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Sample Essay Of Diverticulitis

Diverticulitis is a form of Diverticular disease that occurs when abnormal pouches called diverticula that form on the walls of the lower intestine become inflamed and produces a variety of symptoms such as cramps, bloating, pain in the lower left side of one’s and constipation.  Most often diverticulitis is a result of an inappropriate diet; therefore, “the sigmoid part of the colon has to exert so much pressure to propel the feces that the walls of the intestine herniate.”  [1]

If these particular pouches contract an infection or cause an obstruction a person may require antibiotics or, in an acute case, surgery.  [1]

Diverticulosis and Diverticulitis

Diverticular disease affects the bowel that has many forms; however the most common is diverticulosis and diverticulitis.  

These two conditions are connected in the fact that both are caused from the formation of abnormal pouches called diverticula, however the difference lies in the severity of symptoms patients experience.  People who have these abnormal pouches without symptoms have diverticulosis, but once inflammation occurs and symptoms worsen the condition is considered to be diverticulitis.  

Approximately one in four people that have diverticulosis develop symptoms that are a result of inflammation or diverticular bleeding and this most often occurs in the more developed Western countries such as the United States.  [2]

The bowel measures approximately 25 feet long and contains the small and large intestine, which receive food that is passed through the stomach through the pyloric valve.  The small intestine is the first to receive the food, and the muscles contract and carry food along the path that leads into the large intestine.  There are three sections to the small intestine, the duodenum, jejunum and the ileum and the walls are covered with microvilli, “hair like projections of the mucosal lining that absorb nutrients into the bloodstream.”  [3]

Once food reaches the duodenum, the breakdown process begins as digestive enzymes passed from the stomach, small intestine and pancreas and bile from the liver begin turning proteins into amino acids, fatty acids and simple sugars.  At this point the food is then transferred to the jejunum, where the majority of the nutrients are absorbed and finally, the remaining vitamins are absorbed in the ileum.  [3]

After completing its cycle in the small intestine the waste is then transferred to the large intestine and is processed through four stages – the first being the cecum, second ascending and descending colon, the sigmoid colon and then the rectum.  

There are no nutrients absorbed when the food is processed through the colon; its only job is to remove excess water from the waste and return what is removed to the bloodstream.  As the process continues and the water is removed, the material begins to form a substance that is more solid, which is called stool.  The waste normally spends approximately one to two days in the colon before the body expels the waste.  [3]

As we grow older, most people begin to form abnormal pouches, diverticula that “bulge outward through weak points in the wall of the large intestine” and these individuals are diagnosed with the less severe condition called diverticulosis. [3]

Diverticulosis and is present in approximately fifty-percent of adults between the age of 60 and 80

This condition can affect the entire colon, however most often diverticula develop in the sigmoid colon.  The number of diverticula that form can range from a single lesion to hundreds.  

Most lesions are approximately 5 to 20 millimetres in length and it is very rare that a person develops a giant lesion.  Approximately ten to twenty-five percent of people who have diverticulosis develop and infection or inflammation of the diverticula and require further treatment.  If this happens, the condition is then called diverticulitis.  If diverticulosis and diverticulitis present simultaneously, the patient is said to have diverticular disease.   [3]

Medical professionals believe that diverticulitis is a result of bacteria or hardened stool getting trapped in a diverticulum.  

This complication can often cause a small perforation in the tip of the diverticulum, which then allows bacteria to enter the abdomen and leads to contracting an infection.  This condition often occurs suddenly and patients have no warning. Many patients report pain in the lower left side of the abdomen, nausea, vomiting, chills and constipation, as well as other symptoms such as diarrhea and urination difficulties. The symptom severity presents according to the “infection and the presence of any complications.”  [3]

Several tests can be performed to diagnose the presence of diverticulitis.  

These tests include “barium enema, flexible sigmoidoscopy, colonoscopy and x-ray.”  [2] When the  sigmoidoscopy and colonoscopy are performed, physicians insert a small camera through a tube that is then passed through the rectum so that a picture of the bowel can be examined.  [2] Because diverticulitis presents symptoms that are quite similar to colon cancer, a number of physicians prefer to look directly at the affected area, as this allows for more certainty in the diagnosis and treatment.  [3]  

Most often physicians treat acute diverticulitis with antibiotics, requiring hospitalization so that treatment methods are provided round the clock. If this treatment does not clear the infection, patients may develop an abscess, which is defined as “a collection of pus surrounded by inflamed tissue,” in the abdominal cavity nearby the colon.  [3] Further antibiotics can clear the infection, or if unsuccessful physicians may have to perform a surgical procedure that directly drains the infection from the abscess.  [3] 

The surgical procedure for acute diverticulitis can be invasive, however most often consists of a small camera being inserted into the abdomen and that surgeons perform “key hole surgical techniques” (laparoscopy) so that a segment of the area affected can be removed.  [4] After the diseased area is removed doctors then attach the healthy areas back together and this relieves the symptoms in most patients that require surgical procedures.  Laparoscopic surgery for acute diverticulitis is said to be easier on patients as, unlike open surgery, patients experience less pain and recovery is much faster.  [4]  

Most often doctors attribute the cause of diverticulitis to be a result of insufficient diet and emotional stress.  In most Western countries people have reduced the amount of fiber included in their daily intake and as a result constipation is more likely to occur.  

Medical professionals say that “indigestible fiber from grains, fruit and vegetables provide an important bulk,” which decreases the likelihood of constipation and allows the body to function properly.  [4] Due to the fact that approximately 60% of people over the age of 60 in Western civilizations will develop diverticulosis studies have been performed that focus on the appropriate diet for this condition.  In a study that took place between 1986 and 1992 that included 47,888 male health professionals it was found that the diagnosis of diverticular disease was found in those who had a low amount of fiber in their diet.  

Other studies performed found similar results; therefore, the American College of Gastroenterology states that “it is reasonable to recommend a diet high in fruit and vegetable fiber to patients with uncomplicated diverticulosis.”  [5]

Physicians have associated the onset of diverticulitis with emotional stress; however this opinion is not consistent between medical professionals.  According to Dr. Chesley Hines, a gastroentologist at Ochsner, states that “There is absolutely no proven connection between stress and diverticulitis.”  [5] Taking a different opinion, the physicians attribute the cause partially to human emotion believe that “Stress may not be the definitive cause,” however the symptoms are likely to become magnified as a result.  [5]  

It is important to note that most often patients experience minor symptoms from diverticulitis and these are resolved without treatment, as it is reported that approximately 80% of cases can be treated without extreme measures being taken.  

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Most often patients report mild cramping in the abdominal area and slight nausea in which physicians recommend altering their diet to include higher amounts of fiber, bed rest, high intake of liquids and oral antibiotics. [3] It seems reasonable that if individuals become conscious of living a healthy lifestyle that includes an appropriate diet with a high intake of fiber, the chance of contracting diverticulitis is less likely.   
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[1] Dunne, L. J. (2002). Nutrition almanac. New York: McGraw-Hill.
[2] Salzman, H. & Lillie, D. (2005). Diverticular disease: diagnosis and treatment. American Family Physician, 72(7), 1241-1243.
[3] Johns Hopkins (2003). THE SMALL AND LARGE INTESTINES. Digestive Disorders, 30-56.
[4] Lutz, B. (2007). Pain in the Abdomen. New Orleans magazine, 42(2), 38-40.
[5] Eglash, A. & Lane, C. H. (2006). What is the most beneficial diet for patients with diverticulosis? Journal of Family Practice, 55(9), 813-815.

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