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.

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.

Heartburn affects many of us. In fact the American Gastroenterological Association reports that more than 60 million Americans experience symptoms at least once each month.

The burning sensation you feel is actually stomach acid splashing up into your esophagus. A valve at the end of the esophagus, called the lower esophageal sphincter (LES), normally prevents this. But factors such as overeating, pregnancy or even stress can keep the valve from shutting properly. When that happens, stomach acid can be pushed back up into the esophagus, causing pain along with a sour or bitter taste in the mouth.

Occasional heartburn is normally nothing to worry about and can easily be treated with over-the-counter antacids. However, frequent heartburn may indicate a more serious problem. Over time, stomach acid can damage the wall of the esophagus and, if left untreated, can lead to narrowing of the esophagus, bleeding and trouble swallowing, a condition called Barrett’s esophagus, and even cancer of the esophagus. Prolonged heartburn may also indicate more serious problems such as acid reflux disease, gastroesophageal reflux disease (GERD), gastritis, hiatal hernia or peptic ulcer.

There are several lifestyle changes you can make to help avoid heartburn:

• Avoid trigger foods such as chocolate; coffee; peppermint; spicy or greasy foods; tomato products; and alcoholic beverages.
• Eat smaller , more frequent meals.
• Don’t go to bed with a full stomach. Give food 2-3 hours to digest before going to bed.
• Stop smoking or using tobacco in any form. Tobacco inhibits saliva, the natural protection for your esophagus and the nicotine in tobacco increases acid secretion and relaxes the LES.
• Shed some pounds. Losing weight can help relieve symptoms.
• Eat high-protein, low-fat meals.
• Drink plenty of water during exercise to keep from being dehydrated.
• Avoid tight clothes and belts.

If you still experience heartburn, antacids usually give fast, short-term relief. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide to reduce the chance of diarrhea or constipation. If your symptoms worsen when lying down, raising the head of your bed so that your head and chest are higher than you feet may help.

If symptoms persist or occur frequently, speak to your doctor. Continuous heartburn may indicate a serious problem, and sudden chest pain may be mistaken for heartburn when it is really a sign of heart disease. Your physician may suggest prescription medication or testing such as x-rays to check for ulcers, pH tests to check for acid in the esophagus, or endoscopy to look for other conditions. Seek medical attention when the following symptoms occur:

• Difficulty or pain when swallowing
• Vomiting blood
• Black or bloody stools
• Shortness of breath
• Lightheaded or dizziness
• Neck or shoulder pain
• Heartburn more than 2-3 times per week for more than 2 weeks.

If heartburn is becoming a more frequent problem, keep a heartburn record. Track how often you experience the symptoms, what time of day and what you are eating or doing when the symptoms occur. That will help you get a clearer picture of when it is time to seek medical care and help your doctor more effectively diagnose and treat your condition.

The gallbladder is a storage tank for bile produced in the liver until the body needs it for digestion. Problems occur when the bile hardens into little pebble-like substances called gallstones and block the release of bile into the digestive system. Gallstones can be as big as a golf ball or as small as a grain of sand. Many people with gallstones don’t even know they are there.

When gallstones block the bile ducts, pressure increases in the gallbladder and may result in a gallbladder “attack.” An attack may follow a “fatty” meal, causing pain in the abdomen or in the back either between the shoulder blades or under the right shoulder.

Sometimes the pain subsides after an “attack” because the gallstone has moved. However, infection and rupture can still occur. People with prolonged pain; nausea and vomiting; fever or chills; yellowish coloration of the skin or eyes; or clay-colored stools should see a doctor immediately.

Over one million patients are diagnosed with gallstones each year. The good news is that the gallbladder is one organ you can live without, and surgery to remove the gallbladder is one of the most common surgeries performed on adults in the United States. It can often be done on an outpatient basis and may be performed laparoscopically, or with tiny incisions through the abdomen.

Although anyone can develop gallstones, the following tips can help prevent gallstones or their recurrence once treated.

• Don’t avoid eating or fast. Eating at least three balanced meals each day helps prevent the build-up of bile.
• Watch your diet. A diet that is high in fiber and calcium and low in saturated fats helps prevent the formation of gallstones.
• Maintain your target weight. Obesity increases your risk for gallstones, but so does rapid weight loss. Strive for an overall health plan to achieve a normal weight for your age and height.

Because gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome (IBS), pancreatitis and hepatitis, an accurate diagnosis is very important. Don’t let this little problem become a big issue.

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.