Share:
Diverticulitis causes, symptoms and treatment
If there is a suspicion of diverticulitis, sufferers should consult a doctor immediately. If left untreated, inflammation can lead to serious or even life-threatening complications such as peritonitis or bowel failure. In general, some things can be done to prevent the formation of diverticula in the gut and inflammation. Above all, it is important to have a high-fiber diet with plenty of fruits and vegetables, and regular exercise and sufficient drinking can positively influence digestion.
contents
- What is a diverticulitis?
- Causes of intestinal diverticula
- Diverticulitis symptoms
- Treatment for inflamed diverticula
- Diet and diet for diverticulitis
- Slow change to high-fiber diet
- Operation for diverticular disease
- Prevent diverticulitis
- Naturopathy in diverticulitis
- Bowel diseases prevent by stress reduction
What is a diverticulitis?
The term "diverticulitis" (or "diverticular disease") refers to an inflammation of protuberances in the intestinal mucosa (diverticulum). Intestinal diverticula are common in older people from the age of 60 years (diverticulosis), but usually cause no discomfort and have no pathological value. In more than 90% of cases, the fourth and last part of the large intestine is affected ("sigma"), which is located in the left lower abdomen between the "descending colon" and the rectum. Likewise, however, the protuberances may also be present in all other sections of the colon, with the exception of the rectum. the blind or grim intestine occur.
Various intestinal diseases in the anatomical view. (Image: bilderzwerg / fotolia.com) In about 10 to 20 percent of cases there is an inflammation of the intestinal wall bulges, which occurs mostly limited to the environment of the diverticulum. Likewise, it can lead to an expansion across the intestinal wall and thereby inter alia to a peritoneal inflammation or intestinal obstruction. Physicians usually distinguish between an acutely uncomplicated, acutely complicated and a chronic recurrent diverticulitis in this disease of the large intestine, taking into account, inter alia, the findings of the clinical examination and the colonoscopy.
About three quarters of those affected are the first, uncomplicated variant. Although this can cause unpleasant symptoms, serious health problems or permanent damage to the intestinal wall are not threatened. In the acutely complicated case, however, it can lead to complications such. an abscess or a fistula. If there is a chronic recurrent diverticulitis, the inflammation flares up again and again, permanently damaging the patient's intestinal wall.
Causes of intestinal diverticula
The exact cause of diverticulosis is still unclear. A combination of an increased intestinal pressure and an increase in connective tissue weakness in old age, by means of which the muscle layer of the intestinal wall is gradually "worn out", is suspected. This could explain why diverticula occur more frequently in the elderly. More than two-thirds of people over the age of 85 are affected, whereas those under 40 are rarely affected.
The increased pressure inside the intestine is often caused by chronic constipation. This in turn can also have different triggers. Often there is a close connection to a low-fiber diet, as fast fiber-free diets result in fast bowel movement. In order to be able to transport this through the large intestine, more pressure must be applied - in contrast to normal, smooth-soft excrement. If there is a weakening of the connective tissue parallel to the increased internal pressure, the risk clearly increases that the mucous membrane bulges outwards and a diverticulum arises.
Other risk factors include a lot of red meat, lack of exercise and obesity, and many experts assume that there is a family disposition. Most of the fourth and last part of the colon before the rectum (Colon sigmoideum) affected, which is named due to its S-shaped curvature after the Greek lower case "Sigma". Here the bag-shaped protuberances occur heaped because the site is particularly vulnerable to an interaction of weak intestinal wall and high internal pressure.
The protuberances in the intestinal mucosa (diverticula) are often found in older people often accumulated. (Image: Juan Gärtner / fotolia.com) Remain in the course of constipation remains of the hardened chair in the Aussackungen back, it can thicken so massive that so-called feces are formed. If the hard blobs become firm, the intestinal wall becomes irritated, causing bacteria to invade and cause inflammation or diverticulitis.
Diverticulitis symptoms
Typically, inflammation of the diverticula causes sudden, dull pain in the left lower abdomen, as it is where the often affected intestinal section "sigma" is located. The pelvic pain often radiates to the back, in addition to a palpable, touch-sensitive hardening ("roller") in the abdomen, nausea and vomiting, discomfort during urination (dysuria), bloating and problems with bowel movements such. Diarrhea or constipation occur.
Partly it comes in the course of an acute inflammation to general symptoms such as fever, fatigue and fatigue. Overall, the symptoms are similar to the (right side) symptoms of appendicitis (appendicitis), which is why the disease is also referred to as "left-side appendicitis".
