Volume IV, No. 6 By Frank M. Jordan
Diverticulosis, Diverticulitis and Constipation
Read an important Health Treatment Notice about personal health issues.
Description of Diverticular Disease
Diverticulosis is a form of Diverticular Disease characterized by the presence of Diverticula, which are small pouches that form in the weak parts of the wall of the colon. These Diverticula form along the mucous membrane that lines the colon and often protrude through the muscular outer wall of the colon, or more rarely, through other regions of the large intestine. When Diverticula become infected and inflamed, Diverticulitis occurs.
Many people with Diverticulosis do not experience any discomforting symptoms, but Diverticulitis with inflammation usually brings discomfort in several forms including constipation and/or diarrhea and pain as intestinal cramps in the lower left abdomen area. Lack of adequate quality water and fiber, with attendant constipation are the most common causes.
Diverticulosis and Diverticulitis Causes
For most, constipation, lack of quality water and low fiber intake are principal underlying causes of Diverticulosis as stated. Fiber aids because soluble and insoluble fiber help make stools soft and easy to pass. Adequate fiber also prevents constipation. Quality water equal to ½ of body weight in ounces daily is needed to flush the colon contents timely and further prevent constipation. Peristalsis refers to the ability of smooth muscle in the stomach and intestines to contract; a required action to move the stools through the digestive process, thereby helping to prevent constipation.
Constipation causes the muscles of the colon to strain to move stool that has hardened to a point movement through the digestive process is restricted. This restricted stool movement causes increased pressure in the colon and this increased pressure causes the weak spots in the colon to “bulge out” to become Diverticula. When the sacs or pouches named Diverticula form in weak parts of the colon and “bulge out,” they often become inflamed and infected, with the condition known as Diverticulitis. When Diverticulosis becomes Diverticulitis and far advanced, the lower colon may become distorted and narrow.
This distortion and narrowing of the lower colon may result in thin or pellet-shaped stools, bouts of severe constipation and occasional diarrhea. Approximately 20% of cases of Diverticulosis progress to Diverticulitis.
Symptoms of Diverticulitis
As previously stated, in the digestive system constipation and/or diarrhea can occur as a result of Diverticulitis, with pain often occurring in the lower left stomach/abdomen area. Although most Diverticula are painless, pain can occur with Diverticulosis and Diverticulitis due to spasms and intermittent intestinal cramp pain. This pain is often associated with a change in bowel habits including constipation and/or diarrhea.
Diverticulosis patients infrequently experience bleeding from a ruptured blood vessel in one of the Dirverticula. This bleeding is usually brief in time and in most cases stops of its own accord. However the bleeding may produce a flow of red blood from the rectum, or maroon-colored stools and any rectal bleeding should be checked by a physician. In some Diverticular patients this bleeding may require brief hospitalization and occasionally emergency surgery.
As stated, the infection causing Diverticulitis often clears up after a few days of antibiotics for bacteria treatment to which patients should always add a probiotic to replace damaged good bacteria needed for proper digestion and nutrient delivery in the body. If the condition gets worse, an abscess may form in the colon.
An abscess is an infected area with pus that may cause swelling and destroy tissue. Sometimes the infected Diverticula may develop small holes, called perforations. These perforations allow pus to leak out of the colon into the abdominal area. If the abscess is small and remains in the colon, it may clear up after treatment with antibiotics for a bacterial infection. If the abscess does not clear up with antibiotics, the doctor may need to drain it.
To drain the abscess, the doctor uses a needle and a small tube called a catheter. The doctor inserts the needle through the skin and drains the fluid through the catheter. This procedure is called percutaneous catheter drainage. Sometimes surgery is needed to clean the abscess and, if necessary, remove part of the colon.
Peritonitis, Fistula and Intestinal Obstruction
A large abscess can become a serious problem if the infection leaks out and contaminates areas outside the colon. Infection that spreads into the abdominal cavity is called peritonitis. Peritonitis requires immediate surgery to clean the abdominal cavity and remove the damaged part of the colon. Without surgery, peritonitis can be fatal.
A fistula is an abnormal connection of tissue between two organs or between an organ and the skin. When damaged tissues come into contact with each other during infection, the damaged tissues sometimes stick together. If tissues heal stuck together, a fistula forms. When Diverticulitis-related infection spreads outside the colon, the colon’s tissue may stick to nearby tissues. The organs usually involved are the bladder, small intestine, and skin.
