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.

There are two types of hemorrhoids: Internal, which occur in the rectal tunnel and are associated with rectal bleeding, itching, pain or skin irritation; and external, which occur in or around the anus and are characterized by a hard spot or painful swelling where the blood clot forms.

Hemorrhoids are common in both men and women. In fact, about half the population has them by age 50. They can be caused by a variety of factors, including abdominal disorders, pregnancy, stress, a lifestyle that includes sitting for extended periods of time, obesity, inadequate intake of fiber, lack of exercise, or genetic tendencies.

While home remedies such as creams, suppositories and warm baths may offer temporary relief from the symptoms of hemorrhoids, they often fail to solve the problem.

Despite the lack of long-term relief, far too many people put off seeking treatment. Some are embarrassed to mention their problem; others mistakenly believe that treatment involves surgery and long recovery periods. The good news is that new medical advances make treatment much easier. We offer non-surgical treatments that are quick, easy and virtually pain-free. Most patients are able to resume their normal lifestyle almost as soon as they leave our office.

A word of caution: Rectal bleeding is a common side-effect of hemorrhoids, but it also can indicate a more serious problem. It is important to seek medical attention if: You are over age 40 or have a family history of colon cancer; your hemorrhoids don’t improve with self-care; you have pain or bleed frequently or excessively; you develop bleeding between bowel movements; and/or the onset of your hemorrhoids occurs along with a marked change in bowel habits.

Whatever your political persuasion and feelings about health care reform, the legislation passed by Congress and signed by the President will be a fact that we’ll all have to deal with in the coming months.

As the dust settles on the issue, some aspects of the legislation are clear, but others will take some time to understand and implement.

I can assure you on three important fronts:

• First, at Gastrointestinal Associates, we will continue to be a practice that patients can depend on for accurate and comprehensive information about the health care practices that affect them.
• We also will work very hard to reinforce the bond between patient and physician. To us, that relationship is sacred, and we do not believe that government or anyone else should interfere with the long-standing relationship that exists there.
• And finally, we will continue to provide the highest level of gastrointestinal care and expertise to our patients.

The American medical system, despite its flaws, is still the best in the world, and our physicians represent the best of that system.

This isn’t the first time, and it won’t be the last, that we all will have to deal with change in health care policy, but the points above are our pledge to our patients.

And in a world of change, you can count on that.

The study observed the outcomes of nearly 16,000 colonoscopies performed by 315 gastroenterologists from across the country over a four-week period. Results have shown a definite correlation between colonoscopy withdrawal times, or the length of the procedure, and the detection rates for colon polyps.

Previously, the standard of care model suggested a withdrawal time of at least six minutes during a screening colonoscopy. The study provided clear evidence to support the importance of this minimum time frame to the discovery of colon polyps, the primary cause of colon cancers.

Our physicians are continuously participating in ongoing research and analysis, and our patients benefit from this practice. In seeking new and better medical treatments, our doctors keep abreast of the latest ways to diagnose and treat your gastrointestinal conditions. This results in more thorough examinations, earlier diagnosis and the most effective treatments available.

Particularly when it comes to colon cancer, the best way to prevent or cure the disease is through early detection through screening colonoscopies. This latest study confirms that a withdrawal time of six minutes or longer significantly increases the chances of discovering colon polyps. It is a standard we employ at GIA, and one that will help our patients prevent colon cancer.

Preventing colon cancer is the primary goal of a regularly scheduled screening colonoscopy and the aim of our entire staff of board-certified physicians. We consider it a privilege to be involved in ongoing, specialized training and cutting-edge research in the field of gastroenterology, primarily because it benefits our patients.

In addition to the finest medical care, we know that cost and convenience also play a part in the quality of service you expect. We have that covered as well. Our ambulatory surgery centers (ASCs) allow us to provide personalized care in a convenient, cost-effective way. All our ASCs are state licensed, Medicare-certified and accredited by the Accreditation Association of Ambulatory Health Care (AAAHC).

Ambulatory care refers to medical care provided for patients who are not admitted overnight to a hospital. The popularity of ambulatory care has grown rapidly since the early 1980s, mainly because advances in technology have made many tests, procedures and surgeries formerly done in hospitals safe to do on an outpatient basis.

One of the major benefits to the patient is cost savings. A surgery or procedure performed in an ambulatory surgery center can cost an estimated 30 to 60 percent less than the same procedure performed in a hospital. In our state-of-the-art facilities, our board certified and specially trained physicians perform endoscopies, dilations, colonoscopies, removal of colon polyps, treatments for Barrett’s esophagus and many other endoscopic procedures.

If a procedure is needed that must be performed in a hospital, we have physicians on staff at local hospitals.

Convenience is another reason to choose an ambulatory care facility. Our three offices and ASCs are conveniently located to better serve our patients, are easy to get in and out of, and have plenty of parking. Additionally, our outpatient treatments offer the convenience of returning home after a surgery or procedure which makes the process easier on the whole family.

At Gastrointestinal Associates, our ambulatory surgery centers help us bring you the very best in health care. We provide medical excellence, convenience and cost-savings, getting you in and out and home again quickly.