Diverticulitis: Complications From A Common Colon Problem
A recent study found diverticulitis has been on the rise in this country since the late 1990s. It now accounts for about 300,000 admissions each year for inpatient care.
Dr. Christian Mayorga, a gastroenterologist with Parkland Hospital System, explains this colon problem that can cause pain, obstruction and fever.
From the interview with Dr. Mayorga:
What is diverticulitis? “It’s important (first) to know with diverticulosis is. All along the G-I (gastrointestinal) tract, in the esophagus, small intestine or the large intestine, small outpouches called diverticula can form along the lining of those organs. Sometimes these diverticula can cause symptoms, and the colon those symptoms can be an inflammatory condition called diverticulitis or diverticular bleeding, we call it.”
The pouches are common: “By the time we reach 50 or 60, it affects about half of the population, we estimate. And as we get closer to 80 years older, about 75 percent. It may be related to a particular segment in the sigmoid colon that is particularly susceptible to diverticulosis. It may have to do with the wall in that particular area that’s particularly weak. A combination of the characteristics of the wall of the sigmoid colon, plus the increased pressures within the segment of that colon, can lead to formation of these pockets, but that’s just a theory.”
Reasons for the increase in diverticulitis: “You would expect as the population ages, the incidence of diverticulitis goes up as well. But what they found in the study, the age group of 40 to 49, there was a disproportionate increase in the incidence of diverticulitis. What this is, it’s unclear. Some of the risk factors for diverticulitis include obesity and smoking. We know obesity is at an epidemic level. The leading theory now is the prevalence of obesity in the United States goes up, so will the incidence of diverticulitis in the younger population.”
Diet as a possible cause of diverticulitis: “What I tell my patients is if you haven’t been diagnosed with it, will diet make a big difference in your development of diverticulosis? The answer is unclear. We’re not really sure. If you do have diverticulosis, a low fiber diet does increase your risk of developing the complications.
How serious is diverticulitis? “The majority of cases will recover without consequences (with) a short course of antibiotics. A subset of patients will seek care medical care through the emergency room and are admitted. The majority of them can be treated with antibiotics, I-V fluids or giving them a bland diet. A smaller subset of patients do develop complications due to diverticulitis: pockets of infections adjacent to where the inflammation is; rupture of the colon where the inflammation is, which requires surgery to repair; and the late consequences can be intestinal obstructions – the colon lays down scar tissue and there’s scarring and narrowing of the colon is that particular area.”
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