The most common type of fistula occurs between the bladder and the colon. It affects men more than women and can result in a severe, long-lasting infection of the urinary tract. The problem can be corrected with surgery to remove the fistula and the affected part of the colon. A nutritional cleanse and detox program is helpful.
The scarring caused by infection may cause partial or total blockage of the large intestine. When this happens, the colon is unable to move bowel contents normally. When the obstruction totally blocks the intestine, emergency surgery is necessary. Partial blockage is not an emergency, so the surgery to correct it can be planned and nutritional efforts and supplements should be implemented to attempt to avoid unnecessary surgery.
Diagnosing Diverticulosis and Diverticulitis
As Diverticulosis often causes no symptoms, the presence of Diverticulosis is often discovered accidentally. Diverticulitis is usually evident due to the symptoms described. The doctor may check stool for signs of bleeding and test blood for signs of infection. The doctor may also order x rays or other tests.
Tests to detect Diverticulosis and Diverticulitis include barium enema X-rays, colonoscopy examination and flexible sigmoidoscopy. Flexible sigmoidoscopy enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon.
Preventing and Treating Diverticulosis and Diverticulitis
Unfortunately, there is no known cure for Diverticulosis or Diverticulitis to date. Once Diverticula have formed there is no means for reversing them. However, infection and discomforts can in most cases be controlled and relieved. Diet and nutrition are critical in controlling and relieving discomforts of Diverticulosis and Diverticulitis.
Treatment for Diverticulitis focuses on clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications.
To help the colon rest, the doctor may recommend patient bed rest and a liquid diet, combined with a pain reliever. If Vicotin or Tylenol containing Acetaminophen, now the leading cause of chronic liver disease, are used for pain, be sure to take MG Beta Glucan to nutritionally aid in minimizing potential liver damage.
An acute attack with severe pain or severe infection may require a hospital stay. While most acute cases of Diverticulitis are treated with antibiotics given by injection into a vein and a liquid diet, in some cases surgery may be necessary.
Diets low in fiber named cellulose and hemicellulose are believed to be a principal underlying cause of Diverticulosis. Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water becoming a soft, jelly-like texture in the intestines. Insoluble fiber passes almost unchanged through the intestines. Both soluble and insoluble fiber help make stools soft and easy to pass, while preventing constipation.
Most western diets average 15 – 20 grams of fiber per day, while the amount of dietary fiber required to prevent Diverticulosis is estimated to be 40 grams or more per day. Psyllium Seeds (husks) help to prevent Diverticulosis and help to reduce the discomfort associated with Diverticulitis.
A physician may also recommend taking a fiber product such as Citrucel or Metamucil once a day. These types of fiber products are mixed with water and provide about 2 to 3.5 grams of fiber per tablespoon, mixed with 8 ounces of water.
Until recently, many doctors suggested avoiding foods with small seeds such as tomatoes or strawberries because they believed particles could lodge in the Diverticula and cause inflammation. However, it is now generally accepted that only foods that may irritate or get caught in the Diverticula cause problems.
Foods such as nuts, popcorn hulls, and sunflower, pumpkin, caraway, and sesame seeds should be avoided. The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are generally considered harmless.
People differ in the amounts and types of foods they can eat and thus decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify individual items in one’s diet causing discomfort, diarrhea or constipation.
Herbs, including Chamomile, Ginger, Licorice Root (use the DGL -deglycerized licorice form for not more than 10 days at a time with a 7 day gap) and Cascara sagrada reputedly nutritionally help alleviate Diverticulosis and symptoms. Cat’s Claw and peppermint also aid in nutritional alleviation of Diverticulitis. Additional foods that nutritionally aid in alleviating or preventing Diverticulosis are the same foods that alleviate or prevent constipation.
Constipation is a malady of the digestive system that involves a reduction in the frequency of hard bowel movements.
The following nutritional aids are recommended for regaining and maintaining proper bowel function:
Carbohydrates in the form of Cellulose help alleviate constipation, with Glucomannan of 3,000 – 4,000 mg per day suggested
Hemicelluloses alleviate constipation with Lignin and Psyllium (husk) recommended to add bulk to stools.
Lipids aid with Propionic Acid are suggested which enhances muscular contractions in the colon; producing a laxative effect.
