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Diverticulosis and diverticulitis are technically two different digestive ailments. Diverticulosis is the first and sometimes only phase. If you have diverticulosis, you probably don’t know it. It’s pain free and usually only spotted during a colonoscopy. Diverticulitis, on the other hand, makes itself known with lower left abdominal pain and discomfort.
Diverticulosis is the development of pouches, sacs or pocket-like openings (diverticula) in the colon or bowel walls. Diverticula develop when outward pressure (most often from constipation) in the bowel or colon causes weak spots in the colon wall.
Many times you will not have symptoms from diverticulosis. Most people are unaware that they have it. However, when symptoms are present, you may experience abdominal cramping, bloating, diarrhea, constipation and/or rectal bleeding.
You cannot have diverticulitis unless you have diverticulosis. Diverticulitis results from complications within the sacs that develop from diverticulosis.
When the sacs become thin and infected with bacteria, they can rupture. Diverticulitis is the rupturing of the sacs. Once ruptured, the fluid in the sacs leaks through the colon walls and causes infection. Rupturing of the sacs and subsequent infection are much more serious than just having the sacs.
Diverticulitis can become a life-threatening ailment. Warning signs of diverticulitis include: tenderness in the left abdomen, nausea, fever, chills, vomiting, constipation and cramping.
“I was hospitalized in August of 2002 with Diverticulitis. After being discharged I stuck to a very strict diet – but experienced severe bloating with bouts of diarrhea and constipation. Since using Puristat’s [Colon Cleanse] I have felt like a completely different person. Thank you!” – Karen in MA
Complications from Diverticulitis
If you think you may be suffering from diverticulitis, you need to understand the complications that can result.
Complications from diverticulitis can vary depending upon the severity of your infection. These include bleeding, abscesses, perforations, peritonitis, fistulas and intestinal obstructions. Review below to get a more complete understanding of these complications.
- Bleeding—Though a rare complication of diverticulitis, if bleeding is allowed to worsen it can become deadly. It is believed that bleeding is caused by a blood vessel weakening and bursting. While the bleeding may stop on its own, it can be severe at times. In the case of severe bleeding, you may need surgery to stop it. If you notice blood in your stool or in the toilet, consult your doctor immediately.
- Perforations—Usually the infection from diverticulitis will respond to antibiotics. However, in cases where it doesn’t, you may develop small holes in the colon called perforations.
- Abscesses—If a perforation fills up with puss, you may develop an abscess. Abscesses can be treated with antibiotics but if they don’t respond, you may need surgery to drain them so the puss does not leak into your abdominal cavity.
- Peritonitis—A very large abscess that has leaked into your abdominal area through the perforation causing a spread of infection is known as peritonitis. This requires immediate surgery to clean the infected abdominal cavity and remove any damaged parts of the colon.
- Fistulas—An infection which spreads outside the colon may cause your colon tissue to attach to other tissues, organs or skin. This connection of tissue is known as a fistula. The organs mostly affected are your small intestine, bladder and skin. This type of fistula can be severe and can cause a long-lasting urinary tract infection. You will need surgery to remove the fistula and the part of the colon that has been affected.
- Intestinal Obstructions—Any time your body has an infection, scar tissue is left behind from the healing process. Diverticulitis is an infection and can result in scarring. This scarring can cause a total or partial blockage in the large intestine. When your intestine is blocked, even partially, moving your bowels can be difficult. If you have a partial blockage, surgery can remove the scar tissue. However, if you have a total blockage, emergency surgery will be needed since moving your bowels will be impossible.
An important part of your treatment is the actual diagnosis. There are many different ways to get diverticulosis or diverticulitis diagnosed.
To start with, it is important to understand that a diagnosis of diverticulosis is very uncommon since most individuals won’t experience any symptoms. Most times diverticulosis is found accidentally when exams are being performed for other reasons.
Tests which are used in a diverticulosis diagnosis can be a Barium enema X-ray, flexible sigmoidoscopy or colonoscopy.
