Diverticulosis, not so bad; diverticulitis, not so good

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DEAR DR. DONOHUE: I would like information on diverticulosis. — Anon.

 ANSWER: Anon, you are a paragon of brevity.

 “Osis” means “full of.” A diverticulum is a pea-size bulge. Diverticulosis, therefore, is a bunch of diverticula protruding from the outer wall of the colon. The diverticulum is actually the lining of the colon that has been forced through the colon’s muscular wall. Diverticulosis is common in the Western world because we eat so many refined grains. As a result, stools are dry and hard. The colon has to exert great pressure to push such undigested food through its length. That pressure is responsible for forcing bits of the colon lining through the colon wall and onto its outer surface as diverticula. Two-thirds of those over 65 have diverticulosis. Even though diverticulosis is so very common, it isn’t particularly troublesome. Most people with diverticulosis — 85 percent — are without any symptoms.

 “Itis” indicates inflammation. Diverticulitis consists of inflamed diverticula. It causes pain mostly on the lower-left side of the abdomen. Most diverticulitis patients have a fever, lose their appetite and are quite ill. If symptoms are mild, diverticulitis can be treated at home. If they’re severe, treatment has to take place in the hospital, where the colon can be rested with intravenous fluids and the inflammation treated with antibiotics.

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 Prevention of both diverticulosis and diverticulitis is achieved by increasing fiber in the diet. Fiber is indigestible food, the stuff that holds on to water and keeps stools soft. Unrefined grains are sources of fiber, as are most fruits and vegetables. Psyllium is another fiber source, sold as Metamucil.

 In the past, warning diverticulosis patients not to eat seeds, corn, nuts and popcorn was the thing to do. They’re not the danger that they were thought to be, and these foods are no longer banned.

 The booklet on diverticulosis explains this common problem and its treatment in detail. To order a copy, write: Dr. Donohue — No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

 DEAR DR. DONOHUE: My neurologist has advised me to have deep brain stimulation. I’m not familiar with it and would like some information. What does it entail? How successful is it? How bad should your Parkinson’s symptoms be before having it done? I have had Parkinson’s for 21 years and am in good health otherwise. — J.S.

 ANSWER: The basic working of deep brain stimulation is similar to the working of a heart pacemaker. Through a small opening in the skull, a thin, insulated wire (the electrode) is passed to the target area of the brain, the area causing Parkinson’s symptoms. The electrode is then connected to a battery-operated stimulator, positioned under the skin of the chest below the collarbone. The stimulator is the size of a stopwatch. Electrical impulses pass from the stimulator via a wire to the electrode and then to the area of the brain causing signs and symptoms. Those electrical impulses suppress the errant nerve impulses generated by the brain.

 The procedure has a high success rate, and convalescence is rapid. It’s done when medicines are no longer effectively controlling the illness or when medicines are leading to disruptive side effects.

 DEAR DR. DONOHUE: I work in a small office with a woman who has OCD. She is 35. She is pregnant with her first child. I am concerned for her and her baby. Will she be able to handle the rigors of motherhood? — F.A.

 ANSWER: If the mother-to-be, her husband and her doctor feel she is up to taking care of a baby, then she should have no trouble.

 OCD, obsessive-compulsive disorder, consists of intrusive and distressing thoughts (the obsession) that are controlled only through meticulous rituals (the compulsion). Compulsions are things like constant hand-washing, checking and rechecking to see if the door is locked, nonstop arranging of the fringe on a rug so that all strands are perfectly in place and other such routines. Behavior training, often combined with medicine, can free most people from these endless tasks.

 Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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