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.

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.

Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten, which is found in wheat containing foods such as bread, pasta, cookies, pizza crust and many other foods containing barley, rye and possibly oats. When a person with Celiac disease eats gluten, the body responds by damaging the small intestine. This leads to an inability for the body to absorb essential nutrients.

If left untreated through a gluten-free diet, Celiac disease can cause anemia and stunted growth in children; loss of calcium and bone density; lactose intolerance from intestinal damage; intestinal cancers; and even disorders of the nervous system such as seizures and nerve damage.

Celiac disease is often misdiagnosed because the symptoms are common and resemble several other conditions like irritable bowel syndrome, gastric ulcers and Crohn’s disease. Those with Celiac disease may experience intermittent diarrhea, abdominal pain, bloating, upset stomach, irritability, depression, joint pain, muscle cramps or anemia. Dental and bone disorders, unexplained weight loss, or tingling of the legs and feet may also be indicators of malabsorption from Celiac disease.

Although Celiac disease can affect anyone, people with a family history of the condition are at a much greater risk. Also commonly affected are people with diabetes, Down’s syndrome, autoimmune thyroid disease and microscopic colitis.

With a gluten-free diet, people with Celiac disease can effectively manage the condition and live pain-free. It is not always easy; many foods and even some medications contain gluten. But with the growing number of gluten-free products on the market, even pizza lovers can avoid gluten. A registered dietitian who is experienced in teaching the gluten-free diet can offer advice on how to best maintain the nutritional quality of your diet and help sufferers come up with gluten-free alternatives and achieve a healthy lifestyle.

Once gluten is removed from the diet, inflammation in the small intestine subsides, and the organ will begin to repair itself. People generally begin feeling better in just a few days, though extensive damage may require some vitamin and mineral supplements to correct deficiencies.

On March 1, 2010, results of an international study out of London were released indicating scientists have identified new genetic links to Celiac disease. Their findings could speed the search for better ways to diagnose and treat Celiac disease and possibly even related autoimmune diseases like Type 1 diabetes.

If you are experiencing symptoms and suspect Celiac disease, see your doctor. The best treatment is a strictly followed gluten-free diet, but do not begin a gluten-free diet before you see a physician. If you stop eating foods that contain gluten before being tested, the test results may not be accurate.

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.

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.

We have also posted some news highlights on YouTube.

I am finding new media is opening up incredible ways to provide information that can help keep people well – and for others to share that information with people who need it.

When a symptom appears or when medical questions arise, many people now are checking the Internet first to see if the situation warrants a physician visit. The Internet can be a useful tool in helping to point you in the right direction and a little more comfortable than asking health-related questions over the phone.

However, keep in mind that anyone can put information on the Internet. The key is to make sure the information you are getting is from a reliable source.

Before you believe what you read online, check out the source. For information on gastrointestinal health – including colonoscopies, irritable bowels, gallbladder pain, reflux and so on – you can trust what the experts at Gastrointestinal Associates have to say.

Our Facebook page is filled with information about our doctors and from our doctors, so you can read about an issue and decide if it is time to make an appointment to see us in person. We also have a lot of great information to help you prevent gastrointestinal health issues.

As the main source of nutrition for your body, your gastrointestinal tract plays a vital role in your overall health and wellness. The physicians at GIA are experts in gastrointestinal health, with the knowledge and helpful information you need to keep feeling your best. For example, did you know a fiber deficiency is a leading cause of constipation which can lead to diverticulosis? Adding a little flavorless bran to your favorite foods can help you add fiber to your diet and prevent gastrointestinal problems.

For the latest, most reliable information on gastrointestinal health, turn to Gastrointestinal Associates. Check out our Facebook page or see our recent videos on YouTube with patient testimonials and news worthy information. It’s the best place to find health information from experts who know and care.