During a Barium X-ray, you are given an enema full of Barium. After the Barium has been inserted, an X-ray is taken. The Barium allows for more visibility of the digestive tract and the diverticula can be seen.
The sigmoidoscopy and colonoscopy both consist of a flexible, lighted tube being inserted in the rectum. This allows a direct view of the colon, and any diverticula that exist will be visible.
A diagnosis of Diverticulitis will entail more detailed information from you. Your doctor will start with a complete medical history, then do a physical exam, and if necessary, order more tests.
Be prepared to give the doctor your entire medical history. The information your doctor will need consists of your bowel habits, diet, symptoms, pain and medications.
Once your medical history is complete, the doctor will then do a physical exam. First, a digital rectal exam is done. Your doctor will insert a gloved lubricated finger in the rectum. This reveals any tenderness, blockage or blood that may be present.
To determine if you have any signs of infection, your doctor will do a blood test and check the stool for any signs of blood. If your doctor feels it’s necessary, he or she will order more tests such as X-rays, CT scans or a colonoscopy.
These tests will give your doctor a clearer image of what is going on in your colon, and rule out any other more serious causes, such as colon cancer.
You’ve been diagnosed with diverticulosis or diverticulitis. What’s next?
The most common way to manage these digestive diseases is through a multi-pronged approach that includes dietary modifications, increasing fiber intake, and colon maintenance with herbal colon cleansing or colonic hydrotherapy.
How to feel your best
Below are ways to manage your diet and exercise routines, so you will feel your best.
Modify Your Diet: The key to managing your diverticulosis and diverticulitis is early intervention. The sooner the changes are made, the less pressure that builds on the colon walls.
The key to this is consuming an adequate amount of fiber and water. It sounds “old school” but it works!
Increase your fiber intake by eating more foods containing fiber and/or taking a fiber supplement. See our fiber chart for examples of foods high in fiber. You should consume at least 25-30 grams of fiber daily. Increases in fiber intake have been linked to weight loss as well as many other health benefits.
A dietary supplement containing psyllium is a good way to increase fiber; plus, this tends to produce less gas than high-fiber foods.
An increase in fiber creates softer, bulkier stools that move more easily through your digestive system. This will lower the amount of pressure in your colon which is responsible for the development of diverticulosis and diverticulitis.
Increasing your water intake is crucial and a general rule of thumb is to drink at least ½ your body weight in ounces on a daily basis. Therefore, a 150-pound woman should drink 75 ounces of quality water (herbal teas, broth, and fresh juices can account for some of the liquid). Liquid aids in keeping the pouch-like areas clean of toxic wastes, preventing inflammation.
Do not drink tap water if you can avoid it. Virtually all tap water contains toxins, poisons and fluoride and chlorine. Drink bottled spring water, water filtered using reverse osmosis or water purified through steam distillation.
Try colonic irrigation or herbal colon cleansing. Both colonic irrigation and herbal cleansing can help remove impacted waste, toxins and parasites that have built up in your colon over many years. Removing this impacted waste helps your body absorb nutrients, enhances energy and increases regularity…all factors necessary to manage diverticulitis. Which is best?
There is a misconception that if you suffer from diverticulosis or diverticulitis, you should avoid small seeds, certain grains, lettuce and high-fiber foods because the particles may lodge in the sacs and cause discomfort or inflammation.
This theory has never proven to be true, and actual microscopic review of surgical specimens show this is not the case. There is no reason to avoid these foods. Everyone’s body is different. You must find your own comfort level in the amounts and types of foods you can eat.
You will only be able to tell what works best for you through trial and error.
Some tips for modifying your diet:
- Look for whole grain or whole wheat as the first ingredient when you scan bread and cereal labels.
- Eat as much raw fruits and vegetables as you can; they are easier to digest and have more fiber than cooked or canned foods. They’ll also help with regularity.
- Improve meat dishes by adding fiber with lentils, baked Beans, kidney beans, black-eyed peas, lima beans, bran or oatmeal.
