This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

DIVERTICULITIS

Diverticulitis is an inflammation of the colon. It occurs when small sacs or pouches (diverticula) form on the mucus membrane, often due to constipation. A person strains to pass a hard, dry stool through the intestinal tract. The pressure causes the pouches to form at weak points in the wall of the colon. The pouches themselves don't necessarily create problems (symptoms), but if waste matter collects in them, they can become inflamed and infected.

Often diverticulitis clears up on its own, but complications can occur. If waste matter leaks onto the walls of the outer colon, an abscess (collection of pus) may form. The inflamed diverticular tissue may stick to another organ located near the colon. A hole can form in one of the sacs, and waste matter or pus can flow out into the stomach or pelvic areas of the body, causing a serious inflammation called peritonitis. Occasionally blood vessels in the sacs burst and cause bleeding.

WHAT CAUSES DIVERTICULITIS?

Diverticula tend to become inflamed if there are many of them, if they are spread throughout the colon, if they occur at an early age, or if they have been present for over ten years.

Fiber in the diet helps to push waste matter through the intestine during the digestive process. Many people believe that a diet high in fiber prevents diverticulitis. Until early in this century, people in the Western world ate much more fiber in their diets than they do now, and very few people developed diverticulitis. At the end of the nineteenth century, flour mills stopped using stones to grind wheat and began to use a method that reduces the fiber content in flour. In addition, people now eat more sugar, meat, and refined foods, and less fiber-rich whole grains, vegetable and fruits.

WHO GETS DIVERTICULITIS?

Diverticulitis develops in most people during their sixties, seventies, and eighties. It rarely appears in those under forty, but up to half of all Americans have it by the time they are sixty. It occurs in men and women equally.

You are more likely to get diverticulitis if there is a history of it in your family, if you have gallbladder or coronary artery disease, if you are very overweight, and if your diet is low in fiber.

WHAT ARE THE SYMPTOMS?

Only one in five people with diverticulitis ever develop symptoms. A mild case can cause occasional nausea and pain, constipation, gas and bloating. More serious symptoms include pain and tenderness in the lower abdomen near the groin that is relieved by passing gas or moving the bowels. Pain during urination may indicate bladder involvement. Constipation alternating with diarrhea, a low-grade fever and chills, and rectal bleeding also can be signs of diverticulitis.

If the infection has spread to other organs, discomfort can vary from mild to acute stomach cramping that comes on suddenly. The left lower abdomen may be tender, with pain extending around to the back.

DIAGNOSING DIVERTICULITIS

Blood tests may be taken, and your urine tested. X-rays may be taken of your abdomen. Occasionally a computerized axial tomography (CT) scan may be done.

A CT scan is a special and sensitive type of x-ray in which a pinpoint sized beam is projected into a part of the body to show a detailed picture of the area. An examination of the rectum call a colonoscopy may be performed. Sometimes a biopsy is done, in which a tiny piece of tissue is removed and studied under a microscope.

TREATMENT

Up to 85% of people with diverticulitis recover with medical treatment. Symptoms in many cases can be relieved by adding fiber to the diet. In mild cases, you maybe given antibiotics to take by mouth until the inflammation passes.

If you have a severe, acute attack, you maybe hospitalized. In order to rest your intestines, you will be given food and antibiotics intravenously (dripped directly into your veins). You will take nothing by mouth until the infection clears. This usually happens in two to five days in simple cases, eight to ten days in more serious ones. Muscle relaxants and pain relievers may help you feel more comfortable. If your first attack of diverticulitis is treated successfully, there is a good chance you will not have to be hospitalized again.

If the infection does not clear up, you may need to have the inflamed area removed surgically. This is done to prevent future episodes since the risk of developing serious complications rises with each recurrence.

WHAT YOU CAN DO

One of the most important things you can do is eat more fiber. High fiber foods include whole grains, raw fruits, cabbage, broccoli, spinach, and other leafy greens, carrots, celery, beans, squash, asparagus, and wheat bran. Eat only small quantities of red meat, dairy products, sugar, fried or spicy foods and processed foods.

During severe episodes, you might want to steam fruits and vegetables and put them in a blender to make them more digestible. Cleansing enemas (flushing out of the colon) can rid the colon of old, trapped food. Massage and stretching can help reduce pain and cramping.

COPING

Most attacks of diverticulitis come on suddenly with severe symptoms, but are over in a short time. If you have had one or more episodes, remember that, with medical treatment and dietary changes, you can recover completely. Even chronic diverticulitis, which can last a long time, can be treated either medically or surgically with success.

It is natural to feel anxious or scared about a chronic illness. It can be helpful to talk about your feelings with family and friends. It's also a good idea to look for a support group of people with the same condition. Coping can be easier when you realize you are not alone in your experience. In addition, you can share menu ideas and nutritional information. Diverticulitis is a manageable disease that will not stop you from leading a full, normal life.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

Planetree Health Fact Sheets are developed by Planetree, Inc., a non-profit consumer health organization, founded in 1978. The Planetree Alliance includes hospitals and libraries which, among many other patient-centered concepts, promote the importance of access to health information for patients, families, and community. For more information regarding affiliation with the international Planetree Alliance, call (203) 732-1365 or visit Planetree, Inc. at www.planetree.org.