About half of Americans ages 60 to 80 have diverticulosis, a condition in which pea-sized pouches, called diverticula, bulge outward from the colon. After age 80, almost everyone has it.
Most of the time the pouches don’t cause any problems, but if the diverticula become inflamed or infected, the result is diverticulitis, which produces symptoms like fever, nausea, vomiting, and pain or tenderness in the lower abdomen. It’s unclear why this happens, but it’s generally thought that the pouches become infected after stool or bacteria get caught in them.
“As men age, they tend to have more difficulty with bowel movements, so they need to be more attentive to their digestive health,” says Dr. Joel Goldberg, assistant professor of surgery at Harvard-affiliated Brigham and Women’s Hospital. “Being mindful of your normal bowel patterns and how they vary can help you recognize when something is wrong, so you can seek medical attention.”
Your doctor should confirm the presence of diverticulitis with a CT scan because the symptoms can mimic other conditions, including inflammatory bowel disease or stomach flu. Episodes can last a few hours to several days and recur at regular intervals or after a long period.
Besides the physical problems, diverticulitis can cause emotional issues. A 2015 study in Quality of Life Research found that people with the condition often have feelings of fear, anxiety, and depression.
The role of antibiotics
Antibiotics used to be the first-line treatment even for mild episodes, but the new thinking is that not all diverticulitis should be treated this way. “If there is no fever, the preferred treatment is to manage minor attacks with rest, plenty of liquids, and non-narcotic pain medications,” says Dr. Goldberg.
Antibiotics are now used only for people who have severe pain, fever, and an elevated white blood cell count, as well as those who develop an abscess (a swollen area of tissue that contains pus) or a perforation (when bowel contents spill into the abdominal cavity).
Surgery to remove the affected part of the colon is sometimes necessary if an infection becomes persistent or severe, or if someone has multiple recurrent attacks.
You can help prevent diverticulosis by drinking plenty of fluids and eating a high-fiber diet. Studies have suggested an association between low-fiber diets and diverticulosis, since the condition is less common in places like Asia and Africa, where people eat diets high in vegetable fiber compared with the typically low-fiber diets in America and Great Britain.
Fiber helps to soften the stool so it can pass easily through the intestines. If the stool is too hard, constipation can occur. Straining to pass hard stool puts pressure on your colon, which may cause weak spots to bulge out.
The Dietary Guidelines for Americans recommends 38 grams of fiber per day for men; however, most men only get 15 grams. The best sources of fiber include fresh fruits, vegetables, beans, nuts, corn, and foods containing wheat bran.
If you have trouble getting enough fiber in your diet, a fiber supplement like Benefiber or Metamucil can help. “A tablespoon of any of these adds about 5 to 6 grams of fiber to your diet,” says Dr. Goldberg. Speak with your doctor before taking a fiber supplement, as adding too much to your diet at one time can cause gas and bloating.