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$Title{What is Diverticular Disease?}
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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


What is Diverticular Disease?


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QUESTION:  Please tell me about diverticular disease and how one treats it.

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ANSWER:  Since about 1900, diverticular (a pouch of variable size in the
lining of the intestines) diseases have become very common in the United
States.  Of those suffering diverticula of the colon, about 5 percent are over
50 years of age.  By age 90 approximately 50 percent of that population suffer
from it.  Under age 40 it is not found frequently.  Every year about 200,000
people require hospitalization because of some form of the diseases.
     Most often patient's diverticular problems occur as one of three major
types:  painful diverticulosis, diverticulitis and diverticular bleeding.  It
is uncommon for more than one of those to be present in the same person.  Each
of those conditions usually behave as if they were separate disease entities.
Roughly 95 percent of all such conditions are found in the patient's
descending colon.
     In painful diverticulosis the most frequently occurring symptom is pain
in the lower left side.  At times the pain improves after defecation and may
worsen after eating.  Often bowel habits change ranging from diarrhea to
constipation.  Treatment for painful diverticulosis may include advice to
consume a high-bulk diet and/or drugs.  Surgery is seldom required.
     When one suffers from inflammatory diverticulitis, often acute,
persistent pain in the lower left side develops.  Sometimes the patient also
complains of pains in the back.  There frequently is fever occasionally with
chills and there may be loss of appetite, vomiting and/or change in bowel
habits.  Treatment most often consists of bed rest, antibiotics and
intravenous replacement of fluids.  Some patients obtain impressive benefits
from surgery, although about 80 percent of all patients with inflammatory
diverticulitis recover without surgery.
     Diverticular bleeding most often occurs in the right colon.  Usually such
bleeding comes on very rapidly often accompanied by mild cramps and a strong
urge to defecate.  While a surprising amount of blood may be passed, it ceases
spontaneously in about 80 percent of diverticular bleeding patients.  It
reoccurs only in about 20 percent of those who had an initial attack.
Treatment usually begins with bed rest and replacement of fluids, including
blood transfusions.  If the bleeding continues or reoccurs, surgery may be
needed.  In some cases a colectomy is required.
     Earlier I said we began to see diverticular diseases frequently in the
U.S. about the turn of the century.  Why?  It appears that increased
incidences of the diseases closely followed the introduction of the roller
milling of wheat, a process developed for the refining of flour and sugar--or
the removal of fiber.
     Where high fiber diets are consumed as in the Orient and Africa, the
diseases are rare.  Also, diverticulosis is common among various regional and
ethnic groups when they migrate from areas of high-fiber diets to places where
low-fiber meals predominate.  Diverticulosis is less common among Japanese
living in their home country than among ethnic Japanese living in Hawaii.  It
is less prevalent among the latter group than in Japanese who live on the
mainland.  Additionally, American vegetarians suffer from the diseases less
than others who eat a "usual" diet.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.