Causes, Symptoms and Diagnosis of Diverticulosis and Diverticulitis

Most people have in their colons small pouches 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 are diverticula. The condition of having diverticula is called diverticulosis. About half of all Americans age 60 to 80, and almost everyone over age 80, have diverticulosis.

Most people have in their colons small pouches 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 are diverticula. The condition of having diverticula is called diverticulosis. About half of all Americans age 60 to 80, and almost everyone over age 80, have diverticulosis.

When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people
with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.

Low Residue Diet for Diverticulitis
Grain Products:
· enriched refined white bread, buns, bagels, english muffins
· plain cereals e.g. Cheerios, Cornflakes, Cream of Wheat, Rice Krispies, Special K
· arrowroot cookies, tea biscuits, soda crackers, plain melba toast
· white rice, refined pasta and noodles
· avoid whole grains

Fruits:fruit juices except prune juice
Vegetables:Vegetable juices
Meat and Protein Choice:well-cooked, tender meat, fish and eggs
Dairy:as directed by your healthcare providers

Causes of Diverticulitis
It''s believed that most diverticula are caused by unnoticed muscle spasms, or by pairs of muscles that don''t contract in a synchronized manner. This puts brief but intense pressure on the mucosal layer, causing pressure at the weakest points. The weakest points are the areas around blood vessels that pass through the inside of the wall of the large intestine (also called the colon).
Older people have frailer tissue lining the bowel - this is probably why they have more diverticula.

Symptoms
Most people who have diverticulosis don''t have any symptoms, but some have mild cramps, constipation or bloating. Diverticulitis causes more severe symptoms, including any of the following, but particularly the first two:

· Steady abdominal pain
· Tenderness to pressure in the lower abdomen
· Fever
· Nausea
· Vomiting
· Chills
· Cramping
· Change in bowel habits (constipation or diarrhea)
· Rectal bleeding
· Sharper pain with breathing or jarring movements such as walking.

Treatment Involved for Diverticulitis
Diverticular disease is confirmed by a barium enema which usually shows the tell-tale pockets. If there is still doubt about the diagnosis, a narrow tube may be passed up through the anus to inspect the lining of the bowel (colonoscopy or flexible sigmoidoscopy). Unless acute diverticulitis is actually occurring, a high-fibre diet and sometimes laxatives are used to treat the condition. Fibrous fruits such as apples and pears are best, together with fresh vegetables and grains. Pain due to spasm in the
colon is treated with anti-spasmodic drugs (such as mebeverine) and analgesics (such as paracetamol).

Points to Remember
· Diverticulosis occurs when small pouches, called diverticula, bulge outward through weak spots in the colon (large intestine).
· The pouches form when pressure inside the colon builds, usually because of constipation.
· Most people with diverticulosis never have any discomfort or symptoms.
· The most likely cause of diverticulosis is a low-fiber diet because it increases constipation and pressure inside the colon.

Self-Care
If diverticulitis is treatable at home, patients should expect to remain quiet for a few days. Antibiotics will be prescribed to help kill the bacteria causing the infection. Patients will also temporarily need to avoid all whole grains, fruits and vegetables, so the colon can rest and heal. Once symptoms improve (often in 2 to 4 days) patients can gradually start increasing the amount of high-fiber foods in their diet.

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