Ask The Doctor

Diverticulitis Versus Diverticulosis

Dear Dr. Garner,

Could you tell me the difference between diverticulosis and diverticulitis? My doctor told me that I have diverticulosis. My sister was recently told she had diverticulitis.

She says it is the same thing but I don’t think it is. Could you settle our disagreement? Is there any treatment for either condition? How do you know if you have diverticulosis?

Also, my sister tells me that nuts and seeds are bad for me because I have this problem. Is this true?

Thank you. I have read your column for many years but this is my first question.

Sisterly Dispute
in Ditmars Park

Dear Sisterly Dispute,

Before I answer your question, I would like to recognize Mary Kay Gallagher, who is not only a loyal Tablet reader and Ask the Doctor viewer, but also a great Brooklyn role model and celebrity.

I have good news for you regarding your dispute: You win.

Diverticulitis (di·ver·tic·u·li·tis) and diverticulosis (di·ver·tic·u·lo·sis) not the same thing. It is true however, that diverticulosis may be an early start to diverticulitis.

People who have diverticulosis often have no idea. But when someone has diverticulitis, he or she knows it, as there is pain, fever, bloating, and sometimes intestinal blockage.

What exactly is involved in these conditions? Diverticulosis is a condition in which pouches or pockets develop in the bowel walls. These pouches are known as diverticula. They form because of poor diet, lack of exercise, obesity, and just plain being over the age of 40.

A diet low in fiber can lead to small hard stool which is difficult to pass and requires increased pressure to move it out of the body.  The pressure causes bulging or pockets in the bowel wall. The pouches can also form from constipation with straining and associated increased pressure in the bowel.  When these sacs or pouches get food and waste material trapped in them, they can become infected and cause the condition known as diverticulitis or an inflammation of the diverticula.

A person with diverticulosis has few or no symptoms.  If the condition becomes diverticulitis, there is often bleeding, pain, belly tenderness, nausea, vomiting, and diarrhea.

The condition is common in the United States, but uncommon in Asia and Africa due to dietary differences.
Diverticulosis requires no specific treatment while diverticulitis often requires admission to the hospital, as well as antibiotics and often surgery.

Eating more fiber, such as fresh fruit, vegetables, and whole grains can help reduce your chance of developing either condition. One should also drink plenty of fluids to help keep the stool soft.

It is important to use the toilet without delay when you get the urge to have a bowel movement. Regular exercise also helps keep the bowels regular.

Some doctors recommend probiotics, which are foods or supplements that contain “good” bacteria that help in digestion. They are generally considered safe, but it is always a good idea to check with your doctor to see if they are right for you.

Diverticulitis and diverticulosis are related but not the same disease.

Diverticulitis can have dire consequences and can cause death if not properly treated. On the other hand, diverticulosis, is benign with few symptoms except for bloating and a gaseous feeling.

The conditions are linked to our modern lifestyle and the consumption of processed foods, such as white rice, white bread, most breakfast cereals, crackers, pretzels, and fast food, which lead to increased pressure in the intestines with the formation of the pouches.

If you feel you are straining during your bowel movements, take a stool softener or increase the fiber in your diet (20-35 grams of fiber daily).
In the old days, doctors thought that eating seeds from tomatoes and cucumbers, sunflower seeds or other nuts, got caught in the pouches and caused diverticulitis. Studies have failed to prove this and you are perfectly free to eat these foods.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.

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