Probiotics are essential with Lactobacillus acidophilus included to provide good flora and bacteria in the gut for the digestive process to assist in breaking down food. If antibiotics are taken to resolve Diverticulitis, a potent probiotic is needed to replace damaged or killed good bacteria as collateral damage from the antibiotics.
Minerals to aid include Calcium, often deficient when constipation occurs. Magnesium Sulfate in Epsom Salts is a good natural laxative for constipation by reducing the normal absorption of water from the intestine, thereby enhancing water in the bowel to promote bowel movement. Chronic constipation can occur as a result of magnesium deficiency. Constipation patients are additionally sometimes deficient in Potassium and Sodium.
Neurotransmitters that aid include Acetylcholine produced in the intestines with the important function to enhance the process of peristalsis, or bowel muscle contractions that create motion in bowel movements.
Beta 1,3/1,6 glucan can influence the intestinal microbiota suggesting positive influence to help those with constipation complications and dysbiosis. (See www.betglucan.org under research on “Constipation/Dysbiosis)
Methylsulfonylmethane (MSM) of 500 to 2,000 mg per day nutritionally aids in relieving constipation, particularly in the elderly and enhances needed nutrient absorption.
Vitamins beneficial include Folic Acid with high amounts of up to 800 mcg per day. The B vitamin Inositol, together with Para Aminobenzoic Acid (PABA) are also helpful. Constipation can occur as a result of Vitamin B1 deficiency, with Vitamin B5 stimulating peristalsis. Vitamin C helps alleviates constipation but be aware excessive ingestion of Vitamin C can cause diarrhea as an indication the body has absorbed slightly more Vitamin C than it requires for optimal health. If diarrhea occurs after Vitamin C intake, reduce the amount by half.
Foods recommended are Fruits with Apples, Apricot juice, Bananas, Figs, Grapefruit juice and Lemon juice suggested. Prunes are an effective laxative that alleviate most cases of Constipation. Watermelon also help alleviate constipation.
Grains beneficial include Barley and Bran due to cellulose fiber content. Rice Bran of 17 grams per day alleviates constipation by increasing the stool mass and increasing the frequency of bowel movements. Wheat Bran of 15 grams per day alleviates constipation due to the Polysaccharides (beta 1,4 glucan) in Wheat Bran adding to the weight of the stool as a bulking agent.
Herbs helpful include Aloe Vera juice consumed orally, Cascara sagrada due to the Anthraquinone Glycosides and Chickweed tea. Dandelion helps alleviate constipation, while Fenugreek acts as a natural laxative.
Noni juice aids in alleviating constipation due to the Anthraquinones content of Noni. Green Tea alleviates Constipation due to the Tea Polyphenols.
Castor Oil, as a well-known modern traditional treatment for constipation, is recommended, with Olive Oil acting as a mild laxative effective for many. Molasses often alleviates constipation as a processed food.
Seeds can aid many with 2 – 3 teaspoons of ground Flax Seeds meal consumed with water known to prevent and alleviate constipation. As previously stated, Psyllium Seeds alleviate constipation by adding bulk to stools.
Vegetables are also essential with those preferred being Artichoke Leaf, Avocado and Cabbage juice. Carrots alleviate constipation by creating larger, softer feces due to the Polysaccharides content of Carrots as bulking agents. Green Peas alleviate constipation. Kelp aids due to the Algin content of Kelp which produces a laxative effect by retaining water in the colon. Potato juice and Spinach are beneficial.
Water is essential with a warm glass of water consumed upon wakening and the drinking of quality water equal to at minimum one-half of body weight in ounces daily.
Avoid commercial laxatives and do not take laxatives unless physician directed.
As nutrition deficiencies and toxins become ever more present in the lives of most, the challenges of digestive issues will become more prevalent and serious if not addressed. Fortunately, diet and natural nutritional aids can make major improvements in most digestive challenges, but your personal health care provider should be consulted to assure proper diagnosis of the specific health condition of an individual and appropriate responses natural, nutritional and pharmaceutical.
About the Author: Frank Jordan has a post-graduate degree from the University of Texas at Austin and is a co-patent holder on U.S. patents issued or in application related to the immune response in conjunction with researchers at the University of Nevada School of Medicine, Dept. of Microbiology. Jordan also hosted the Healthy, Wealthy and Wise national radio show heard in all 48 continental U.S. states weekdays. Learn more about Frank Jordan on the web at www.frankjordan.com .
Reprinted with permission from Immunition Reports. .
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