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  #1   ^
Old Sat, Mar-17-18, 22:29
Ms Arielle's Avatar
Ms Arielle Ms Arielle is online now
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Default Diverticular disease: Epidemiology and management

I found this and wondered is those of living LC are at risk, or does the 2 salads a day reduce diverticulosis?


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174080/

Abstract
Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction.

EPIDEMIOLOGY
The incidence of diverticular disease has increased over the past century (2,5,6). Autopsy studies from the early part of the 20th century reported colonic diverticula rates of 2% to 10% (6). This has increased dramatically over the years. More recent data (5) suggest that up to 50% of individuals older than 60 years of age have colonic diverticula, with 10% to 25% developing complications such as diverticulitis. Hospitalizations for diverticular disease have also been on the rise. According to an American study evaluating hospitalization rates between 1998 and 2005 (2), rates of admission for diverticular disease increased by 26% during the eight-year study period. Similar trends have been observed in Canadian and European data over the same time period (5,7).

Diverticular disease has traditionally been believed to be a disease affecting the elderly (8). The prevalence of diverticular disease is as high as 65% by 85 years of age and estimated to be as low as 5% in those 40 years of age or younger (8). However, more recent literature has reported an increase in the incidence of diverticular disease among younger patients. For example, a large review of the Nationwide Inpatient Sample (NIS) of 267,000 admissions for acute diverticulitis between 1998 and 2005 (2) showed that the average age of patients decreased over the study period from 64.6 to 61.8 years. Incidence rates increased most dramatically among groups 18 to 44, and 45 to 64 years of age (incidence per 1000 population: 0.151 to 0.251, and 0.659 to 0.777, respectively). In contrast, incidence remained stable over the study period in persons between 65 and 74 years of age, and actually decreased in persons 75 years of age or older. Moreover, a very high incidence of diverticular disease in young patients was reported in a review of 238 patients admitted with diverticulitis to the surgical service at the Medical Center Hospital in San Antonio, Texas (USA) between 1981 and 1990 (9). In this review, 26% of patients were 40 years of age or younger. These patients had a more aggressive form of disease, requiring more surgical intervention than older patients, and they exhibited a five-fold increase in the risk of complications, such as fistula, compared with their older counterparts. Given the presumption of the low incidence of diverticular disease in young patients, nearly one-half of these patients were often misdiagnosed at presentation – most commonly with appendicitis.

Diverticular disease has long been regarded as a disease of western countries. The highest prevalence of this condition is in the United States, Europe and Australia, where approximately 50% of the population 60 years of age and older have diverticulosis (5,6). This common occurrence is in contrast to that in the developing world, where countries in Africa and Asia have prevalence rates of less than 0.5% (6,11,12). The western diet, particularly its deficiency in dietary fibre, has long been implicated as a causative factor for these geographical variations (6,13–16). This hypothesis was supported by a study that compared stool weight and transit time in 1200 individuals in the United Kingdom and rural Uganda (13). The United Kingdom subjects, who were shown to have lower fibre intake, had a transit time of 80 h and a mean stool weight of 110 g/day. This was significantly lower than in the Ugandan subjects, who had much shorter transit times (34 h) and greater mean stool weights (450 g/day). The prolonged transit time and small stool volumes were believed to predispose to diverticular disease by increasing intraluminal pressure. Moreover, there is growing evidence that the rates of symptomatic diverticular disease are on the rise because areas in the developing world are becoming increasingly westernized (14,15). For example, the rates of diverticular disease have increased among urban black populations of South Africa compared with rural black populations in the same country (14). The role of dietary fibre deficiency as a contributor to diverticular disease was further supported by a large prospective cohort study of more than 47,000 men who were followed over a four-year period (16). Dietary fibre intake was found to be inversely associated with the risk of developing diverticular disease, with an RR of 0.58 (95% CI 0.41 to 0.83; P=0.01).

In addition to the geographical variability in the prevalence of diverticular disease, there is significant variability in the location of diverticula within the colon in different regions of the world. In western countries, it has been well described that diverticulosis is primarily left sided, particularly involving the sigmoid colon (2,6–8). This is in contrast to findings in Asia, where right-sided diverticulosis dominates (17–19). In a review of 615 cases of diverticulosis detected on double-contrast barium enema examinations between 1975 and 1982 in Tokyo, Japan (17), 70% were right sided. Similar diverticular distribution has been shown in Hong Kong and Singapore (18,19). The reason for these differences remains unclear. Early hypotheses suggested that left-sided diverticula were acquired, whereas right-sided diverticula were more likely to be true diverticula and, thus, congenital (20,21). However, subsequent studies have shown that, similar to left-sided diverticula, the majority of right-sided diverticula are ‘false’ and are likely acquired (18,22). In fact, as Asian populations have begun to adopt a more westernized diet, the rates of diverticular disease have been shown to increase to the same extent noted in the west (17). This increase in diverticular disease, however, remains predominantly right sided. Factors other than deficiencies in dietary fibre are likely to play a role in the development of right-sided diverticulosis as demonstrated by studies that show that even with a high-fibre diet, the rates of right-sided disease are high. For example, a study from China (23) reported a diverticulosis rate of 62% in patients with high-fibre intake (greater than 14 g/day). More research is needed in this area to better identify potential causative factors.


