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Wednesday, August 8, 2012


While the information contained in The Colonoscopy Chronicles will be as accurate as possible, it is not intended as medical advice. You should consult your personal physician regarding your own medical issues. So, you've had your colonoscopy, and now your doctor tells you that you have diverticulosis. You nod your head knowingly, since your doctor acts as if you should know exactly what that means, as she speeds on to her discussion about your hemorrhoids. But in reality, you really don't know what that means, and by now, it's too late to ask her. The recovery room nurse hands you a slick brochure telling you all about diverticulosis. You tell your friends at the health club the next day that they found diverticulosis, and suddenly your hearing stories about nuts, seeds, popcorn, Aunt Sally's ruptured colon, antibiotics, and now your head is swimming. After all, you just came her for a good workout and now your ready to check into the Mayo Clinic. Help!! Well-Doctor Mike is here to give you the Baby Boomer's Underground Guide to Diverticulosis. Stick with me, kid, you'll be fine! I am going to try and distill twenty three years of experience as a Gastroenterologist into a few paragraphs about diverticulosis-so please realize that this is not a comprehensive review of the topic. Rather, I am going to tell you the exact same thing that I tell my patients, what I consider the basics about diverticulosis.So here goes............ First of all,when the colonoscopy is over and we are reviewing the results, if diverticulosis is present, I let the patient know. I explain that it is a common finding-that probably at least 60-70% of people get diverticulosis. However, the good news is that the vast majority-perhaps 95% or so-will never experience any problems related to their diverticulosis. I go on to explain that diverticulae are little pouches in the colon,and while they are extremely common, we don't exactly know what causes them. There are many theories, most relating to the amount of dietary fiber we eat,but they are probably genetic to some extent, since they tend to run in families. I also explain that while the vast majority of people do not develop problems from the diverticulosis, the two major complications are diverticulitis, and bleeding. I explain that diverticulitis occurs when the pouches become infected. This leads to abdominal pain that is usually in the left lower part of the abdomen, and sometimes in the middle af the abdomen, below the navel. Other associated symptoms can include fever, or constipation. I advise patients to be aware of those type of symptoms and to seek medical attention right away if they occur, since they might need antibiotics to combat the diverticulitis. I explain that the bleeding associated with diverticulosis is usually painless, and sudden in onset. The bleeding is usually fairly severe when it occurs. Again, I advise patients to seek medical attention immediately if they have suspected diverticular bleeding. Finally, I explain to them that for years we advised patients to avoid nuts, seeds, and popcorn, on the theory that those particles are undigestible, and can get lodged in the diverticular pockets and cause diverticulitis. It seemed like a logical instruction-but the problem is, that it turned out that there was really no good evidence that ingesting nuts, seeds, and popcorn had anything to do with diverticulitis. Therefore, I currently do not restrict those items in my patients with diverticulosis, but rather just suggest a general high fiber diet. And that, my friends, is my "Readers Digest" version of diverticulosis. Naturally, this is a very simplified version of a very complicated topic. I did not touch on some of the less common, but very serious complications of diverticulitis, such as perforations, abscesses, or obstructions which may require surgical intervention. I also did not touch on those who have frequent, recurrent episodes of diverticulitis that may require elective surgery. But remember, these serious complications are not common. But because they may be fairly dramatic,even though they are not common, they get a lot of notoriety.