By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HIGH-FIBER DIET, GOOD BOWEL HABITS CAN PREVENT DIVERTICULITIS

Question: One day last week, I suffered all day with a lot of stomach pain, so the next day I went to see my doctor. She conducted a few tests and told me I have diverticulitis. I took antibiotics, and now I feel fine a week later. What should I do to make sure I don’t get this again?

Answer: Diverticulitis is a disease of the large intestine -- also called the colon -- that can be quite painful and, in some cases, very serious. Before I explain this disease more fully, though, I need to tell you a little bit about the colon, itself.

The colon is a cylinder of muscles in your abdomen. It's part of the digestive tract and helps move waste products out of your body. Diverticular disease develops when parts of the wall of the colon weaken and start to give way. That causes little pouches or pockets to protrude out through the wall. These pouches are known as diverticula, and -- according to the National Digestive Disease Information Clearing House -- about half of all Americans older than sixty have them.

The presence of diverticula is called diverticulosis and does not in and of itself cause any symptoms. However, if one of these pouches becomes inflamed or infected, the result is often severe cramping and tenderness on the lower left side of your abdomen. Fever and nausea might also be present. This potentially serious condition is called diverticulitis.

When you saw your doctor, she probably asked you about bowel habits, symptoms, pain, diet and medications. She may have also conducted a digital rectal exam to check for tenderness, blockage or blood. Other common tests would include checking the stool for signs of bleeding, blood tests to look for signs of infection, and X-ray studies.

You were wise to consult your doctor promptly when you first started to have symptoms. That’s probably one of the reasons you recovered in just a week. Most cases of diverticulitis are like yours -- relatively mild and responsive to antibiotics alone. Sometimes, however, a liquid diet and some time in bed to “rest the colon” are also required.

Hospitalization is necessary in severe cases. For instance, if there is a total blockage of the colon, a massive infection, or a perforation of the intestinal wall, immediate surgery would be necessary.

After an acute episode has been successfully treated, there may still be the need in a few cases for non-emergency surgery to reduce the chances of recurrence. This preventive surgery involves removing the part of the intestine where the diverticula are present.

Most doctors today believe that low-fiber diets are the main cause of diverticulitis. The disease was first noticed in the United States in the early 1900s when processed foods were introduced. These foods tend to be low in fiber. To prevent diverticulitis, eat lots of high-fiber foods.

A high-fiber diet will also make you less prone to experience other digestive problems. So eat plenty of foods such as whole-grain breads, beans, peas, fruits and vegetables. Also, you may be able to lower your risk of diverticulitis by drinking plenty of fluids and not putting off bowel movements when you feel the urge to go.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.