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Diverticular Disease: Causes, Symptoms and Treatments

Thursday, Jun 05, 2014

Our physician expert talks about this common condition and how to help prevent it. He also answers the question, "Should I avoid nuts and seeds?"

Robert Akbari, MD is a colon and rectal surgeon with years of experience treating both simple and complex colon and rectal problems. He is an expert in the surgical and non-surgical treatment of these issues.

What is diverticular disease?

Diverticular disease is a condition that occurs when a person has problems from small pockets, or sacs, that have formed and pushed outward through weak spots in the colon wall. Each pouch is called a diverticulum. Multiple pouches are called diverticula.

The colon is part of the large intestine. The large intestine absorbs water from stool and changes it from a liquid to a solid form. Diverticula are most common in the lower part of the colon, called the sigmoid colon.

Who usually gets diverticula?

Having one or more diverticulum is a condition called diverticulosis. These pockets form on the colon as people get older. About half of Americans age 50 and older have these pockets and therefore have diverticulosis.

However, in the last 10 to 15 years diverticulosis has been more common among younger people, and it can be more aggressive in young people. The only prevention is eating a healthy diet, which makes you less likely to have these issues.

What causes diverticulosis?

It is generally believed that the low-fiber, high-fat Western diet is the main cause.

How is diverticulosis diagnosed?

Many times diverticulosis does not cause any symptoms, and it is generally found during a colonoscopy. Talk to your doctor about scheduling a colonoscopy. Find a physician online or call the PulseLine at 215-345-2121.

How can diverticulosis be prevented?

Fiber is the best prevention. The best sources are fresh fruits and vegetables (versus canned), whole grains and cereals and beans. People usually get about 15 grams of fiber a day in their diet. The goal is 25 to 30 grams.

Fiber works best when a person is well hydrated. Fiber and fluids go hand in hand. The way I think about fiber is like an ocean sponge. If there is no water in it, it is rock hard. But if you add water it gets nice and soft. That helps with passing stool.

What about fiber supplements?

There are lots of these on the market. They all work about the same. If I had to pick one I would suggest Benefiber, since it has no taste and you can mix it in with liquids. But be aware that some medications may have interactions with fiber, so the medication and the fiber may need to be taken at different times during the day. It's best to read the label on your medication to be sure.

What is diverticulitis?

This happens when one of the pockets or diverticulum pops or becomes inflamed and infected. Symptoms include abdominal pain, fever and sometimes diarrhea.

How is diverticulitis treated?

It is important to contact a doctor for treatment. Sometimes the person is given antibiotics, or IV antibiotics in severe cases. Some people have multiple attacks over the years. Surgery is recommended in certain cases to remove the section of colon with the diverticulitis. It depends on the severity of the condition. Sometimes surgery is done to prevent the next attack.

Many times surgery can be avoided. If a person does need surgery, it can often be done through minimally-invasive or laparoscopic techniques, and maybe even with robotics.

What is diverticular bleeding?

This occurs when a small blood vessel on the wall of the diverticulum ruptures. The person passes a lot of blood. There are several ways to stop the bleeding. At Doylestown Hospital, interventional radiologists can embolize the blood vessel if the bleeding is severe.

Should people with diverticulosis avoid nuts and seeds in their diet?

This is basically a myth, as research has never proven the link between seeds and nuts and diverticulum. What has been proven is the benefit of adding more fiber to the diet and maintaining a healthy diet overall.

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