October 31, 2009 in Features

High-fiber diet clears tract

Peter H. Gott, M.D., United Media
 

DEAR DR. GOTT: I am 80 years old. My doctor doesn’t seem too concerned that I’ve been diagnosed with diverticulosis involving the entire colon. How concerned should I be? Can this become worse? At present, I have little pain and no bleeding. When I told my doctor that I usually have pain in the morning, she said it was probably my spine giving me problems. A CT scan revealed stenosis and disc herniation, but my back condition hasn’t worsened since 2002. What should I worry about most? Should I see a spine doctor in case I eventually get worse? Or should I concentrate on my diverticulosis? I’m afraid to exercise and have been very careful.

DEAR READER: Diverticular disease is a condition of the digestive tract characterized by small pouches that protrude through the muscular wall of the large intestine. When a number of pouches are present, the condition is known as diverticulosis. When inflammation occurs, the condition is known as diverticulitis.

Diverticulosis is rather common and occurs frequently with advancing age. The condition is observed more often in women than in men. Causes may include a weakening in the wall of the colon, chronic constipation, the repeated use of laxatives and enemas, and a low-fiber diet.

Because of a lack of symptoms, the condition often goes undiagnosed. In fact, it may be discovered only during the course of a barium enema X-ray. When symptoms do occur, they often present in the lower left side of the abdomen. They can occur on the right and have been confused with appendicitis. Nausea, vomiting, bloating, pain and alternating constipation and diarrhea have been reported.

When no symptoms are present, there is no need for medical treatment with the exception of the modification to a high-fiber diet. Speak with your primary-care physician or gastroenterologist regarding ways you can bring your diverticulosis under control.

Spinal stenosis is a narrowing of one or more areas of the spine. The condition can cause pain and numbness, cramping, and even difficulties with bladder and bowel function. Mild symptoms can often be helped with over-the-counter pain relievers, physical therapy or a brace. More severe cases might require surgery.

There are two ways that disc herniation occurs. The first is when the disc simply slips out of place. This puts pressure on the nerves and spinal cord. The second is when there is a tear in the cartilage on the outer portion of the spinal disc. This allows the inner fluid to seep out, putting pressure on spinal nerves. Regardless of the cause, this condition can cause pain, discomfort and limited range of motion. Mild symptoms can be controlled by rest, over-the-counter pain medication, muscle relaxants, hydrotherapy and decreased activity. More severe cases will likely be controlled by prescription medication and more aggressive therapy.

If you haven’t had an exacerbation of symptoms for seven years, I would consider you quite stable. Speak with your physician regarding a possible exercise regimen so you can remain as active as possible. While you should remain cautious and not overdo, you can put your fears on the back burner and enjoy life.

To provide related information, I am sending you a copy of my Health Report “Diverticular Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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