YOUR HEALTH - MEDICINE 101

DIVERTICULITIS
“You are what you eat.” Have you ever heard that old adage? This one turns out to be true, especially when it comes to a medical problem known as diverticulitis. It's a very common problem in the bowels of Western society and it's got to do with the food we eat.

Diverticulum is a fancy medical word meaning a blind pouch or sac leading off from the bowel. If you have more than one diverticulum, you have diverticulosis, and if they become infected or inflamed you have diverticulitis.

A diverticulum looks like this – an outpouching on the wall of the bowel, much like the bulge of an old bicycle tire.

Diverticulum are very rare under the age of 30 – only about 1% of us have them, but as we age they become more common, especially after the age of 60. To understand why you have to understand the anatomy of the colon or large bowel.

The colon is simply a tube about six feet long and a couple of inches in diameter. It consists of a mucosa lining surrounded by muscle. It’s this muscle that makes the stool within the colon move along and the muscle does this by doing what muscles do best - contracting. Of course if all the circular muscles in the colon contracted at once the stool wouldn’t move anywhere. So what happens is one segment of the muscle contracts while the segment below relaxes. This pushes the stool along in a wave-like series of contractions called peristalsis. It’s like milking the bowel contents forward.

Now, don't cringe, this is important.

It turns out that diverticuli form where these circular areas of muscle are penetrated by muscles and blood cells, producing a small gap or weak area between the muscle layers. If the bowel content is thicker, more viscous, you need more pressure to push it along, and thus more pressure is exerted on this weak area in the muscle in the bowel wall. This is what causes the diverticulum, and here’s where the food comes in. This is much more common in western countries where the diet is low in roughage or fibre. It’s virtually unheard of in Africa or other areas where the people eat lots of vegetables. The feeling is that the lack of fibre causes an increased viscosity of the bowel content, increased pressure within the bowel and thus this blowing out of the lining of the bowel to cause the diverticulum.

Sometimes, these pouches in our bowel will become inflamed or infected. That's when we get pain, fever and sometimes blood. And if the divericuli burst, the infection is sent into other organs.

But there's a real simple prescription here. Your mother was right when she told you to eat your vegetables. A diet higher in the fibre of fruits and vegetables decreases your chances of having diverticulosis and its complications.