Have you ever experienced an episode of diverticulitis? It's certainly an unpleasant experience. It does not matter whether you are one of those that has not experienced it or one of those that has had a bad case of diverticulitis; you definitely don’t want to experience it anytime soon. Luckily for you, the findings of a recent study may help prevent diverticulitis.
Diverticulitis is an inflammation of diverticula in the intestinal wall of the human body. Diverticula are small, baggy herniations of the mucosa that protrude through the muscular layer of the large intestine. Their size ranges from 0.5 to 1 cm in diameter, and they communicate with the lumen of the intestine through a special door of varied lengths and calibers. That characterized by the presence of non-inflamed pouches in the large intestine is known as diverticulosis, and it is especially common among the elderly.
In the early 20th century, diverticulosis was present in 5-10% of the population, and it is now found in 20-50% of people older than 60. This is mainly a disease that takes place in Western civilization. In African and Asian countries, diverticulosis affects less than one percent of the population. This difference in geographical distribution is attributed to dietary differences in the different cultures. It is believed that diverticula may develop due to a diet low in plant fibers. Modern diets that are unhealthy can cause bowel muscle spasms, especially in the colon. As a result of these spasms, pressure increases in the lumen, causing the surrounding mucous membrane to fall through weak spots in the muscle of the bowel wall. Diverticulitis and diverticulosis are especially common among those who are obese and that live a sedentary lifestyle. They are also two times more common among people with intestinal hypermotility, like patients with irritable bowel syndrome.
Diverticulosis can remain undiscovered and is mostly found by accident during a radiological or endoscopic examination or when there is a complication, like bleeding or diverticulitis caused by inflammation of diverticula. Only a small number of patients actually experience noticeable symptoms. These may include bloating, mild cramping, and irregular stools.
Diverticulitis occurs in around 10-15% of diverticulosis cases, and it usually takes place in the descending part of the colon. It is characterized by manifested sudden pain (often in the lower left quadrant), fever, and elevated white blood cell counts. In the weeks prior to a diverticulitis attack, patients may experience constipation, diarrhea, and frequent urination.
Causes of Diverticulitis
The cause of inflammation of the diverticulum is most likely mechanical in nature, because diverticula do not contain muscle and are therefore difficult to empty. Coupled with disrupted blood flow to the area, the diverticula become an ideal place for the proliferation of bacteria and can easily become obstructed, perforated, or inflamed.
Diverticulum often develops when high pressure inside the colon pushes against the naturally weak spots in the colon region. This leads to the initiation of marble-sized pouches, which protrude out through the colon wall.
The condition of diverticulitis occurs when the diverticula breaks or tears, leading to swelling, infection, or both.
Diagnosis of diverticulitis is normally made by an X-ray examination with double-contrast, which offers the most reliable findings. A colonoscopy is a less reliable means of detection, because the openings of diverticula are difficult to spot in the colon, which contracts regularly. During the acute phase of diverticulitis, use of a barium enema and colonoscopy can be dangerous, because they can lead to pressure that may result in the rupture of an inflamed diverticulum. These diagnostic methods are usually safe after an adequate course of antibiotic treatment. Generally, repeated attacks of diverticulitis in the same area require surgical treatment.
Treatment of Diverticulosis
- In patients who experience pain, anticholinergics should be used to reduce the contraction of their intestines.
- A diet rich in vegetable fibers (fruits and vegetables) and unprocessed bran products that act as laxatives help regulate digestion and decrease symptoms.
- An increase in water is also recommended for patients with these conditions. Drinking plenty of water and other fluids eliminates the occurrence of constipation and regulates the bowel flow.
Fibers preserve stool softness and reduce pressure inside the intestines, allowing easier movement of waste through the digestive system. An increase in the amount of fiber in your diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber also prevents constipation that can irritate diverticula. The American Dietetic Association recommends a daily fiber intake of 20 to 35 grams, and it is important to meet these guidelines if you want to avoid these digestive conditions.
What should be included in the diet?
Mentioned below are the fiber-rich foods which should be included in the meals of the diverticulitis patient:
- Whole-grains, e.g., cereals like wheat, rice, gram, barley, etc.
- Beans, like red beans, kidney beans, black beans, and French beans.
- Fresh Fruits, such as apples, apricots, prunes, oranges, avocados, bananas, and pears.
- Vegetables, like potatoes, peas, spinach, carrots, tomatoes, etc.
- Dried Fruits, like almonds, peanuts, and raisins
- Starchy foods are a good source of fiber, and thus, crispbread, pasta, boiled brown-rice, brown bread, and whole meal bread may turn out influential.
One can consult a doctor or an expert dietitian if any difficulty is encountered during the framing of an accurate diet plan. Intake of a fiber supplements, such as Psyllium (Metamucil and Konsyl) or Methylcellulose (Citrucel), may also offer relief and help prevent constipation.
What all should be avoided to prevent diverticulitis?
An individual may attain a good digestive health and eliminate the risk of diverticulitis by following a few key steps:
- Avoid over-consumption of red meat (beef or lamb)
- Fatty foods, which take more time to digest, should not be consumed, since they become a major cause of intestinal blockages.
- Increase the fluid intake.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as Aspirin, Naproxen, and Ibuprofen, may lead to increased diverticular bleeding, and thus, it is strongly recommended to avoid their use.
- Never delay the bowel movement, and make a quick response toward the bowel urges, since these may lead to strain on the colon muscles and increase the infection.
- Hard-to-digest foods, like nuts, popcorn, corn, and seeds, should not be consumed, as these may worsen the problem of constipation.
Fiber and water may be useful in both preventing and treating diverticulitis, so it is important to have a sufficient amount of each in your diet.
- Diverticulitis is an inflammation of the diverticula in the intestinal wall of the human body.
- A diet rich in vegetable fibers and unprocessed bran will have a laxative effect that will help regulate and decrease the symptoms of diverticulitis.
- An increase in water will help patients who are constipated.