What are diverticula and how do they form in the colon. How does diverticulosis differ from diverticulitis. What are the main causes and risk factors for developing diverticular disease. How are diverticulosis and diverticulitis diagnosed and treated. When should you seek medical attention for symptoms related to diverticular disease.

What is Diverticulosis and How Does It Develop?

Diverticulosis is a common condition characterized by the formation of small pouches called diverticula that bulge outward through the wall of the colon (large intestine). These pouches typically develop in the weakest areas of the colon wall, where blood vessels penetrate the muscle layer.

The prevalence of diverticulosis increases with age. Approximately half of all individuals over the age of 60 have this condition. The primary cause is believed to be a low-fiber diet, which can lead to increased pressure within the colon and weakening of the intestinal wall over time.

How does a low-fiber diet contribute to diverticulosis?

A diet low in fiber can result in:

• Harder, smaller stools
• Increased strain during bowel movements
• Higher pressure inside the colon
• Weakening of the colon wall over time

These factors create an environment conducive to the formation of diverticula.

Recognizing the Symptoms of Diverticulosis

Most people with diverticulosis experience no symptoms at all. The condition is often discovered incidentally during routine screenings or tests for other gastrointestinal issues. However, some individuals may experience mild symptoms such as:

• Occasional abdominal cramping
• Bloating
• Changes in bowel habits, including constipation

When symptoms do occur, they are typically mild and can often be managed through dietary changes and over-the-counter pain relievers.

How is diverticulosis diagnosed?

Diverticulosis is frequently diagnosed through imaging studies or endoscopic procedures, including:

1. Colonoscopy
2. CT scan
3. Barium enema X-ray

These tests allow doctors to visualize the interior of the colon and identify the presence of diverticula.

Understanding Diverticulitis: When Diverticulosis Becomes Inflamed

Diverticulitis occurs when one or more diverticula become inflamed or infected. This condition is more serious than diverticulosis and can lead to significant complications if left untreated.

What are the symptoms of diverticulitis?

Common symptoms of diverticulitis include:

• Severe abdominal pain, typically on the left side
• Fever and chills
• Nausea and vomiting
• Changes in bowel habits
• Bloating and gas

In some cases, diverticulitis can lead to more serious complications such as bleeding, perforation of the colon, or the formation of abscesses or fistulas.

Diagnosing and Treating Diverticulitis

If you suspect you have diverticulitis, it’s crucial to seek medical attention promptly. Diagnosis typically involves a combination of physical examination, medical history review, and diagnostic tests.

What diagnostic tests are used for diverticulitis?

Doctors may use the following tests to diagnose diverticulitis:

• CT scan of the abdomen and pelvis
• Blood tests to check for signs of infection
• Stool samples to rule out other gastrointestinal conditions

These tests help confirm the diagnosis and assess the severity of the condition.

How is diverticulitis treated?

Treatment for diverticulitis depends on the severity of the condition. Mild cases may be managed at home with:

1. Antibiotics to treat infection
2. Pain relievers
3. A liquid or low-fiber diet until symptoms improve
4. Rest and monitoring

Severe cases may require hospitalization and more aggressive treatment, including intravenous antibiotics, pain management, and possible surgical intervention.

Preventing Diverticular Disease Through Lifestyle Changes

While you can’t prevent the formation of diverticula entirely, certain lifestyle changes can reduce your risk of developing diverticulosis and prevent complications like diverticulitis.

How can you reduce your risk of diverticular disease?

Consider implementing these lifestyle changes:

• Increase your fiber intake through fruits, vegetables, and whole grains
• Stay well-hydrated by drinking plenty of water
• Exercise regularly to promote healthy bowel function
• Maintain a healthy weight
• Quit smoking if you currently smoke
• Limit red meat consumption

These changes can help maintain colon health and reduce the risk of diverticular disease.

The Role of Diet in Managing Diverticular Disease

Diet plays a crucial role in both the prevention and management of diverticular disease. A high-fiber diet is particularly important for individuals with diverticulosis or those recovering from diverticulitis.

What foods should you eat to manage diverticular disease?

