Diverticulosis & Diverticulitis
Who cares about diverticular disease? Not me, particularly; but if you or someone you know is affected by it, then you would. So I have undertaken an exhausting research project (thanks, Google) that probably anyone could duplicate or improve on in some way. This is Poonurse reporting on... Diverticular Disease.
So What's The Deal?
Even though these two names sound the same (and no, I didn't make them up), they are very different in the opinion of your colon.
Diverticula are small pouches in your colon that bulge outward through weak spots, like an inner tube poking out through weak places in a tire, or like my ass bulging out when I try to wear jeans that are obviously too tight in a pathetic attempt to reclaim my lost youth and former attractiveness before multiple marriages to controlling losers sucked the life right out of me.
Each pouch is called a diverticulum. When you have more than one, you have diverticulOSIS. When the pouches become infected or inflamed, you have diverticulITIS. Stay with me, now... this will get semi-interesting at some point soon. Hopefully.
What Could Cause This?
Now that we know about our colons' potential to make deadly pouches inside of any one of us, it would be good to know how to prevent this from happening. Doctors believe that a low-fiber diet is the main cause of diverticular disease. (Let's just refer to it as DD from now on because I'm getting very tired of typing out the whole thing. *Note* DD is very different from the ED that Bob Dole is always talking about in those commercials.)
So it's the old story: not enough fiber. Genetics might play a part, too, but since there isn't anything that any of us can do about that, let's just latch right onto the fiber theory.
Fiber is the part of fruits, vegetables and grains that the body doesn't digest. There are two kinds of fiber -- soluble and insoluble -- but I'm not EVEN going to get into. One kind of fiber is all I can deal with at this point in my life. Fiber makes your poop soft and easy to pass and prevents constipation- - that's all I think we need to know. Aim to get 25 to 30 grams a day.
Brief Boring History Part You Can Skim Over Without Endangering Your Health
DD was first noticed in the United States in the early 1900's. This was about the same time that processed foods were introduced into the American diet, although I can't think what processed foods these could have possibly been. I know there weren't Cheetos, Fritos, Little Debbie Cakes or anything like that available back then, so I am a tad suspicious of the supposed link to processed foods. Also -- who the hell knew what was going on in the world in the 1900's? I guess a lot of people kept diaries or something. Anyway, DD's been around a while.
DD is most common in developed nations -- particularly the U.S. where we tend to come down with a lot of stuff like this. Low-fiber diets are rampant in the U.S. The disease is rare in countries in Asia and Africa, where people eat high-fiber vegetable diets. Although I have to wonder -- in Asia and Africa, aren't they are too busy worrying about deadly diseases like AIDS and the plague to really concentrate on DD and the pouch-making activities of the large intestine? I think DD would be the LEAST of their worries.
How Do You Know If You Have It?
Diverticulosis' symptoms can range from nothing at all to mild cramps, bloating, and constipation. Other non-deadly bowel diseases, such as Irritable Bowel Syndrome and ulcers might cause these same symptoms, so don't run around saying "Poonurse said I have Diverticulosis" if you experience any of these symptoms. In fact, keep my name out of it altogether, if possible.
Diverticulitis is far more serious, anyway. The most common symptom of this is abdominal pain, usually on the left side of the lower abdomen. You might also have fever, nausea, vomiting, chills, cramping, and constipation. Bad things can happen from here on out.
Diverticulitis can lead to severe complications like bleeding, infections, perforations, or blockages in the intestines. It ain't fun. If you develop any of these, you'd better get yourself to a doctor, pronto. Bleeding rarely happens, but sometimes a blood vessel in a diverticulum weakens and bursts. (I HOPE it goes without saying that if you are bleeding from the rectum, go to a doctor. But judging by the number of people who write in saying, "I'm bleeding from the rectum, what should I do," it apparently needs saying. So I'm saying it: go to the doctor.)
An infection caused by diverticulitis often clears up after a few days of treatment with antibiotics. But if it doesn't, you might get an abscess in your colon. Colons are pretty particular about who they let set up housekeeping in there, and if you get an abscess (an infected area that fills up with pus), the colon will serve an eviction notice in the form of rupturing and sending the pus to a new home in your spanking-clean abdominal cavity. This pisses off the abdomen, which will retaliate by doing its best to kill you. At this point, doctors have to get all involved to settle the dispute. To get rid of an abscess that doesn't respond to antibiotics, the doctor has to stick a needle into your abdomen and drain the fluid out through a catheter. This is expensive and probably very painful. Sometimes surgery is needed to clean out the abscess and actually remove part of the colon.
One more bad thing (but an interesting little complication) is called a fistula. This is an abnormal connection between two organs. When damaged tissues come into contact with each other, they tend to stick together. If they heal that way, a fistula forms. The most common type of fistula is between the bladder and the colon. It occurs mainly in men, thank God. It makes them have frequent urinary tract infections, and requires surgery to fix. I don't know why I think fistulas are so interesting, but I do.
Your intestines can also just go on strike and shut down production completely. While it sounds restful for the colon, it is a serious emergency and requires immediate surgery.
OK -- I'm Scared -- So What Is The Treatment?
The best treatment, of course, is prevention, which is why I'm constantly on your backs about fiber. For God's sake -- if you can't be bothered to eat properly, get Metamucil or some other fiber product and use it.
If you do get DD (and remember, it's not always your fault. Genetics plays a role, so feel free to blame your parents), adhering to the aforementioned high-fiber diet and pain medications will in most cases help relieve the symptoms.
Until recently, doctors believed people with diverticulosis should avoid foods with small seeds, such as tomatoes or strawberries or brownies with pot in them (unless you take the seeds out). They thought the seeds could lodge on the small pouches and cause problems. Apparently someone decided that this is no longer true, so I'm giving you a green light on the pot brownies. Zucchini, cucumbers, raspberries, and poppy seeds are also generally considered harmless. You should, however, avoid nuts, popcorn, sunflower seeds, pumpkin seeds, and sesame seeds. But your colon may have a different idea about what it will and will not tolerate, so keep track of what seems to piss it off.
If you get mild diverticulitis, your doctor will often prescribe antibiotics, put you on a liquid diet (no, not a beer diet), and give you some nice pain relievers that can often be hoarded and used just to get a buzz when you need one.
A severe attack will require a hospital stay. Along with your nice liquid diet and pain medication, you might also part with a portion of your colon. The goal of this surgery is to keep the attacks from coming back, and to prevent serious complications.
What Have We Learned?
Probably nothing, but what I'm trying to get across is that it's always best to do what you can to prevent these kinds of things from happening. Go get your Metamucil or Citrucel or generic fiber supplement. Often times they can be mixed with Jack Daniels for a tasty and entertaining way to ensure colon happiness. I also hope you know I was kidding about the brownies. That would be a waste of some perfectly good green.
Poonurse is an RN with 25 years experience in labor and delivery. Her qualifications
include seeing a lot of poop, and owning a computer. Also, she works in Michigan, which she calls the asshole
of the universe, so that's another bit of credibility.
Got a question for her?