Diverticulitis is inflammation or infection of one or more diverticula. Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis.
When the pouches become infected or inflamed, the condition is called diverticulitis. Diverticulitis is a common disease of the bowel, in particular the large intestine. Diverticulitis occurs in people with diverticulosis. It most commonly affects the sigmoid colon, which is the last part of the large intestine just before the rectum. Diverticulitis is more common in people older than 40. It can be severe in people of any age. Diverticulitis most often affects middle-aged and elderly persons. People with Diverticulitis have left lower quadrant abdominal pain, fever, and an elevation of their white blood cell count. Patients may also complain of nausea or diarrhea and some others may be constipated. Less commonly, an individual with diverticulitis may have right-sided abdominal pain. This may be due to right-sided diverticula or a redundant sigmoid colon.
Patients are studied with a CT scan (computed tomography). The CT scan is very sensitive (98%) in diagnosing diverticulitis. It may also identify patients with more complicated diverticulitis, such as those with an abscess. CT also allows for X-ray guided drainage of associated abscesses, possibly sparing a patient from surgery.
B.E. (barium enema) and colonoscopy are contraindicated in the acute phase of diverticulitis due to the risk of perforation.
The first time a patient has acute diverticulitis the doctor will treat them with bowel rest (ie, nothing by mouth), IV fluids, antibiotics. Recurring acute attacks or complications of diverticulitis usually require immediate or elective surgery.
Upon discharge patients are placed on a high-fiber diet. There is some evidence this lowers the recurrence rate. In some cases, surgery may be required.
The cause of diverticulitis is thought to be from increased colonic pressures. The sigmoid colon has the smallest diameter of any portion of the colon, and therefore the portion which would be expected to have the highest intraluminal pressure (laws of Laplace). Low dietary fiber, particularly non-soluble fiber (also known as "roughage") predisposes people to diverticulitis. Mechanical blockage of a diverticulum, possibly by a piece of feces, leads to infection of the diverticulum.
Dietary fiber is the part of a plant that provides and maintains the plant's structure. Cellulose, hemicellulose, polysaccharides, pectins, gums, mucilages, and lignins are dietary fibers. These fibers can't be digested by the human body. For this reason, they can help correct disorders of the large intestine (colon), and keep it functioning normally. Therefore, it is important to increase the amount of fiber in the diet. Fiber (also called roughage or bulk) promotes peristalsis (the wave-like contractions that keep food moving through the intestine). Also, high-fiber foods expand the inside walls of the colon. This eases the passage of waste. Fibrous substances pass through the intestine undigested. They also absorb water, resulting in softer, bulkier stools.
To improve your diet, add foods that contain more dietary fiber. You can include some or all of the following:
Whole-grain foods (such as bran cereals) and breads (those made with whole wheat grains).
Fresh fruits (including the skin and pulp).
Dried or stewed fruits (such as prunes, raisins, or apricots).
Root vegetables (such as carrots, turnips, or potatoes).
Raw or fresh vegetables, such as cabbage. (Lettuce is actually low in fiber.)
Eating bran cereal in the morning is often the easiest way to obtain fiber. All-Bran, 100% Bran, Bran Buds, oat bran, oatmeal, and Raisin Bran are some of the high-fiber cereals presently available. Bran can cause rumbling intestinal gas and even some mild cramping, so it should be eaten in small amounts at first. The amount can be increased as the body gets used to it. The goal should be one to two large, soft, formed stools a day.
You should also try to follow these dietary rules:
Drink plenty of liquids, including fruit or vegetable juices and water. Drink at least six cups of water or fluid a day.
Eat slowly. Chew your food thoroughly. This allows the saliva and digestive juices of the stomach, liver, and pancreas to break down food more easily. It may also help prevent problems from developing in the lower digestive tract.
Eat your meals at regular intervals.
Some professionals recommend restricting the following foods in diverticulosis diets: nuts, poppy seeds, caraway seeds, rye seeds, popcorn, crunchy peanut butter, corn, cucumber, and squash; as well as fruits and vegetables with seeds such as strawberries, figs, and tomatoes. However, there has never been any medical proof that these foods are injurious. Many gastroenterologists allow and even encourage consuming these foods, depending on an individual's tolerance. http://www.gicare.com/pated/edtgs01.htm