Include the following foods in your diet:

• Whole grains (e.g., brown rice, whole wheat bread, oatmeal)
• Fresh fruits and vegetables
• Legumes (beans, lentils, peas)
• Nuts and seeds (in moderation)

These fiber-rich foods help promote regular bowel movements and reduce pressure in the colon.

Are there any foods to avoid with diverticular disease?

Historically, patients were advised to avoid nuts, seeds, and popcorn, but recent research suggests these foods don’t increase the risk of diverticulitis. However, during acute flare-ups of diverticulitis, a low-fiber or liquid diet may be recommended temporarily.

When to Seek Medical Attention for Diverticular Disease

While many cases of diverticulosis are asymptomatic and can be managed through lifestyle changes, it’s important to know when to seek medical attention.

What symptoms warrant immediate medical care?

Seek medical attention if you experience:

• Severe abdominal pain, especially on the left side
• Fever above 100.4°F (38°C)
• Persistent nausea and vomiting
• Significant changes in bowel habits
• Rectal bleeding

These symptoms may indicate diverticulitis or other serious complications of diverticular disease.

Living with Diverticular Disease: Long-term Management and Outlook

For most people, diverticulosis is a manageable condition that doesn’t significantly impact quality of life. However, it’s important to be aware of potential complications and take steps to prevent them.

What is the long-term outlook for people with diverticular disease?

The outlook for individuals with diverticular disease is generally positive. Most people with diverticulosis never develop diverticulitis. Of those who do experience an episode of diverticulitis, about 50% will have a recurrence. Maintaining a healthy lifestyle and following medical advice can significantly reduce the risk of complications.

Long-term management strategies include:

1. Regular follow-up appointments with your healthcare provider
2. Adhering to a high-fiber diet
3. Staying physically active
4. Managing stress levels
5. Promptly addressing any new or worsening symptoms

By following these strategies, many people with diverticular disease can lead normal, healthy lives with minimal disruption.

Can diverticular disease lead to more serious conditions?

While complications are relatively rare, diverticular disease can sometimes lead to more serious conditions, including:

• Peritonitis (inflammation of the abdominal lining)
• Abscess formation
• Fistulas (abnormal connections between organs)
• Intestinal obstruction
• Severe bleeding

These complications are more likely to occur in cases of recurrent or severe diverticulitis. Regular medical check-ups and prompt attention to symptoms can help prevent or manage these complications effectively.

Understanding diverticular disease and its potential impact on your health is crucial for effective management. By working closely with your healthcare provider and making necessary lifestyle adjustments, you can minimize the risk of complications and maintain optimal colon health. Remember, early detection and prevention are key in managing diverticular disease successfully.

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Diverticula are small pouches that bulge outward through the colon, or large intestine. If you have these pouches, you have a condition called diverticulosis. It becomes more common as people age. About half of all people over age 60 have it. Doctors believe the main cause is a low-fiber diet.

Most people with diverticulosis don’t have symptoms. Sometimes it causes mild cramps, bloating or constipation. Diverticulosis is often found through tests ordered for something else. For example, it is often found during a colonoscopy to screen for cancer. A high-fiber diet and mild pain reliever will often relieve symptoms.

If the pouches become inflamed or infected, you have a condition called diverticulitis. The most common symptom is abdominal pain, usually on the left side. You may also have fever, nausea, vomiting, chills, cramping, and constipation. In serious cases, diverticulitis can lead to bleeding, tears, or blockages. Your doctor will do a physical exam and imaging tests to diagnose it. Treatment may include antibiotics, pain relievers, and a liquid diet. A serious case may require a hospital stay or surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

• Diverticular Disease

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• Diverticulitis

  (Mayo Foundation for Medical Education and Research)

• Diverticulosis and Diverticulitis

  (American College of Gastroenterology)

• Diverticulosis and Diverticulitis

  (National Institute of Diabetes and Digestive and Kidney Diseases)

  Also in Spanish

• Dietary Fiber: Essential for a Healthy Diet

  (Mayo Foundation for Medical Education and Research)

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• Diverticulitis Diet

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• Diverticulitis: Can Certain Foods Trigger an Attack?