In addition to the geographical variability in the prevalence of diverticular disease, there is significant variability in the location of diverticula within the colon in different regions of the world. In western countries, it has been well described that diverticulosis is primarily left sided, particularly involving the sigmoid colon (2,6–8). This is in contrast to findings in Asia, where right-sided diverticulosis dominates (17–19). In a review of 615 cases of diverticulosis detected on double-contrast barium enema examinations between 1975 and 1982 in Tokyo, Japan (17), 70% were right sided. Similar diverticular distribution has been shown in Hong Kong and Singapore (18,19). The reason for these differences remains unclear. Early hypotheses suggested that left-sided diverticula were acquired, whereas right-sided diverticula were more likely to be true diverticula and, thus, congenital (20,21). However, subsequent studies have shown that, similar to left-sided diverticula, the majority of right-sided diverticula are ‘false’ and are likely acquired (18,22). In fact, as Asian populations have begun to adopt a more westernized diet, the rates of diverticular disease have been shown to increase to the same extent noted in the west (17). This increase in diverticular disease, however, remains predominantly right sided. Factors other than deficiencies in dietary fibre are likely to play a role in the development of right-sided diverticulosis as demonstrated by studies that show that even with a high-fibre diet, the rates of right-sided disease are high. For example, a study from China (23) reported a diverticulosis rate of 62% in patients with high-fibre intake (greater than 14 g/day). More research is needed in this area to better identify potential causative factors.
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  #2   ^
Old Sat, Mar-17-18, 22:48
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I think if your digestion is working fine then the raw lettuce is fine but if you are having difficulty or pain then you might want to stick to a cooked diet. Predigested if you will.

I was very sick a few years ago with what was thought to be diverticulitis but that was only a guess on the doctors part from the outside guessing in..LOL

I was so sick that I couldn't get out of bed for almost 6 months (they said it was an autoimmune response) the pain was so severe it was like a knife stabbing me and I couldn't stand up straight and didn't eat anything raw for a year. During the worst period I survived on chicken soup with only chicken until I could finally add celery and onion cooked down for hours.
I had to cut out ALL Fiber.

Finally I had a colonoscopy when it became a little better and it turned out to be a spot of inflammation in my colon.

Just add a note and I wish I had kept a diary to remember but one thing that my body kept telling me to have was coconut oil which I was putting in my coffee. It's like I craved it. That would really help too.
No doctor told me what to eat, I just physically could not eat much, just the sight of most foods made me know my body couldn't take it.

Last edited by Meme#1 : Sat, Mar-17-18 at 23:00.
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  #3   ^
Old Sat, Mar-17-18, 23:26
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Ms Arielle Ms Arielle is online now
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wiki has an in teresting page=easy to read and comprehensive
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  #4   ^
Old Sat, Mar-17-18, 23:33
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The old advise for Colon issues is just like low fat dieting...all wrong. They tell you to eat high fiber but if a Colon isn't doing well that's the last thing anyone should do.
I read recently read a post someone wrote that when people are eating high fiber they need to increase their water consumption by a huge amount in order to lubricate the colon enough to handle all of that bulk.
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  #5   ^
Old Sat, Mar-17-18, 23:51
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Here is a web-site that I found back when I was at my worst and it has to do with foods causing histamine reaction in the body and foods with histamine which list as one of the bad effects as Colon related problems.
I had to cut out all of this:

Spices/sauces that might cause problems:
ascorbic acid
autolyzed yeast
BHA and BHT
benzoates
catsup (ketchup)
cayenne
cloves
chili powder
horseradish
hot curry powder
hydrolyzed protein
meat tenderizers
miso
mustard
oleoresin paprika
paprika
pickles
red pepper
soy sauce
tamari
vinegar
worcestershire sauce
MSG – monosodium glutamate
metabisulfites
sulfites
Sorry this list above is from another source that I did not bookmark

If you want to read more about Histamine, here is the link:

https://www.mindbodygreen.com/0-111...ntolerance.html

But if you want my honest opinion, I think it's the antibiotics doing this to people's Colon.
I just had to take my granddaughter who is only 16 to the emergency room straight from school, she couldn't stand up straight the pain was so bad. Lots of tests later, no answers but I recognized it as the Colon area.

