Diverticular Disease and Diverticulosis
Diverticular disease is when pockets or bulges (diverticula) form in the lining of the colon (large intestine). This is usually due to aging and it is estimated 5% of people will have diverticula by age 40 and 50% of seniors will have these by the age of 80. It is surmised that with age the colon loses some of its muscular strength and straining at the stool, especially in cases of constipation, may cause the formation of diverticula. In most people this condition called diverticulosis is without any symptoms and this is the most common digestive disorder to hit the aging population. Many people have no idea they have diverticulosis until they do a routine test like a colonoscope and then they are told they have these diverticula pockets. Only 1 in 4 of people with diverticulosis will go on to get diverticulitis.
Diverticulitis is when these pockets become inflamed or infected. In these cases stool or undigested food gets stuck in one or more pockets and these pockets become inflamed, or in a worse state scenario become infected.
In the US about 300,000 patients are admitted to hospitals every year for diverticulitis. From 2006 to 2011 there was an increased rate of ER visits for diverticulitis, while there were reduced rates for admission rates and for surgery.
Usually, the onset is sudden with intense pain usually on the lower left side of the abdomen and, often accompanied by a high fever 100.4F (38C) or more and frequent bowel movements. Sometimes there is slight or heavy bleeding from the rectum. Rarely there may be bleeding of dark purple blood.
The symptoms of diverticulitis are similar to other diseases like:
- Irritable bowel syndrome,
- Stomach ulcer
- Gall bladder disease and stones
- Colorectal cancer
Usually a positive diagnosis can only be made by a CT scan. A blood test may be taken to see if there is an elevation in white blood cells to show infection, but this is not always accurate.
In mild cases diverticulitis can be treated at home with antibiotics prescribed by a doctor. However, some cases become acute infections, sometimes accompanied by an abscess that forms next to the intestine and these usually have to be treated in a hospital. Depending on the severity of the infection, one can expect to spend 7-10 days in the hospital with antibiotics administered by IV. If there is also an abscess, it will be drained in the hospital in a procedure called percutaneous abscess drainage (PAD).
Surgery is extremely rare for diverticulitis, but may be advised when there are complications. Surgery is usually by resection, but it can also be a colostomy, especially if the bulging of a pocket leads to a rupture, which can cause peritonitis (infection throughout the abdominal cavity. This is a life-threatening emergency and must be treated immediately in the hospital.
A “Western Disease”
Diverticulitis has been nicknamed a “Western Disease” because it is more prevalent in western countries like the US and is rarer in Asia and Africa, probably due in some parts to genes, but most likely it is because the Western Diet is low in fiber.
Research has shown that seniors aged 50-70 who eat a high-fiber diet and drink 2-3 quarts of water a day have a 40% lower chance of admission to hospital with complications for diverticular disease – compared to others in their age range with the lowest amount of dietary fiber. Drinking enough liquids and eating a high fiber diet make the stools softer and easier to move without undue straining.
Also, people who have had an attack of diverticulitis or have been told they have diverticulosis pockets are told to avoid eating hard nuts, seeds and popcorn as these can get stuck in a pocket and cause an infection.
Other Diseases that May Lead to Short or Long-Term Care
If you or your loved one have diverticulosis or have had attacks of diverticulitis, be sure to mention this if the need for short-term rehabilitation or long-term skilled nursing care arises due to other reasons like heart attacks, stroke, dementia, hip fracture, lung disease, Alzheimer’s or Parkinson’s disease, etc. People with dementia may not remember their medical history and may not advise the facility that they have had diverticulitis. Be sure to choose a rehab where your loved one’s dietary needs can be tailored to meet their health requirements.
Royal Suites Healthcare and Rehabilitation
Royal Suites Healthcare and Rehabilitation in Galloway Township, New Jersey, is a 5-star skilled nursing and rehab facility on eight beautiful wooded acres in Galloway Township, New Jersey. They offer a wonderful, nutritious cuisine suitable for every taste and every health condition.
While 50% of seniors will develop diverticula (pockets) in their colons, only one in four will go on to develop diverticulitis. Only rarely does diverticulitis lead to surgery. Following a high fiber diet and drinking enough liquids is usually enough to prevent diverticulitis.