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• Fiber: How to Increase the Amount in Your Diet

  (American Academy of Family Physicians)

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• Diverticula, Diverticulosis, Diverticulitis: What’s the Difference?

  (International Foundation for Gastrointestinal Disorders)

• ClinicalTrials. gov: Diverticular Diseases

  (National Institutes of Health)

• ClinicalTrials.gov: Diverticulitis

  (National Institutes of Health)

• ClinicalTrials. gov: Diverticulum, Colon

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• Article: Enhancing Disease Classification in Abdominal CT Scans through RGB Superposition Methods. ..

• Article: Incidence of diverticulitis recurrence after sigmoid colectomy: a retrospective cohort study…

• Article: Usefulness of water pressure observation in detection and direct clipping of. ..

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Diverticulitis: Causes, symptoms, and treatments

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Diverticulitis occurs when pouches begin to protrude outward from the wall of the colon, becoming infected and inflamed. It can cause pain and changes in bowel habits. Eating fiber may help prevent it.

However, these pouches can protrude without becoming infected. This is known as diverticulosis, and the pouches are called diverticula. Many individuals have a number of diverticula but feel no ill effects. However, when a pouch becomes infected, it can be very painful.

Around 50 percent of people are thought to have diverticulosis by the age of 50 years. An estimated 10 to 25 percent of people with diverticulosis will go on to develop diverticulitis, although this figure is debated, and some believe it may be as low as 1 percent.

By the age of 80 years, an estimated 65 percent of people have diverticulosis.

A study found that the incidence of diverticulitis among young obese adults is growing. A National Institutes of Health (NIH) report revealed that the cost of digestive diseases is now more than $141 billion a year in the United States.

This MNT Knowledge Center article will look at the causes, symptoms, risk factors, and treatments of diverticulitis and related conditions. We will also discuss the diverticulitis diet.

Fast facts on diverticulitis

• Diverticulitis is an infected pouch in the colon.
• Symptoms of diverticulitis include pain, constipation, and blood in the stool.
• One of the main causes of diverticular disease is thought to be a lack of dietary fiber.
• Most people can self-treat the condition.
• Surgery for diverticulitis may be necessary if the condition is recurring.

Was this helpful?

The symptoms of diverticulosis and diverticulitis are different.

Diverticulosis symptoms

The majority of people with diverticulosis will never experience any symptoms. This is called asymptomatic diverticulosis.

There may be episodes of pain in the lower abdomen. More specifically, usually in the lower left side of the abdomen. The pain often comes when the individual eats or passes stools. There may be some relief after breaking wind.

Other symptoms include:

• changing bowel habits
• constipation and, less commonly, diarrhea
• small amounts of blood in stools

Diverticulitis symptoms

When diverticulitis becomes inflamed, symptoms include:

• constant and usually severe pain, usually on the left side of the abdomen although occasionally on the right
• fever
• more frequent urination
• painful urination
• nausea and vomiting
• bleeding from the rectum

It is unknown why pouches start to protrude outward from the colon. However, a lack of dietary fiber is often thought to be the main cause.

Fiber helps to soften stools, and not consuming enough dietary fiber leads to hard stools. This may cause more pressure or strain on the colon as muscles push the stool down. This pressure is thought to cause the development of diverticula.

Diverticula occur when weak spots in the outside layer of colon muscle give way and the inner layer squeezes through.

Although there is no clear clinical evidence proving a link between dietary fiber and diverticulosis, researchers claim that the circumstantial evidence is convincing. However, the topic is hotly debated.

In parts of the world where dietary fiber intake is large, such as in Africa or South Asia, diverticula disease is fairly uncommon. On the other hand, it is quite common in Western countries where dietary fiber intake is much lower.

However, other reports have debunked the link between increased dietary fiber and diverticulitis prevention, advising that it may actually increase the likelihood of the disease.

Previously, the consumption of nuts, seeds, and corn was thought to be a cause of diverticula development, but a study in 2008 found no link.

Sometimes, a doctor will recommend that someone with diverticulitis goes on a special diet, to give the digestive system an opportunity to rest.