If the treatment is started late or stays off completely, serious complications can occur. In about 10% of cases, for example, there is a perforation (perforation), which can lead to an abscess or peritonitis (peritonitis). If the inflammatory swelling of the intestinal wall causes a narrowing of the intestine, it can also happen that the stool is no longer transported and accumulates. The result is a so-called "intestinal obstruction" (ileus), which can be life-threatening without immediate therapy or surgery.
In the course of the disease, small tubular connections may arise between various sections of the intestine, intestine and bladder (entero-vesical) or intestine and vagina (entero-vaginal), which are referred to in medicine as "fistulas".
Typical for diverticulitis are sudden, dull pelvic pain on the left side. (Image: chajamp / fotolia.com) Treatment for inflamed diverticula
Patients with diverticulosis usually have no symptoms and, as a rule, do not need treatment. Nevertheless, it is advisable to pay attention to a special fiber-rich, fiber-poor diet in order to reduce the risk of inflammation of the diverticulum. If this is already present, the therapy usually takes place at the first onset of a spurt in the hospital, in order to be able to recognize possible complications in good time and treat them if necessary.
The treatment usually begins with a waiver of food (meal), bed rest, infusions or parenteral nutrition and intravenously administered antibiotics. If the inflammation has subsided, a gradual diet with food such as tea, broth, rusk and white bread takes place after medical instruction.
Easier forms of diverticulitis, however, are usually treated on an outpatient basis with a low-fiber diet to avoid additional irritation of the inflamed diverticulum. If comorbidities or a general immune deficiency are present, the administration of antibiotics may also be indicated. In addition, anti-spasmodic drugs (spasmolytics) can be used as needed to relieve the pain.
Diet and diet for diverticulitis
Diet plays a central role in the therapy, because during an acute inflammatory push as well as after an operative procedure the intestine should be spared. Accordingly, the Society for Nutritional Therapy and Prevention (FET e.V.) recommends a fasting phase in the first one to two days for the improvement of severe inflammation, in which instead of solid only liquid drinking food is consumed and if necessary infusion solutions are administered. Afterwards, in the second phase, the slow build-up of a low-fiber and low-fat diet takes place, in order to protect the intestine and avoid re-inflammation.
Here are all foods that are easy to digest and fiber-free, such as. Unsweetened tea (especially chamomile or herbal tea), rusks, low-fat, clear soups, chopped vegetables (zucchini, spinach etc.) and fruits (such as peaches, pears, applesauce), low-fat yoghurt or steamed lean meat in small pieces.
It should be avoided raw vegetables, salads, onions, leeks, raspberries, blackberries and pineapple. Even fatty foods such as fried potatoes, French fries, chips and fatty meats and sausages (salami, offal, etc.) and dairy products (cream, sour cream, cream yoghurt) are poorly tolerated by many sufferers. The same applies to hard-boiled eggs, whole grains, cereals, coffee, black tea, fatty fish (eel, herring etc.), strong spices and mustard.
Inflammation of the intestinal diverticulum should be avoided on foods that are difficult to digest, such as raw vegetables. (Image: Hetizia / fotolia.com) Until the inflammation has completely subsided, FET e.V. should continue to maintain a moderate diet. The specific menu is based on the tolerability of the food, which must be tested slowly and gradually by the patient accordingly. In general, it has proven in many cases that the dishes are neither too hot nor too cold and without extreme flavors (spicy, sour, strong seasoning) prepared. In addition, the FET e.V. recommends to take several small meals throughout the day to relieve the intestine and to chew every bite carefully and in peace. Likewise, many diverticulitis patients get a gentle preparation of the corresponding foods (e.g., by steaming or steaming) better than when fried, fried or baked.
Slow change to high-fiber diet
If the inflammation has completely healed, it should be slowly switched to a fiber-rich diet, as substances such as e.g. Pectin or cellulose promote intestinal activity (peristalsis) and prevent symptoms such as constipation or constipation.
Dietary fiber is found in cereals or cereals, as well as in fruits, vegetables and legumes, the content of which may depend, inter alia, on the variety and the degree of ripeness. According to the German Nutrition Society (Deutsches Gesellschaft für Ernährung e.V.), adults should eat at least 30 grams a day as a guideline for dietary fiber, with about half coming from cereal products and the other from vegetables and fruits.
Especially recommended are foods such as rye wholegrain bread, wholemeal pasta, wild rice, potatoes with shell and cabbage (eg broccoli, Brussels sprouts, cauliflower). Other important suppliers of valuable plant fibers are legumes (peas, beans, lentils, etc.), nuts, apples, berries and dried fruits. In addition to the solid food, it is also important to drink at least two liters a day, so that the fiber is enough liquid to swell and thus for an unlimited functionality.
