ASK THE DOCTOR:
More fiber will stave off diverticulosis
By DR. JIM MITTERANDOQ I recently had a flexible sigmoidoscopy that showed I have diverticulosis. My doctor said this was common and no need to worry. Should I be concerned? My friend told me not to eat nuts and fruits with small seeds. What should I do? What is the difference between diverticulosis and diverticulitis? Am I at increased risk for cancer?
A Diverticulosis affects one-half of Americans age 60 and over. Too little fiber contributes to hard stools that are slow to pass. This increases pressure in the colon causing bulging of the colon wall resulting in small, ¼ inch pouches called diverticula. Diverticula tend to develop on the left side of the colon where the stool is harder. Diverticulosis is less of a problem in other countries where fiber intake is higher.
Diverticulosis generally does not cause any symptoms. It is often an incidental finding during flexible sigmoidoscopy, colonoscopy or barium enema.
Occasionally, diveticula can cause rectal bleeding. Sometimes, the pouch can become inflamed or infected called diverticulitis. Signs of diverticulitis include left lower abdominal pain and fever in someone over age 40. Most infections are treated on an outpatient basis with oral antibiotics. More severe infections are treated with hospitalization, bowel rest (no eating), IV fluids and IV antibiotics.
Diagnosis is often made simply by history and examination and may require blood tests and CT scans. Occasionally, people require surgery if the infection does not clear, an abscess develops or the diverticula ruptures or diverticulitis recurs. The surgeon removes the effected part of the colon. During severe infections, the surgeon may need to create a temporary colostomy (an opening of the belly from which the colon drains stool into a bag) that can later be reversed.
Diverticulosis does not increase your chance of colon cancer.
Years ago, people were warned to avoid foods with small seeds out of fear that they might become stuck in a pouch causing diverticulitis. This is no longer believed to be true. In fact, you should increase fiber by eating at least five to seven servings of fruits and/or vegetables per day to strive for 30 grams of daily fiber intake. If you have a hard time consuming this much fiber, consider adding a fiber supplement such as psyllium (Metamucil, Fiberall) or methylcellulose (Citrucel). Drinking plenty of fluids and exercising regularly will also reduce the risk of developing both constipation and diverticulosis.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2003 The Patriot Ledger
Transmitted Tuesday, September 23, 2003