Initially, only clear liquids are allowed for a few days. These include:

• ice chips
• fruit juice without pulp
• broth
• ice pops
• water
• gelatin
• tea and coffee without cream

As symptoms ease, a person with diverticulitis can start to include low-fiber foods, including:

• canned or cooked fruits and skinned, seedless vegetables
• low-fiber cereals
• eggs, poultry, and fish
• milk, yogurt, and cheese
• refined white bread
• pasta, white rice, and noodles

Foods to avoid

Gastrointestinal problems often come with a list of foods to avoid. It has been suggested in the past that nuts, popcorn, and seeds can cause symptoms to flare up.

However, as the causes of diverticulitis are not known, the National Institutes of Health advise that there are no particular foods to exclude from the diet that will improve diverticulitis symptoms.

The high-fat, low-fiber diet that characterizes Western eating has been shown to increase the risk of diverticulitis in a recent study. It is best, therefore, not to eat red meat, deep-fried foods, full-fat dairy, and refined grains.

Food should be excluded based on individual experience. If you find that a particular type of food aggravates the effects of diverticulitis, avoid it.

It is not fully understand why diverticulitis occurs. Bacteria in the stool may rapidly multiply and spread and cause the infection. It is thought that a diverticulum might become blocked, possibly by a piece of stool, which then leads to infection.

Risk factors include:

• age, as older adults have a higher risk than younger individuals.
• being obese
• smoking
• lack of exercise
• a diet high in animal fats and low in fiber
• some medications, including steroids, opiates, and non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen

Some studies have indicated that genetics may be a factor.

Share on PinterestA number of techniques may be used to aid diagnosis.

Diagnosing diverticular and diverticular-related diseases can be challenging, and there are a number of tests that might be carried out to ensure correct diagnosis.

There are several illnesses and conditions with similar symptoms, such as irritable bowel syndrome (IBS), so diagnosis of diverticular disease is not easy.

A doctor can rule out other conditions by having some blood tests done. They may also use the following techniques:

Colonoscopy: The doctor has a look inside the colon using a thin tube with a camera at the end called a colonoscope. The colonoscope enters through the rectum. Hours or a day before the procedure begins, people are given a laxative to clear their bowels.

A local anesthetic is given before the procedure starts. This test is not usually done during an acute episode of diverticulitis, but done around 6 weeks after resolution to ensure there are no signs of cancer.

Barium enema X-ray: A tube is inserted into the rectum, and a barium liquid is squirted into the tube and up the rectum. Barium is a liquid that shows up in X-rays. When organs that do not normally show up on an X-ray are coated with barium, they become visible. The procedure is not painful.

Diagnosing diverticulitis

If an individual has a history of diverticular disease, the doctor will be able to diagnose diverticulitis by carrying out a physical examination and asking some questions about symptoms and their medical history.

A blood test is useful because if it reveals a high number of white blood cells, it probably means there is an infection. However, many people without a high number of white blood cells may still have diverticulitis.

People who have no history of diverticular disease will need additional tests. Other conditions can have similar symptoms, such as a hernia or gallstones.

A computer tomography (CT) scan may be used and is often the most helpful. A barium enema X-ray may also be useful. If symptoms are severe, the CT scan may tell whether the infection has spread to another part of the body, or whether there is an abscess.

Individuals can often self-treat if the case is not too severe.

Diverticulosis treatment

Most people can self-treat their diverticular disease if it is mild, mainly with the help of painkillers and by consuming more dietary fiber.

Painkillers such as aspirin or ibuprofen should be avoided as they increase the risk of internal bleeding, and may also upset the stomach. Acetaminophen is recommended for pain relief from diverticular disease. Acetaminophen is available for purchase over the counter or online.

Eating more dietary fiber, which includes fruits and vegetables, will help resolve the symptoms by softening stool and helping stool patterns become more regular. This may sometimes take a few weeks.

Bulk-forming laxatives may help those who have constipation. It is important to drink plenty of fluids with these medications.

People who experience heavy or constant rectal bleeding should see their doctor.

Diverticulitis treatment

Share on PinterestAntibiotics may be used to treat some cases of diverticulitis.

