Confused and a little scared...

[Paul-Bishop]

  : : Just about a month ago, in the middle of the night, I
  : : began to feel slightly ill, and had a "crampy" pain in
  : : my lower left abdomen.  By the morning, I was in severe
  : : pain, nauseous, and was running a fever.  My wife took
  : : me to the ER at our local hospital.  Initially they
  : : thought it might be Prostatitis, or even kidney stones
  : : (I have a history of calcium stones); however, after
  : : a Barium GI CT scan, I was diagnosed as having acute
  : : diverticulitis.  I was admitted, and ended up spending
  : : a week in the hospital, and at one point even was asked
  : : to sign the consent for emergency surgery- resection of
  : : the colon- with a possibility that I would end up with
  : : a temporary colostomy.  Luckily, after large doses of
  : : antibiotics (and more than a little Demerol), I started
  : : to get better.  I was released after the week, sent home
  : : with 750mg of Cipro bid, Flagyl 250mg qid, Percocet
  : : q4hours as needed.  After 10 days (the regimen length),
  : : I was feeling quite a bit better and was following the
  : : low-residue diet, slightly modified because I don't
  : : tolerate Lactose very well for the past three years or so.
  : : The pain and nausea have come back, and my doctor has put
  : : me on another 14 day regimen of Cipro and Flagyl.  I
  : : assume this will kill off the remaining infection.  I really
  : : hope so, as I have already lost nearly 20 pounds in less
  : : than a month.
  : : My question is twofold:  How did I get this, and how
  : : likely is it to get worse?
  : : I don't fit the profile for Diverticulosis very well- I
  : : am 31 years old, and in the words of others, a "veggie nut".
  : : My diet was extremely rich in fiber, including usually
  : : 3-4 servings of fresh fruit per day (apples especially),
  : : whole grain breads, granolas, etc.  I am extremely regular
  : : in BM, 2xDay, in the morning and again in the evening.
  : : My stools are characterically "soft", and I can't even
  : : remember if I have EVER been constipated.  In short, I
  : : don't match with the profiles for diverticular disease.
  : : Since I did get it, is there something else that could
  : : have caused it?  
  : : The reason I ask is because if there is another reason,
  : : I want to avoid a recurrence of this.  Since diverticula
  : : never "heal", is diverticular disease "progressive"?
  : : Since the infection and swelling undoubtedly weakens the
  : : intestinal wall even more, with recurrence, is there a
  : : greater risk of perforation, etc with each episode? Is
  : : there a greater risk of colon cancer if you have
  : : diverticulosis?  Other than a high fiber diet, what can I
  : : do to stay as healthy as possible?
  : : Sincerely,
  : : Paul Bishop
  : Dear Paul Bishop,
  : The exact mechanism for the development of diverticula is unknown, however, it is felt that due to increased intraluminal pressure in the colon. Low dietary fiber is felt to lead to decreased stool volume and increased intraluminal pressure. Diverticula form as a result of herniation of the mucosa through the muscular colonic wall at points of weakness, which correspond to sites of penetrating arteries. Diverticulitis refers to inflammation occuring in diverticular sacs. This may occur secondary to microperforation of diverticula. Diverticulitis may be associated with abscesses (collections of pus), sinus tracts and fistulae (abnormal connections between the colon and other organs) or obstruction (blockage of intestine). Although diverticulitis often occurs in elderly patients it is not unheard of in younger persons. Diverticulitis tends to be more virulent in younger patients. There is no association between colon cancer and diverticular disease. Diverticular disease is considered a benign (non-malignant) disorder. On the other hand, in rare instances diverticular disease and colon cancer may coexist.
  : In patients with recurrent episodes of diverticulitis or who have complications are treated surgically. Maintaining a daily intake of 25-35 grams of dietary fiber is currently the only preventative measure felt to be helpful. I hope you find this information helpful.
  : This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
  : If you wish to be seen at our institution, please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
  : HFHSM.D.-ym
  : *Keywords: diverticulitis
  

[HFHSM.D.-ym]

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  Thanks for the information - doing my best to stay well!
  -PB
Dear Paul Bishop,
It was my pleasure. I wish you continued good health.