The wall of the colon is composed of several layers, two of which are an inner, smooth layer, surrounded by a muscular layer. At times, the muscular layer can weaken, which allows the inner layer to protrude, forming a small pouch. This pouch is referred to as a diverticulum, and the presence of diverticuli is called diverticulosis. Stool can become trapped within the diverticulum and can set up an infection, which is referred to as diverticulitis. Diverticulitis causes abdominal pain, fever, diarrhea, and passage of blood in the stool. Diverticulitis is second only to hemmorhoids as the most common reason for passage of blood into the stool. In its most severe form, diverticulitis can result in rupture, or perforation, of the diverticulum, which is a surgical emergency requiring an immediate colostomy.
Diverticular disease becomes more common with advancing age. It is found in approximately fifty-percent of people over the age of sixty, but only twenty percent of these will become symptomatic. The development of diverticular disease is attributed to an increase in the pressure within the colon leading to a weakening of the muscular layer that allows the inner layer to protrude. This process is believed to be due most often to a diet low in dietary fiber, high in refined sugar, and occasionally chronic constipation. While diverticulosis can occur anywhere in the colon, flare-ups of diverticulitis usually occur in the lower one-third of the colon, known as the sigmoid.
The diagnosis of diverticular disease is made on the basis of history, physical exam, and diagnostic studies.
The diagnostic studies can include:
- Barium enema, an X-ray procedure.
- Stool analysis.
Treatment and Prevention
A severe case of diverticulitis can require hospitalization for gastrointestinal rest, fluids, IV antibiotics, and occasionally transfusion. Less severe cases can be managed more conservatively at home with dietary changes, fluids, and oral antibiotics. Cayenne, chamomile, goldenseal, papaya, and yarrow extract have antibacterial effects, and they can be used along with Aloe Vera, which promotes healing of the inflamed tissues and eases constipation.
The goal of self-care is the prevention of diverticular formation, and the prevention of flare-ups of diverticulitits once diverticuli have developed. The following are recommended as preventive measures:
- A high fiber diet, with a minimum of thirty grams per day.
- Fluids. Six to eight glasses of water per day. Fluids and fiber are essential for the promotion of regular bowel function.
- Proper gastrointestinal bacterial flora, with supplementation with Acidophilus.
- Digestive enzymes. Supplementation may be necessary to assure proper digestion.
- Nutritional supplements. B-Vitamins and zinc are helpful in supporting GI function and repair.
- Avoid certain foods. Meats, dairy products, refined sugars, and processed foods should be avoided as they contain very little fiber. Nuts, seeds, and grains should be avoided, as digestion converts them into smaller fragments that can become trapped within a diverticulum, creating a flare-up of diverticulitis.