may not be surprising then that a primary cause of these pockets is our modern American diet. Most of us eat a considerable amount of low-fiber processed foods and animal products. And few of us ingest enough of the high-fiber ones (such as vegetables and fruit) needed by our digestive tract to form bulky, soft, and easy-to-pass stools.
One of the most common #colonhealth conditions is largely preventable with smart dietary choices, explains colorectal surgeon Sara Berkey. @MedStarWHC via https://bit.ly/2IIsUVg
It’s estimated that, before age 40, fewer than 20% of Americans have diverticulosis. But by age 60, more than half of us have developed the protruding pockets in our lower digestive tract. The good news: you may never know you have this condition. Although some people may develop changes in their bowel movement patterns or abdominal discomfort, many of us never experience noticeable symptoms. In fact, the condition may go completely unnoticed until a person has a routine colonoscopy or a CT scan of the abdomen for other reasons.
What’s the Big Deal, Then?
About 5% to 15% of people with diverticulosis will go on to develop diverticulitis, a more serious condition that occurs when one or more of the pockets break, leaking bacteria into the surrounding tissues and causing infection. Classic symptoms include fever, nausea and vomiting, and pain in the lower left of the abdomen. For some people, symptoms can be intense enough to warrant a visit to the emergency room.
Diagnosis is typically made via blood work, and sometimes a CT scan, to determine the extent of infection around the colon and rule out other causes. It’s difficult to predict who will go on to develop diverticulitis, although research suggests a family history may increase risk. Some patients with diverticula may develop diverticular bleeding instead of the bacterial infection, which can require hospitalization and even blood transfusions if it doesn’t stop right away. Locating the source of these bleeds can be challenging.
How Is Diverticulitis Treated?
Taken orally at home or given intravenously at the hospital, antibiotics are typically the first-step treatment and work well to resolve the infection in most cases. A low-fiber liquid-heavy diet is recommended for a few weeks to help ease inflammation in the colon (before getting back on track toward a fiber-rich diet), and a colonoscopy is usually scheduled so we can take a closer look at the infected areas.
For some people, it may be as simple as that. For others—and it’s difficult to predict who—the first episode may be the start of a random cycle of continuous flare-ups that become more frequent and more serious over time, leading to other complications. These can include full tears or “perforations” in the colon wall that allow germs to spill into the larger abdominal cavity and cause infection.
Repeated bouts of diverticulitis can also create scar tissue that narrows the colon and creates partial or complete intestinal blockages, as well as abnormalities called “fistula” which are connections between the colon and bladder, or between the colon and vagina in women. These more serious conditions usually warrant surgery to remove the diseased parts of the colon.
At MedStar Washington Hospital Center, we have a very high success rate with these surgeries and are typically able to perform these repairs laparoscopically or robotically, helping patients recover faster than traditional surgery would allow. Surgery for diverticulitis is usually reserved for the most serious cases.
How to Keep Your Colon Healthy
- Eat plenty of high-fiber foods each day, including vegetables, fruits, legumes, and whole grain products. Contrary to “ancient wisdom,” you do not have to avoid foods like popcorn, nuts, or seeds. We recommend getting about 30 grams of fiber in your diet each day—the average American diet contains only about half of that.
- Unless you’re a vegetarian, it can be hard to get enough fiber through food alone. Consider adding 10 mg to 15 mg of an over-the-counter fiber supplement, like Metamucil® taken with water, to your daily routine.
- The verdict is still out on whether probiotics—strains of live bacteria found in dietary supplements and certain foods—may help to prevent or treat diverticulosis or diverticulitis. Research is still underway.
- Drink plenty of water on a regular basis.
- Get enough physical activity each day.
- Limit dietary fat and red meat, as well as use of aspirin and ibuprofen, if possible.
- Avoid smoking.
If you’ve noticed abdominal discomfort or pain, please reach out to us to discuss your concerns and explore your symptoms. Our specialists listen carefully, recommend the right testing, and prescribe treatments that can keep you active and restore comfort to your life.
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