Health, Nutrition

Diverticular Disease: What Is It and How to Manage It

It is estimated that about 50% of people over the age of 60 are living with diverticular disease.  Many people have heard the name, but many more are unsure of what it is, seeing as a large percentage of those who have diverticulosis do not suffer from any symptoms.  Diverticulosis is characterized by pouches forming in the colon, usually caused by a low fiber diet.   Individuals on low-fiber diets are more prone to constipation, which can cause increased colon pressure during a bowel movement and may lead to weakening of the colon wall and eventually diverticula.  Food can back up into the diverticula, or pouches in the colon, and bacteria can begin to thrive there leading to infection.  When these pockets, or diverticula, in the wall of the colon become inflamed or infected, this is specific type of diverticular infection called diverticulitis.  Although most people with diverticulosis never develop diverticulitis, it is more common in people as they grow older and symptoms should not be overlooked as surgery may be necessary for proper treatment. Common symptoms of diverticulitis include:

  • Pain on lower left side of the abdomen
  • Stomach pain
  • Fever
  • Bloating
  • Diarrhea
  • Nausea
  • Cramping
  • Rectal Bleeding

A CT scan will typically be recommended for patients experiencing these symptoms.  The problem is diverticulitis will not always appear on a CT scan.  Physicians need to make the diagnosis using alternative means, such as inquiring about symptoms, bowel habits, and diet.  Feeling tenderness on the lower left side of the abdomen is a common indicator, but can be confirmed by a colonoscopy – to identify diverticula – and stool culture or blood test to confirm infection.

If diverticulitis is identified by your physician, this infection can usually be treated and cured by antibiotics, such as Cipro or Levaquin.  There are times, however, where surgery is required to remove the affected part of the colon, and rejoin two healthy sections.  With the portion of the colon with diverticula gone, a patient can more easily avoid other infections in the future.

If you are living with diverticulosis, or have suffered from infection stemming from this bowel disease, changing your diet could be the simplest and most beneficial course of action.  High fiber diets can ensure easier bowel movements, cleaner/healthier intestinal tracts, and a reduction in the incidence of diverticula forming. The following are foods recommended to increase your daily intake of fiber

  • Fruit: Raw apples, peaches, pears, and tangerines.
  • Vegetables: Fresh broccoli, squash, carrots, and brussel sprouts.
  • Starchy vegetables. Potatoes, baked beans, kidney beans, and lima beans.
  • Grains: Whole-wheat bread, brown rice, bran flake cereal, and oatmeal.

I recommend a Mediterranean diet, which includes many fiber rich components described in the list above.  The Mediterranean diet has long been celebrated as one of the healthiest diets in the world and is inspired by traditional dietary patterns of residents along the Mediterranean coast. Places such as southern Italy, Greece and Spain have greatly influenced the dietary components. The core aspects of the diet include nuts, whole grains, olive oil, fruits, vegetables, unrefined cereals, high consumption of legumes, moderate to high consumption of fish, moderate consumption of cheese and yogurt.

If diet alone is not enough, or sticking to a diet plan like the Mediterranean proves too difficult, consult your doctor about taking fiber supplements like Metamucil.  Any combination of these can help reduce diverticular disease and symptoms.

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Author: David B. Samadi, MD - Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital - Medical Contributor

Dr. David B. Samadi is the Chairman of Urology, Chief of Robotic Surgery and Lenox Hill Hospital, and Professor of Urology at Hofstra North Shore-LIJ School of Medicine in New York City. He is a board-certified urologist and an oncologist specializing in the diagnosis and treatment of urologist diseases, prostate cancer, kidney cancer and bladder cancer, and specializes in advanced minimally invasive treatments for prostate cancer, including laparoscopic radical prostatectomy and laparoscopic robotic radical prostatectomy. Dr. Samadi developed his own SMART (Samadi Modified Advanced Robotic Technique) surgery for the robotic removal of cancerous prostates.

Visit website: www.roboticoncology.com

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