Diverticulosis

　　Although the specific cause of diverticulosis is not yet known, most experts believe that the main reason for its formation is the pressure generated by the small, hard stools produced by the defecation of low-fiber diet. The high pressure produced by abnormal colonic motility (possibly due to low fiber content in the diet) forces the intestinal endothelium to penetrate the weak points of the colonic extramuscular layer.

　　Abnormal colonic motility causing the disease, characterized by chronic or recurrent abdominal pain, diarrhea, abnormal defecation habits, and abnormal stool properties, and lacking gastrointestinal structural or biochemical abnormalities, is a syndrome that often coexists with other functional gastrointestinal diseases such as gastroesophageal reflux disease (GERD) and functional dyspepsia (FD). It is necessary to undergo examinations to rule out organic diseases that can cause these symptoms. Gastrointestinal functional disorders include abdominal pain, bloating, abnormal defecation habits, abnormal stool properties, mucous stools, which may persist or intermittent, and lack morphological and biochemical abnormalities that can be explained. The characteristic is the irritability of intestinal function.

　　Complications such as intestinal perforation, abscess, fistula, intestinal obstruction, massive bleeding, inflammation, perforation, and cancer inside the diverticula. Discomfort is usually relieved after defecation and flatus. Diarrhea is often characterized by small amounts of loose, unformed stool, and may include a sense of urgency or incomplete defecation. Stool may contain white mucus, resembling snot, and generally no pus or blood. Some patients alternate between diarrhea and constipation, with stool sometimes dry and hard, resembling sheep dung, and sometimes loose. Most people have obvious symptoms such as insomnia, anxiety, depression, and other nervous and mental symptoms.

　　Most patients with diverticulosis have no symptoms. However, some scholars believe that when patients experience unexplained abdominal pain, diarrhea, and other abnormal defecation, the exact cause may be diverticulosis. The opening of the diverticula can bleed, sometimes severely, with blood entering the intestinal cavity and then being excreted through the anus. This type of bleeding can occur when stool becomes trapped in the diverticula and damages the blood vessels (usually the blood vessels next to the diverticula). Bleeding from diverticula in the ascending colon is more common than in the descending colon. Colonoscopy can determine the cause of bleeding. Diverticulosis mostly occurs with bleeding. The condition can be divided into two stages:

　　1. Diverticula formation stage:Rising of the colon wall to form abnormal sacs, known as diverticula.

　　2. Diverticulitis stage:Metabolic products of the body and bacteria trapped in diverticula can cause inflammation and even lead to perforation. The condition of most patients only stays in the first stage.

　　Eating a diet rich in fiber can prevent diverticulosis. Diverticulosis patients should consume foods with relatively high fiber content. Food supplements, such as flaxseeds, can be used to increase the fiber content in food, promote normal bowel movements, and prevent constipation. Avoid excessive intake of fats and irritant foods such as coffee and alcohol, engage in regular physical exercise, and reduce the body's response to various stresses, which is sufficient to achieve the treatment goal. Reduce the intake of gas-producing foods in daily diet, such as dairy products and soybeans.

　　Colonoscopy to check for any abnormalities in the intestines, as the colon is long and the sigmoid colon is free and there are many folds in the anal canal, making it easy to twist and difficult to insert the scope. The angles at the splenic flexure and hepatic flexure of the colon are often less than 90°, and it is also challenging for the scope to pass through. Check blood, urine, and stool conditions, and pay attention to body temperature, fever, diarrhea, and abnormalities in the lymphatic system.

　　What kind of food is good for diverticulosis

　　1. Eat more fruits and vegetables.

　　2. Drink more boiled water.

　　3. Reduce the intake of irritant foods such as tobacco, alcohol, coffee, strong tea, and various spicy seasonings such as scallion, ginger, garlic, chili, pepper, curry, etc.

　　If diverticulosis develops into diverticulitis, the patient needs to rest in bed and use analgesics and antibiotics. Although the pain of diverticulitis often occurs in the left lower abdomen and usually worsens slowly over a few days, the pain may also occur suddenly, similar to appendicitis. If you suspect that your diverticulosis has developed into diverticulitis, you should consult a doctor and adhere to a diet of liquid or low-fiber foods.

　　The real danger of diverticulitis lies in the possibility that the diverticulum may rupture and leak intestinal contents into the pelvic cavity. This can cause severe systemic infection. However, in most cases, diverticula do not rupture, but may become infected and cause intestinal dysfunction. Occasionally, diverticulitis can lead to obstruction, bleeding, abscess, or leakage of the intestinal wall. These conditions are quite serious and require immediate treatment, sometimes even surgery. Therefore, if you have been diagnosed with diverticulitis, it is necessary to discuss the emergency treatment of diverticulitis with your doctor, as well as what symptoms require immediate treatment. Treatment of severe diverticulitis first requires the patient to rest in bed and receive intravenous nutritional support, i.e., stop oral food intake to allow the intestines to rest. If the patient develops an infection, antibiotics are used. (Mild cases can be handled at home - lying in bed, consuming liquid food, and antibiotics.)

　　If the patient develops peritonitis, surgery may be required. The surgery can remove part of the inflamed colon and then reconnect the remaining part.

　　通常，治疗的目的在于减轻肠道痉挛。摄入高纤维食物（蔬菜、水果和燕麦片）是减轻痉挛的最佳方法。如果摄入高纤维食物无效，可补充未精制的麦麸或使用容积性泻药，如在240毫升水中加入3.5克车前草，每天1次或2次。甲基纤维素可能也有一定的疗效。因为需要一定的肠腔压力来推动肠内容物运行，因此，应避免低纤维饮食。憩室无需外科手术治疗。但是，由于巨大的憩室发生感染和穿孔的可能性较大，因此，需要进行手术治疗。