Learn about Diverticular Disease

We all age, no matter what products or procedures we may use to slow the process. It’s visible in the skin, through wrinkles, sagging, and cellulite. Despite our best efforts, nature eventually wins, as gravity slowly tugs on us. What you probably do not realize is that a similar process can happen in your gut.

As we get older, the colon (the lower part of your digestive tract), is prone to forming small out pouchings called diverticula. These are rarely seen before age 40, but by age 80 almost everyone in the US has them (interestingly these are uncommon in Asia and Africa). These small pouches vary in size and number, some having very tiny openings, and some very large. These pockets form in areas of the colon wall that are weaker, and once formed, will not recede. Though not fully understood, it is believed that regional dietary habits influence the development of diverticula. One major dietary difference among these regions is the consumption of fiber. Studies have shown that a lack of appropriate dietary fiber intake leads to constipation, putting additional pressure on the gut. Thus, it is believed that age, long standing constipation and straining leads to a greater chance of diverticula formation.

You will most likely not know you have diverticula unless you have a colonoscopy (which is recommended for everyone over the age of 50). They rarely cause noticeable symptoms, with 2 exceptions. First, they can become infected. This condition is known as diverticulitis. It is very painful and can cause cramping and diarrhea. Antibiotics are required and at times the condition can be severe enough to require hospitalization. The second noticeable symptom is diverticular bleeding, which can be a terrifying experience characterized by the sudden urge to have a bowel movement, resulting in a torrent of pure red blood in the toilet! Dizziness and lightheadedness are also associated with diverticular bleeding. Diverticula may have small vessels closer to the surface that can bleed profusely and then suddenly stop. The bleeding is not predictable and hard to prevent, but luckily tends to be self-limited. You may want to consult a Gastroenterologist for acute rectal bleeding, but in some cases, these bleeds may be frequent enough to require surgery to remove the section of the gut that is affected.

While determining if you have diverticular disease may not be high on your priority list, it may be a good idea to get a colonoscopy, eat a balanced, high fiber diet and look out for symptoms.

For more information, visit: https://www.asge.org/home/for-patients/patient-information/understanding-diverticulosis

Helicobacter Pylori ABC

Did you know that almost half of the world has a bacteria called Helicobacter pylori (H. pylori) in their stomach? This is very common, typically with no noticeable effect on your everyday life. However, in some people, the H pylori bacteria can cause a lot of upset stomachs.

H. pylori infection usually occurs in childhood (though some are at higher risk than others), and remains asymptomatic in most people throughout their lives. When it does cause trouble, it is associated with stomach ulcers (peptic ulcer disease), and can be a risk factor for stomach cancer in those affected. This does not mean you should rush to your doctor for testing if you have no symptoms. In fact even in people who show signs of infection, there is minimal cancer risk if treated with a short course of medications.

So how do you know you have H pylori? Here is an example.

You wake up in the morning, maybe with a nagging cough. Your mouth tastes bitter. As you eat each meal, your chest burns, and you feel bloated and uncomfortable. The acid rushes back up into your throat, burning as it trickles back down to the stomach. You are nauseated, burping, perhaps embarrassed to even be near your friends for a meal. You regularly chew on over the counter antacid medications for some minor relief, and you cannot remember the last time you tried that spicy taco sauce at your favorite Mexican restaurant, for fear of hours of agony. Maybe there was even a time you noticed your stools turned tarry-black and you vomited dark, almost coffee-ground like material. You brushed it off and avoided those triggering foods, but the symptoms still come, daily and frequently.

The above symptoms do not guarantee you have H. pylori without testing, but they certainly warrant a visit to the doctor. Since H. pylori is just one of the causes of ulcer disease and reflux, your doctor will likely try a medication to block acid first and advise you to avoid eating trigger foods or eating before bedtime. If this does not work, or you fall into a higher risk group, they may test your stool or blood, or even perform an EGD (esophagogastroduodenoscopy, or looking at the stomach and throat with a camera) to test for the bacteria. If positive, you will need to take a 2 week course of 3-4 medications, including an acid blocker, 2 antibiotics, and possibly some bismuth. The symptoms should heal up quickly if the bacteria is to blame, and many people do not have issues afterwards.

Never wait if you are bleeding, losing a lot of weight unintentionally, or having troubles swallowing. These can be signs of more worrisome issues. You are not alone in your symptoms, so if in doubt, ask.