The Facts about Diverticulosis and Diverticulitis

If you’re struggling with abdominal cramps, gas and diarrhea alternating with constipation, you may be one of many people suffering from diverticulosis.

Diverticulosis, a condition in which small pockets or pouches extend out from the inside lining of the large intestine, is very common in people over age 40. In fact, at least one-third of all Americans over age 45 and more than two-thirds of those over age 60 have this condition. Diverticulosis can be present in the intestines for years and never be discovered unless you have a colonoscopy or barium enema X-ray.  Often, people experience no symptoms from the condition and only discover it when they are having an unrelated medical treatment in or around the intestine. However, well over ½ of people with diverticulosis will experience at least mild symptoms from the disease.

This odd-sounding condition may cause mild lower stomach discomfort which usually is not serious. In severe cases, bleeding may occur from the pouches, but this symptom is not common. However, diverticulosis can lead to a more serious condition, diverticulitis, which occurs when the pouches become infected, causing fever and moderate to severe lower abdominal discomfort.  Diverticulitis can cause diarrhea, abdominal pain and cramping with or without fever — symptoms similar to those experienced with Irritable Bowel Syndrome. Only 20 percent of patient cases with diverticulosis advance to diverticulitis.

The exact cause of diverticulosis is still not completely understood. Doctors suspect that the pouches may be caused when colon muscle spasm creates pressure inside the colon which causes small weak spots in the intestine walls to balloon out (herniate), causing the pouches. The actual diverticulum may measure up to ¼ inch in size so they are small but sometimes significant! The walls of the large intestine grow thicker with age, which may be one reason for the added pressure incurred during a bowel movement. Other contributing factors could be stress, irritable bowel or not enough fiber in your diet, which causes the intestine to work harder during digestion.

Once formed, diverticula are permanent, and treatments are mainly dietary. To reduce the risk of developing diverticulitis, people with diverticulosis should eat a high-fiber diet that includes whole grains, fruits and leafy vegetables. It is also beneficial to drink plenty of water and exercise regularly. Recent research indicates that consumption of nuts, seeds and corn does not increase the risk of diverticulosis or diverticular complications as had been commonly believed. So it is safe to try those foods and if they do not cause symptoms, a small to moderate amount is fine.

Patients experiencing abdominal pain from diveriticulosis may benefit from anti-spasmodic drugs. Medication may also be prescribed to help control stress, reduce bloating and stomach problems or relieve diarrhea and constipation. If the condition advances into diverticulitis, bed rest, antibiotics and even hospitalization may be required.

The symptoms of diverticulosis – gas, stomach cramps, pain and diarrhea alternating with constipation – are also common in other, sometimes serious diseases. If you’re suffering from these symptoms, contact us so that we can properly diagnose and treat the source of your problems.

Most people are diagnosed with Crohn’s at around age 20-30, although it can occur at any age. It also is more common in Caucasians, people with a family history of the disease and people who smoke. Cigarette smoking is the most controllable risk factor for developing the disease. Smoking also worsens symptoms and increases the likelihood that a patient will eventually need to have surgery.

Typical symptoms of Crohn’s include persistent diarrhea (which may be bloody), cramping, abdominal pain, fever, loss of appetite and weight loss.

A colonoscopy is usually required to make a diagnosis of Crohn’s.  Other helpful tests often used in the evaluation include blood tests, stool samples, abdomen x-ray or CAT scan, and video capsule endoscopy (Pillcam).   A colonoscopy involves a sedated examination of the entire colon with a flexible, lighted tube with an attached camera. The procedure also provides an opportunity for your doctor to take small tissue samples for laboratory analysis, which may help confirm a diagnosis.

There is no known cure for Crohn’s, although symptoms can be treated with drugs and sometimes surgery. The disease may also go into remission for years at a time.

Living with Crohn’s can be difficult, but patients can help manage the problem of chronic diarrhea by diet and lifestyle changes. If you have Crohn’s, following these tips may lessen your symptoms:

• Take the medications recommended by your gastroenterologist.
• Limit dairy products.
• Eat low-fat foods.
• Avoid gas-producing foods like beans, cabbage and broccoli.
• Limit your intake of raw fruit juices and fruits (especially citrus fruits), spicy food, popcorn, alcohol and caffeinated beverages.
• Eat several small meals throughout the day.
• Drink lots of liquids.
• Avoid stressful situations.
• Reduce stress by exercising, meditating and/or following relaxation techniques.
• If you smoke, quit

If you are experiencing the symptoms of Crohn’s disease and are concerned that you may have the disease, see your doctor.

The absolute best way to prevent and detect colorectal cancer is with a screening colonoscopy. We recommend that everyone be screened at the age of 50, earlier if there is a family or personal history of cancer, and at regular intervals after that. For African-Americans, screenings should begin at age 45.

While there are other tests being developed to detect colorectal cancers, only a screening colonoscopy can help you prevent cancer before it happens. Most colon cancers begin in benign colon polyps, or abnormal tissue growths. A benign polyp usually takes several years to become cancerous. During that time, there is a “window of opportunity” to find it and remove it before it turns cancerous. Any polyps found during a screening colonoscopy are removed and tested.

