WHAT ARE DIVERTICULA?
About the article
This is a digitised version of an article from The Cayman Compass's print archive. Occasionally, the digitisation process introduces transcription errors, or other problems.
See the article in its original context from July 1985.
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At a later stage, this little sac then protrudes out through and beyond the wall of the colon. It could be likened to a hernia. Diverticulae do occur elsewhere in the bowel, but it is much less common.
This is a very frequent occurence in that 50% of adults over the age of 40 are said to have some diverticula.
What is the cause of diverticula and what is diverticulitis?
Our current thinking links diverticula to constipation.
You will recall in previous articles the stress your Caymanian doctor puts on a high fibre diet, lots of bulk in the colon and regular and daily bowel movements.
It takes pressure off the bowel and these little hernias are less likely to occur.
However, some new research has been done by a New Zealand physician, Dr. Geoffrey Wynne-Jones, who claims that, because in our society it is not thought to be polite to pass gas rectally (flatus) in the company of others, that because of this, there is increased pressure within the colon and this causes these little herniations or diverticula.
He feels that diverticula were not a problem in rural primitive societies where it was unnecessary to control flatus.
He claims that gas is forced back up into the large bowel and this to-and-fro movement results in greater pressure which causes these weak spots to give way.
Another cause is irritable colon syndrome, or spastic colon as it used to be called, in which there is some spasm in different areas of the colon, with increased intraluminal pressure inbetween these areas of spasm.
Diverticula are usually asymptomatic or without symptoms.
It is only when a seed or a nut, etc. gets caught in one of these pockets that the bowel starts cramping (on and off) causing lower abdominal pain (usually on the left side) often with constipation or diarrhoea and abdominal distention and gassiness. The pain stops when the foreign body is dislodged.
When the little pocket or diverticulum becomes irritated and sufficiently inflamed, it can break open and result in an infection and abscess - this is called diverticulitis.
When this is present, the pain becomes much more severe are persistent and is localized to one spot.
It is associated with nausea, vomiting and fever, with a mass often present in the left lower quadrant of the abdomen.
Surgery is still not always necessary - only when the abscess does not remain localized or there is some other complication. Usually it can be treated conservatively with a stool softener, rest for the bowel, intravenous fluids and antibiotics.
However, it is most important to realize that diverticulitis can now pretty well be eliminated by means of a high fibre diet and prevention of constipation, which in turn causes gas.
Avoid junk foods which are low in fibre, avoid laxatives, and substitute a high fibre diet with a natural wheat bran supplement, if necessary.
It might also be advisable to stay away from "windy" foods, especially when we are in the company of others for along period of time such as an extended car or plane trip.
It should always be possible to take a short walk and get rid of the flatus.
Perhaps with these suggestions you can well avoid diverticula and diverticulitis - and surgery! Your Caymanian Doctor