Mild cases of diverticulitis can generally be treated by the individual. However, a doctor may prescribe antibiotics, as well as acetaminophen for the pain.

It is important to complete the whole course of antibiotics, even if symptoms get better.

Some people may experience drowsiness, nausea, diarrhea, and vomiting while they are taking their antibiotics.

Antibiotics include ciprofloxacin (Cipro), metronidazole (Flagyl), cephalexin (Keflex) and doxycycline (Vibramycin).

For those on the contraceptive pill, it is important to remember that antibiotics can interfere with its effectiveness. This effect on the contraceptive pill continues for about 7 days after stopping the antibiotic, so another form of contraception should overlap with this time.

Hospital treatment may be necessary if any of the following apply:

• Normal painkillers do not alleviate the pain, or the pain is severe.
• The individual cannot consume enough liquids to keep hydrated.
• The person with diverticulitis cannot take oral antibiotics.
• They have a poor state of health.
• The doctor suspects complications, often if the immune system is weak.
• Treatment at home is ineffective after 2 days.

Hospital patients are generally given antibiotics intravenously (IV), as well as fluids if they are dehydrated.

Surgery

People who have at least two diverticulitis episodes may benefit from surgery. Studies indicate that such patients are significantly more likely to have further episodes and complications if they do not have surgery.

A colon resection removes part of the affected colon and joins the remaining healthy parts together.

Patients who undergo colon resection will have to introduce solid foods into their system gradually. Apart from this, their normal bowel functions will not usually be affected.

Peritonitis: Infection may spread into the lining of the abdomen if one of the infected diverticula bursts. Peritonitis is serious and can sometimes be fatal. It requires immediate antibiotic treatment. Some cases of peritonitis require surgery.

Abscess: This is a pus-filled cavity that requires antibiotics. Sometimes, surgery is required to get the pus out.

Fistula: These are abnormal tunnels, or tubes, that connect two parts of the body, such as the intestine to the abdominal wall or the bladder. A fistula can be formed after infected tissues touch each other and stick together; when the infection is over, a fistula forms. Often, surgery is needed to get rid of a fistula.

Intestinal obstruction: The colon may become partly or totally blocked if infection has caused scarring. If the colon is blocked completely, emergency medical intervention is needed. Total blockage will lead to peritonitis. If the colon is partially blocked, they will need treatment. However, it is not as urgent as total blockage.

Depending on the degree of scarring and the extent of blockage, a colon resection may be needed. Sometimes, a colostomy may be required. A hole is made on the side of the abdomen, and the colon is redirected through the hole and connected to an external colostomy bag.

Once the colon heals, it is rejoined. In rare cases, the doctors may have to create an internal ileoanal pouch.

People who eat a well-balanced diet with plenty of fruit and vegetables have a lower risk of developing diverticulitis.

What is tickling, and why are we so afraid of it?

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16:33, August 14, 2019

Photo: pxhere.com

Are you ticklish? Everyone will answer this question in their own way: someone starts to laugh at the slightest touch to any area on the body, and someone will not flinch even if you tickle his feet with a bird feather. Yes, and the feeling, you see, is strange: it seems to be funny to us, but at the same time we want to be tickled as soon as possible. So what is tickling, where did it come from and why are we afraid of it? Let’s take it in order.

• What is tickling?
• Where did she come from?
• Why can’t you tickle yourself?
• Not only people are afraid

What is tickling?

The sensation of tickling is familiar to everyone, but not everyone is familiar with its nature. Scientists call tickling the effect on the skin, in which excitement, impetuous laughter and characteristic reflex movements occur, which are accompanied by an increase in breathing and pulse. And, in principle, the sensation of tickling can occur in any part of the body, but most Sensitive to touch are the inner surface of the ears, ribs, neck, armpits, abdomen, groin, popliteal fossae and feet. At the same time, some people are more, while others are less susceptible to such influences, so they say about the first – they are afraid of being tickled, but about the second – not.

Where did it come from?

People of science still have not come to a consensus about why we are ticklish. According to the first hypothesis , tickling is a human reflex reaction to insects and small animals, which has not disappeared in the course of evolution. That is, with the help of tickling, the body protects us from poisonous creatures that threaten our lives.