With removal of polyps, we can prevent colorectal cancers. When a cancer that is found early over ninety percent of cases can be treated and cured. We look forward to the day when colorectal cancer is no longer a life-threatening disease because individuals are taking steps toward prevention.

There is a pre-screening cleansing procedure to follow, but the actual screening procedure takes only about 15-30 minutes. With minor sedation, the procedure is actually painless.

Let’s work together to win the fight against colorectal cancer. Schedule your screening colonoscopy today.

A total of 48 persons referred by The InterFaith Health Clinic and The Free Medical Clinic of America received free screenings from the physicians and staff of Gastrointestinal Associates and The Endoscopy Center.

I believe I speak for my fellow physicians and the staff when I say that we feel privileged to have helped make the day a success. It was gratifying to all of us to receive the hugs of support and thanks from the patients.

Our physicians and staff volunteered their time for “GIA Screening Colonoscopy Day” so that these individuals will have the same opportunity as the rest of us to avoid colon cancer, the second deadliest type of cancer.

The national health care debate has focused attention on the role of physicians and other health care professionals. I think this event is a great demonstration of the concern medical professionals have for their patients’ well-being. I recommend a day of this type to other gastrointestinal practices across the country.

We also wanted to make everyone more aware of the need for screenings to prevent colon cancer. Persons over 50 need to have the exam, and those with a history of colon cancer in their family should be screened even sooner.

Out of the 48 tested Oct. 17, a total of 25 had polyps removed and sent for testing – 16 women and nine men. Twenty-three had no polyps – 15 women and eight men. Polyps can lead to cancer, and that’s why early detection is so important.

In addition to my colleagues and staff, I want to add my thanks to event sponsors Anesthesia Associates of Knoxville, Mercy Health Partners, Premier Surgical Associates, The Endoscopy Center, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc. Media sponsors were the Knoxville News Sentinel and WBIR-TV 10.

Thank you one and all.

With colon cancer ranked as the second-deadliest cancer, GIA is making free colonoscopy exams available to a group of people in the Knoxville area who are less able to afford the vital screening procedure.

We have termed it “GIA Screening Colonoscopy Day,” and practice gastroenterologists will perform the exams for about 50 persons who were referred by the InterFaith Health Clinic and the Free Medical Clinic of America.

Our physicians and staff volunteered their personal time for GIA Screening Colonoscopy Day so that these individuals will have the same opportunity as the rest of us to avoid this deadly cancer.

There is a message in this event for everyone, because early detection is the key in the battle against colon cancer.

Anyone over 50 should have a colon exam. Persons who have a history of colon cancer in their families may need to have the exam even earlier.

GIA appreciates the help of Dr. Tom Kim of the Free Medical Clinic of America and the InterFaith Health Clinic in identifying recipients and collaborating to make the day a success. We also thank Mercy Health Partners and Premier Surgical Associates, who will stand by in case additional medical facilities or surgical assistance might be needed. Other partners include the The Endoscopy Center, Anesthesia Associates of Knoxville, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc., for prep kits. Media sponsors include The Knoxville News Sentinel and WBIR-TV.

I personally thank all of our co-sponsors and especially our physicians and staff who gave up their day off to help these very worthy recipients. Our hope is that everyone will see the value of screenings to prevent colon cancer.

According to the very thorough article, a profusion of Web sites, clinics and wellness spas have sprung up, claiming that colon cleansing can cure a number of ills from headaches and chronic fatigue to arthritis and cellulite.

Called hydrotherapy or “colonics,” proponents say that flushing the colon with warm water removes waste that leaks toxins into the body. A diet of processed foods, pharmaceuticals, stress and lack of exercise has clogged up our lower intestinal tracts, advocates of colonics say.

Cleansing can dramatically improve a person’s health and well-being, they add, as well as contribute to weight loss.

Gastroenterologists generally say “balderdash.”

A good friend and gastroenterologist colleague of mine, Dr. John I. Allen of Minnesota, is quoted in the Wall Street Journal article.

“I have seen a lot of colons and the notion that people have pounds of feces and evil toxins built up in there is pure fantasy,” he told the Journal.

The overwhelming majority of gastroenterologists I associate with, including my colleagues here at Gastrointestinal Associates (GIA) and those in my network of professional associations, agree with Dr. Allen.

The Wall Street Journal added: “Healthy colons are self-cleaning, they (gastroenterologists) say, and evacuating the colon via other means can do serious harm, even causing the sluggishness the cleansing purports to fix.”

Dr. Allen estimates that he has done about 20,000 colonoscopy exams. Here at GIA we have done more than 200,000. So we have a platform to speak from on healthy colons.

My main message to people considering colonics is to investigate and be wary. Right now, only Florida licenses colon hydrotherapists.

I agree with hydrotherapists and others that a healthy diet of whole grains and fruit contributes to colon health. That diet – with more fiber, less fat and higher fluid intake – can also relieve constipation.

Do colonics contribute to decreasing the risk of colon cancer? There is not enough evidence to say that.

There are certain other risks to colonics that people need to be aware of, including the possibility of infection and rectal perforation.

Hydrotherapists told the Wall Street Journal that they are “personal trainers” for the colon. My advice is to consult your physician if you think you have a problem with your colon. He or she has years of medical training and experience to diagnose and treat your condition.