Diverticulosis usually painless; diverticulitis painful

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DEAR DR. DONOHUE: Because I was having stomach pain, my doctor had me get a barium enema. It showed that I have diverticulosis. The doctor doesn’t think this is the cause of my pain. Why not? My dad had diverticulosis and was in the hospital for treatment. Just what is it? – R.B.

ANSWER: Diverticulosis is a colon that has little pea-size bulges – diverticula – on its outer wall. The bulges are the colon lining that has pushed its way through the colon’s muscular wall. About half of all people over 50 have diverticulosis. It’s prevalent because our diet is too refined. The outer coat of grains – the bran – is removed when flour is refined. Bran is fiber, and fiber keeps undigested food moist in its passage through the colon. When food residue dries, the colon has to exert great pressure to pass it downward and outward. That high pressure balloons the colon lining through the colon wall to form diverticula on the outside surface of the colon.

Most of the time, diverticula produce no symptoms. Only about one in every 10 diverticulosis patients complains of lower-stomach discomfort, most often on the left side and most often mild. The treatment of diverticulosis is a gradual increase in the amount of daily fiber. People should work toward getting 25 grams of fiber every day.

Diverticulitis is diverticulosis when the diverticula have become inflamed. The inflammation occurs if bits of hard stool clog the neck of the diverticulum. Diverticula swell and their blood supply can be cut off. This brings on severe stomach pain, and it usually makes the person nauseated and provokes vomiting. Body temperature rises. Sometimes there is rectal bleeding. People with diverticulitis are maximally uncomfortable and seek medical help promptly.

Diverticulitis is treated with a clear-liquid diet and antibiotics. If the pain is great or if there is bleeding, then hospitalization with intravenous feeding and intravenous antibiotics becomes necessary.

The diverticulosis booklet explains this problem in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I just want to know what the signs of colon cancer and gastroesophageal reflux are. – T.S.

ANSWER: The colon is 4 to 5 feet long. The signs of colon cancer depend on what part of the colon harbors the cancer. Blood in the stool, a change of stool color to tarry black, fatigue, anemia, stomach cramps and stools that have become narrow are some signs of colon cancer.

However, the ideal in colon cancer detection is to discover it well before any signs appear. One way of achieving that goal is for everyone to have a colonoscopy beginning at age 50. A colonoscope allows the doctor to see every inch of the colon and to snip any colon polyps, the precursors of colon cancer.

GERD, gastroesophageal reflux, is the upward splashing (reflux) of stomach juice and stomach acid into the esophagus, which was never designed to come into contact with those corrosive fluids. GERD is popularly called “heartburn,” and just about everyone recognizes what heartburn is since just about everyone has had at least one episode of it. In addition to the pain of heartburn, GERD can bring sour material into the mouth, can give rise to chest pain, can produce a chronic cough or can make the voice hoarse. I have a friend who developed an ulcer of the vocal cords from GERD. Asthma attacks are another possible GERD sign.

DEAR DR. DONOHUE: My husband’s PSA test has risen. What I want to know is if dipping tobacco and never spitting out the juice could have caused the change in his PSA test. I am very disturbed about this. – G.B.

ANSWER: PSA is the blood test for prostate cancer. Dipping tobacco – putting a pinch of it between the lip and gum – does lots of horrible things, but it doesn’t raise the PSA test.

Dipping can lead to cancer of the mouth, gum recession, tooth decay and an increase in the heartbeat.

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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