According to another version , tickling is a side effect that appeared during the development of the nervous system. And now tickling is considered a borderline reaction of the body to external influences, something in between the body’s responses to affection and pain.

Why can’t you tickle yourself?

Photo: danielam/pixabay.com

Ancient Greek sage Aristotle noticed that it is impossible to tickle yourself . But why? The fact is that the body understands what exactly causes tickling, and reacts to it accordingly. Therefore, when a person tries to tickle himself, and there is no external threat, the cerebellum predicts his actions and suppresses the alarm signals that are sent to other parts of the body.

Not only people are afraid

Interestingly, not only people, but also monkeys are afraid of being tickled. And if the monkey is tickled, it will laugh. Of course, her laughter will be different from a human one, and yet it is quite possible to recognize it. Moreover, at the end of the last century, scientists managed to find out that rats also emit an ultrasonic signal with a frequency of 50 kHz when they are tickled. And such a signal can also be considered an analogue of laughter.

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5 scientific facts about tickling

You will laugh, but the seemingly banal tickling mechanism for the scientific community is one big question. Currently, a lot of research has been done on the basis of which there are a number of explanations for the nature of this feeling, but none is still the main one. Can a person tickle himself, why do we laugh from tickling, who is less susceptible to this sensation, do animals have the same mechanism and how do laboratory rats laugh when they are tickled – not without the help of science, we will try to understand these and other “ticklish” questions.

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Animals

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Psychology

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Why we are ticklish

According to one of the versions, this is a defense mechanism of our body, an unconditioned reflex that we inherited from animals of a lower class. The meaning is simple: tickling is needed to quickly detect and eliminate insects from the most vulnerable parts of the body, and not to bully friends. Scientists also believe that tickling is one of the side reflexes that arose during the development of our central nervous system. This is a kind of response of the body to touching areas with a large number of nerve endings and blood vessels (feet, abdomen, armpits and other most “ticklish” places), a borderline reaction between the main types of contact exposure (caress and pain).

Why do we laugh when ticklish

The million dollar question. Often the process of tickling causes negative emotions, it can even be unpleasant and painful. Therefore, at this moment we should not be laughing. Scientists managed to establish that two parts of the human brain react to tickling at once: one responsible for pleasant sensations, and the second, which is responsible for the reflex protective function. Some scientists argue that laughter in the case of tickling is a kind of prelude to crying from discomfort or severe pain, and the mass of involuntary, discordant reflected movements at this moment are similar to a reaction from severe pain.

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An interesting fact: when laughing (both from a tickle and from a joke), a person does not pronounce either syllables or individual letters. This is due to the fact that at this moment the speech centers in the human brain are suppressed. That is why in a fit of laughter it is so difficult for us to squeeze even a word out of ourselves.

At what age do we begin to be ticklish

Scientists have found that even newborns have sensitivity to tickling, but only closer to six months do they begin to respond to it with a smile or laughter. The fact is that at the very beginning of life, our brain does not associate the sensation of tickling with the impact from the outside world, and only in the process of socialization do we have a specific response to such an impact. By the way, psychologists believe that the playful tickling of a child by parents is excellent for emotional rapprochement.

In the course of life, the sensitivity to tickling decreases markedly. This is due to the fact that with age, the overall tactile sensitivity in the whole body decreases.

Who else, besides humans, feels tickling

Our closest relatives – great apes – also feel tickling, except that their reaction to it is slightly different, but also has common features with laughter. During observations of chimpanzees in the late 1980s, it was found that primate parents, just like us, playfully tickle their cubs.

But the biggest ticklers are lab rats. They are ready to perform special tasks to be tickled once again, plus, when tickled, these rodents emit a certain ultrasonic signal with a frequency of 50 kHz. This signal is analogous to laughter, as it is associated in rats with play behavior.

Why you shouldn’t tickle yourself

If you are a mentally healthy person, then the process of self-tickling will end in failure for you. The thing is that the cerebellum of our brain very accurately determines the position of our limbs, the coordinates of which are immediately reported to the motor cortex.