Last edited by Meme#1 : Sun, Mar-18-18 at 00:00.
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  #6   ^
Old Sun, Mar-18-18, 00:10
PilotGal PilotGal is offline
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how interesting about the different regions of the diverticulitis and the different regions around the world.

i know, when I have an attack, it's always on the left side.
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  #7   ^
Old Sun, Mar-18-18, 22:13
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Ms Arielle Ms Arielle is online now
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Quote:
Originally Posted by PilotGal
how interesting about the different regions of the diverticulitis and the different regions around the world.

i know, when I have an attack, it's always on the left side.


wow, you too.

THis IS a common problem.
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  #8   ^
Old Thu, Jul-05-18, 11:14
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Mayflowers Mayflowers is offline
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Quote:
Originally Posted by PilotGal
i know, when I have an attack, it's always on the left side.



This time my attack was all over my abdomen so bloated. It hurt on the left and the right side! Then when I started Flagyl, the pain was localized on the left lower quadrant. Now its subsiding and getting twinges on the left side after 4 days of medication. Stomach is still bloated.
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  #9   ^
Old Sun, Mar-18-18, 10:11
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Ms Arielle Ms Arielle is online now
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WOw , Meme. THat was a tough year, and Im sure the months after were a trial too.

What do you think triggered the inflammation in the gut?

Also, I understand why they waited on your colonoscopy. I did a lot of reading last night, and if the bowels are inflammed , the tissue is weak and perforating the bowel is a real risk.
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  #10   ^
Old Sun, Mar-18-18, 10:31
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That's exactly right, you can perforate the intestine if it's inflamed. But, one fellow on here also posted that if there is a spot of inflammation it might be encapsulated because the body does that and doing a biopsy (which I had)can disturb that and I do believe that is a risk but what can you do when you need to find out. The biopsy was negative with a grouping of like cells but I believe if it were not for LC it might have been cancerous. I still have a reminder from time to time that it is still there. Soy sauce or horseradish makes it hurt so I have to watch that because obviously that spot is still there.
I believe it was a combination of stress and antibiotic use that could have caused it. Many antibiotics these these days list ulcerative Colitis (among other things) as a side effect.
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  #11   ^
Old Sun, Mar-18-18, 22:11
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Ms Arielle Ms Arielle is online now
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Yes, I have come to appreciate the LC effect on cancer cells. Remarkable. My oncologist was more concerned that I took a 99 mg potassium pill rather than eat a banana........sheesh...

Interesting that info does not exactly list a normal amount of fiber. I will assume that the 30 g per day is the number used.

There is no mention of using probiotics or prebiotcis either.

I looked at the list again---holy cow. I can see why many are irritating to an already compromised GI, and many of those would be beneficial to keeping a healthy gut healthy.

Again modern medicine doesnt have prevention information.
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  #12   ^
Old Sun, Mar-25-18, 09:58
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Since going gluten free, my relationship to fiber and my intestines has been radically changed.

I could feel my intestines healing for months; a kind of warm glow throughout my whole torso I also could not handle fiber much at all; leafy greens and cooked vegetables, that's my rule now. Anything like flax seed or other heavily fibered, low carb, foods, is... not a good idea

I tried probiotics and yogurt with berries, but what really completed the transformation was kombucha. I found a low sugar source and a little goes a long way, but I am now a champion digester.

Found great help and good information at GutSense.org

Everything he says was true for me.
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  #13   ^
Old Mon, Mar-26-18, 09:08
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Ms Arielle Ms Arielle is online now
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THanks to your post, intake of fiber is changing. FOcus more on the microbes like I used to.

THANK YOU.

I looked at ingredient list and will start with eating shell fish like shrimp with the shell on. In my rush rush world, I stopped shelling them.
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Old Mon, Mar-26-18, 09:45
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gutsense on diverticulitis

I found his links confusing at first, so make sure you check this link.
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  #15   ^
Old Mon, Mar-26-18, 10:28
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HA

THis fits with MIL living on just yogurt.

The basic goal is to have smooth running GI. My assessment at this time is MODERATE fiber, fiber from real foods, and lots of probiotics foods.

Dont eat just one food, but a wide variety. The tradtional probiotic foods, pickled foods, ran from dairy to cabbage. Pickled eggs, pickled beets, etc. All means of preserving foods but most contain fiber and probiotics.
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