- Add unprocessed wheat bran to some of your favorite meat and carbohydrate meals. Meatloaf, pot pies, breads, muffins, casseroles and other baked goods can easily include wheat bran in the recipe without distorting the flavor.
- Increase the fiber in your dairy products by adding fresh fruit, whole grain or bran cereals to yogurt or cottage cheese.
- Replace all-purpose flour with oat bran in your baked good recipes.
- Eat a variety of high-fiber foods to increase your fiber intake and supplement with a psyllium-based product if you need additional fiber.
- Gradually increase your daily fiber intake. Rapidly increasing your fiber can result in uncomfortable gas, bloating, cramping and/or diarrhea.
Exercise: Your Colon’s Best Friend
Though a scientific link has yet to be established, the connection between people who exercise on a regular basis and regularity does exist. Your entire intestinal tract is surrounded by muscle. Strong abdominal and intestinal muscles are vital for proper bowel function and speedy transit times.
When intestinal muscles are toned, the right amount of liquid is removed from waste prior to elimination. If intestinal muscles are not toned, this slows the elimination process. This leads to an unhealthy amount of liquid being removed from the stool, causing waste impaction, expansion of the colon walls and hardened stools.
Like any muscle in your body, colonic muscles lose their tone from lack of proper stimulation and lack of use.
Some situations that can lead to the lack of muscle tone are:
- A diet low in fiber
- Lack of mobility, sedentary lifestyle and/or excessive bed rest
- Long-term use of laxatives, chronic diarrhea and loosely formed stools
- Neural interference (drugs or damage to nerves)
In most cases, loss of muscle tone can be reversed with physical exercise and a diet high in fiber.
Discontinue use of stimulant laxatives, diuretics and drugs that could interfere with your normal bowel function (with proper guidance from your healthcare professional).
As with any changes to your health routine, consider meeting with a trained heath practitioner before beginning any exercise routine. You can improve your muscle tone with minor changes like walking, taking the stairs or parking in the farthest spot from the store.
Dietary changes can and should be implemented gradually. Remember, with rapid increases in dietary fiber, you may become uncomfortably bloated and experience gas and intestinal cramping. Don’t let that stop you…a diet high in fiber is critical to good colon health.
Sometimes dietary modifications, colon cleansing and exercise aren’t enough to relieve your pain. There may be an infection from diverticulitis, and medical intervention is needed.
Once diverticulitis is present, your doctor will concentrate on clearing up the infection, reducing inflammation, resting the colon and preventing complications.
Antibiotics are prescribed to fight any infection, and bed rest along with a liquid diet are implemented to rest the colon and allow for self healing.
If your pain is unbearable, your doctor may prescribe a pain medication along with an anti-inflammatory to reduce uncomfortable cramping and swelling. The combination of these treatments will help prevent future complications. Most respond to these treatments within 2-3 days, and antibiotics will be continued for a 10- to 14-day period.
If your attacks of diverticulitis don’t respond to antibiotics, are frequent or severe, or if complications develop, surgery may be needed. The surgery, called a colon resection, involves removing the infected colon part and reattaching the two healthy pieces. During the surgery your doctor will also drain any collected puss, protecting against future infection.
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Once you’ve been diagnosed with diverticulosis or diverticulitis, there is no reversing the condition. The best way to manage diverticulosis and diverticulitis is to keep the pressure in your colon at low and constant levels.
Pressure levels increase and become unstable when impacted waste builds up in your colon. You can reduce the amount of waste in the colon at any given time by speeding up your transit time. To do this you must:
- Consume at least 25-30 grams of fiber daily.
- Never put off the urge to have a bowel movement.
- Drink ½ your body weight in ounces daily—purified or distilled water only.
- Do not use chemical laxatives or enemas to assist in bowel movements
- Complete a seasonal colon cleansing program.
It’s said an ounce of prevention is worth a pound of cure. This is particularly true for diverticulosis or diverticulitis. The more prevention you implement, the more you will ensure a healthier life and guarding against life-threatening complications. That makes prevention the cheapest insurance you’ll ever “buy.”