Nagging abdominal pain and a new bout of constipation? You might be dealing with diverticulitis, a condition that occurs when small pouches form in the colon and become inflamed or infected.
Diverticulitis is more common as you age, affecting approximately two-thirds of people over 60, according to the National Institutes of Health. While some risk factors, such as age, are unavoidable, many lifestyle choices — diet, physical activity and weight management, for instance — can help reduce the risk of developing this uncomfortable gastrointestinal disorder.
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What Is Diverticulitis?
Normally, the lining of your colon is smooth. Diverticulosis occurs when small pockets, called diverticula, form along the colon wall. These pockets develop due to weakening within the muscle layers of the colon (also known as the wall of the large intestine).
Diverticulitis is the microperforation of those pockets — or acute inflammation or infection of the diverticula, says Dr. Sherif Andrawes, director of gastroenterology at Staten Island University Hospital at Northwell Health in New York. Pressure in the colon or bacterial disease often lead to this kind of inflammation or infection of the diverticula.
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Risk Factors for Diverticulitis
The exact cause of diverticulitis isn’t clear, but there are risk factors that can contribute to the formation or irritation of diverticula:
— Age. Your risk for diverticulitis increases as you age, particularly after 40.
— Constipation. Ongoing constipation, caused by sluggish digestion or hardening stools, can increase pressure in the colon.
— Diet. A diet low in fiber may lead to harder stools — and, therefore, constipation — increasing your risk.
— Genetic disposition. Some patients just have weaker connective tissue structures, Andrawes says.
— Obesity. Excessive intra-abdominal fat can weaken the structure of tissue and increase abdominal pressure.
— Certain medications. Taking medications like nonsteroidal anti-inflammatories, or NSAIDs, and opioids can increase your risk.
— Smoking. Smoking promotes widespread inflammation, impairs blood flow and weakens connective tissue in the colon, which can increase your risk for diverticulitis.
— Low activity levels. Not getting enough physical activity can slow the motility of your colon, leading to constipation and increased pressure in the colon.
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Symptoms of Diverticulitis
Diverticulosis, a precursor to diverticulitis, normally doesn’t cause any symptoms. In some cases, it may cause mild abdominal discomfort. But generally, “patients would not know that they have diverticulosis,” Andrawes says.
Once it advances to diverticulitis, however, symptoms are more likely to occur, though they can vary in severity.
In severe cases, diverticulitis symptoms may include:
— Abdominal pain, usually in the lower left side
— Fever
— Nausea
— Vomiting
— Chills
— Changes in bowel habits
“The pain of diverticulitis usually lasts hours and days, and sometimes it’s really severe,” adds Dr. Ashkan Farhadi, a board-certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
[Read: A Patient’s Guide to Digestive Diseases.]
When to See a Doctor
Diverticulitis is usually an acute condition, meaning it comes on suddenly.
Some patients even end up in the emergency room, Andrawes says.
If you’re not experiencing an acute attack but do have persistent symptoms that interfere with daily life, visit your primary care doctor or a gastroenterologist. Addressing diverticulitis early can help prevent it from progressing to more severe stages that may require more intensive treatment.
Diagnosing Diverticulitis
Diverticulitis overlaps with several other gastrointestinal disorders, so doctors often work through specific symptoms to rule out other GI conditions.
For example, Farhadi notes that blood in the stool is unlikely to be associated with diverticulitis. Similarly, although patients with diverticulitis can occasionally experience diarrhea, loose, watery stools are not typical symptoms of the condition.
In addition to a medical history and physical examination, your doctor may order the following:
— Imaging scans, such as a CT scan, which is most commonly used
— Blood tests
— Stool tests
— Colonoscopy — however, this could irritate the colon and may be avoided
“A lot of the time, the first diagnosis happens in the emergency room,” Andrawes says.
Treatment for Diverticulitis
Diverticulitis treatment varies based on the severity of the condition.
Mild to moderate diverticulitis treatment
For some people, mild cases of diverticulitis may resolve on their own.
For others with mild to moderate cases of the disease, treatment typically involves antibiotics. Patients are also advised to rest during recovery and may need to return for follow-up imaging scans to ensure the infection has resolved.
Severe diverticulitis treatment
In severe cases of diverticulitis, surgery may be required. If patients develop complications like an abscess or perforation, surgical intervention becomes necessary.
In these instances, the affected diseased part of the colon may need to be removed.
How to Prevent Diverticulitis
Diverticulitis prevention starts at home. Eliminating risk factors — primarily lifestyle-related factors — is key.
Each time you have an episode of diverticulitis, your risk increases for experiencing another episode, Farhadi explains — particularly because you’ve proven you have predisposing factors.
But changing those factors can help reduce future recurrence. Here’s how to get started:
1. Be active
Today’s lifestyle filled with phones, computers, sitting in an office and driving cars eliminates a lot of activity out of the day, Andrawes says.
The lack of ambulation in itself can even predispose the patient to digestive issues.
Movement, however, improves intestinal motility — which is how your muscles move food and waste through your digestive tract — so staying active throughout the day can help prevent diverticulitis flare-ups.
2. Eat a high-fiber diet
Fiber helps soften the stool and improve your digestion
The modern Western diet goes heavy on red meat, sugar and processed foods, while often lacking sufficient fruits and vegetables.
“Everything’s preserved,” Andrawes says. “Everything is cooked in a way that’s appealing to the customer, but not necessarily healthy or high in fiber.”
The Dietary Guidelines for Americans recommends women consume 22 to 28 grams of fiber and men 28 to 34 grams every day, depending on age. However, a majority of Americans fall short of that goal.
High-fiber foods to incorporate regularly in your diet include:
— Legumes
— Nuts and seeds
— Cruciferous vegetables, such as broccoli and Brussels sprouts
— Berries
— Root vegetables, such as carrots and sweet potatoes
— Whole grains, such as quinoa, oatmeal and brown rice
3. Maintain a healthy weight
Having overweight or obesity means excess fat in your abdominal region, which puts added pressure on the colon. This pressure can cause weakening of the muscles in your colon, which increases your risk for developing diverticulitis.
Achieving and maintaining a healthy weight can help reduce this risk. If you’re having trouble dropping weight or don’t know where to begin, talk to your health care provider for guidance and resources that can support your efforts.
4. Stay hydrated
Dehydration can affect your body negatively — including your bowel movements. Staying hydrated is important to maintaining regular bowel habits and staving off constipation, a major risk factor for diverticulitis.
Daily hydration recommendations can vary, but generally, men should aim to consume at least 13 cups of water daily and women 9 cups.
5. Manage stress
Although stress doesn’t have a direct, evidence-based connection to diverticulitis, it may play a role.
“It’s not a direct causality,” Andrawes says, meaning there’s not a direct relationship where stress itself causes diverticulitis. “It’s more of an association.”
Farhadi adds that when we’re experiencing stress, usually there are some changes in bowel habits. For example, stress may cause worsening constipation, which is then a direct risk factor for diverticulitis.
You also may be more likely to indulge in unhealthy foods while stressed, skipping out on important nutrients that come with a well-balanced, fiber-rich diet.
As a result, managing your stress levels may help curb other risk factors for diverticulitis.
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Diverticulitis: What to Know and How to Prevent It originally appeared on usnews.com