Operation for diverticular disease
If complications occur, surgery is often necessary. These include intestinal perforation, severe bleeding from the diverticulum, a narrowing of the bowel or fistulas, as well as surgery may be indicated in repeated episodes or lack of success of previous treatment. It is also recommended for young patients under the age of 40 and those at risk (for example, with immunosuppression) as they are at increased risk for recurrent disease (recurrence risk).
In the procedure, the affected intestinal tract with the inflamed diverticula are removed and the bowel ends are then reconnected. Due to medical progress today, this is done more and more frequently by means of minimally invasive procedures (laparoscopy), in which special instruments and a miniature camera are introduced into the surgical area via a small incision. The so-called "keyhole technique" usually provides the patient with a number of benefits, including shorter hospital stays, fewer scars, and less pain.
In some cases, such as ruptured diverticula, on the other hand, classic "open" bowel surgery (laparotomy) via an abdominal incision is required. In such an emergency, often an artificial intestine outlet (stoma) must be placed to relieve the bowel and favor the healing process.
A healthy, fiber-rich diet, adequate drinking and regular exercise can prevent the development of diverticula. (Picture: Picture-Factory / fotolia.com) Prevent diverticulitis
Intestinal diverticula are very common in the elderly, especially in the elderly. If these do not cause any complaints, they have no pathological value and require no special treatment. However, if the bulges ignite, diverticulitis develops, which, if left untreated, can lead to serious complications. Accordingly, the best protection is to prevent as far as possible the formation of intestinal diverticula or, in the case of existing protuberances, to reduce the risk of inflammation.
Above all, it is important to have a fiber-rich diet with plenty of fruit, vegetables and whole-grain products to keep the contents of the intestine soft and easily passable. It is also important to always pay attention to normal weight and adequate drinking (at least 2 liters of water or tea a day) and regular physical activity to positively support the activity of the intestine. There are usually two to three sessions per week that are ideal for training for at least 30 minutes (for example, jogging or swimming)..
Naturopathy in diverticulitis
In addition, in the treatment of inflammatory disease of the colon various naturopathic procedures and means are available to relieve the symptoms. Both for the prevention and for the treatment of existing diverticulitis, for example, special healing teas come into question. The classic is the chamomile, as it has an anti-inflammatory, antispasmodic and soothing, drying and flatus-like effect. Accordingly, the popular medicinal plant can also be useful as a home remedy for diarrhea and constipation.
In combination with anise and fennel, chamomile is helpful for flatulence.
Recipe for fennel anise chamomile tea
|
An infusion of peppermint may help if distended abdomen, pain, nausea or flatulence occur as part of diverticulitis.
The medicinal herb Oregano is well suited for complaints of the entire digestive tract, for example, for the internal use of a tea from a teaspoon of dried herb and 250 ml of boiling water is prepared and allowed to draw for about five minutes. Caraway and marjoram have proven themselves in the natural treatment, as well as the anti-inflammatory ginger plant "turmeric".
Since many diverticulitis patients suffer from a bloated stomach and excessive accumulations of gas in the gastrointestinal tract, various home remedies for flatulence can offer a beneficial aid. For example, antispasmodic and pain-relieving moist-hot wraps, which are placed on the inflated abdomen, have proved their worth.
The "Hot Seven" can provide relaxation through their antispasmodic properties. This is a particularly intensive application in the field of Schüssler salts, for which 10 tablets of the salt magnesium phosphoricum (No. 7) are placed in a cup and doused with boiling hot water. Once the tablets have dissolved, the hot sieves are drunk in small sips. It should be noted that a metal spoon is never used for stirring, as the effect of the salt could be changed by the metal.
Hasty food in between beats fast on the stomach and strains the intestine. (Image: ajr_images / fotolia.com) Bowel diseases prevent by stress reduction
In addition to a wrong diet, stress and hecticness in everyday life can quickly "hit our stomach" and affect the intestine accordingly. Accordingly, should always enough time and rest to eat, chewed thoroughly on a quick lunch "to go" be waived.
It is important to ensure adequate rest periods and at least seven hours of night sleep, in order to give the body the chance of appropriate regeneration. A good balance in tension and inner restlessness, for example, offers a quiet walk in the evening or a hot bath, with the addition of essential oils can increase the effect noticeably. Here, aromatherapy primarily recommends relaxing and antispasmodic oils, such as, e.g. Lavender, juniper or clary sage.
Different stress reduction techniques and techniques can provide relaxation and a sense of inner balance. For many people, for example, yoga, meditation or autogenic training have proved their worth. Likewise, traditional Chinese forms of movement and martial arts such as Taijiquan (Tai-Chi) or Qigong have been gaining in popularity in recent years. (nr, updated on 17.10.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)