The dietary treatment for diverticulitis flare ups has taken an about-face in recent years. In the past, people were advised to adhere to bland and low-residue diets. These are exactly the diets which, it seems, were responsible for causing the diverticulosis in the first place. Nowadays, people are encouraged to consume diets that are higher in fiber and roughage. The fiber increases the quantity of stool and softens its consistency. Commercial preparations, such as Metamucil, also have a similar effect.
Although fiber may not be of benefit to all people, it does seem that a high fiber diet lessens the frequency of the problems that may result from diverticulosis. It is hoped that high fiber diets, when eaten at younger ages, may even help to prevent diverticulosis from occurring at all.
The key to the use of fiber is to use it in moderation. As many people already have discovered, fiber, found in cereals, fibers, and vegetables, can itself cause a sense of bloating and cramps. People should eat a quantity of fiber that does not cause these problems, yet is sufficient for softening the stools. This can only happen with trial and error, and anywhere from three to eight weeks must be allowed to see if fiber has an effect.
It is hoped that as people become much more aware of the importance of dietary fiber, then diverticulosis, a disease of modern society, may become a thing of the past.
Diverticulitis is often incorrectly diagnosed on presentation and computed tomography (CT) scanning is probably the best tool for correcting this situation. That's the conclusion of a retrospective analysis of 125 acute diverticulitis cases undertaken by researchers at the University of Alberta, Edmonton. The cases were seen between mid - 2005 and early 2007.
The study was undertaken in part to assess compliance with treatment guidelines for complicated and uncomplicated diverticulitis endorsed by the Canadian Society of Colon and Rectal Surgeons. Results were presented here at the annual meeting of the Royal College of Physicians and Surgeons by Dr. David Williams, a general surgery resident at the university.
Guidelines recommend complicated diverticulitis cases with free perforation or fistula be treated surgically. Percutaneous drainage is recommended if an abscess is found. Conservative management is advocated for uncomplicated cases with antibiotics and bowel rest recommended.
In their analysis, the researchers assessed how valuable clinical markers such as fever, pain and white blood cell count were in making a correct diagnosis. A similar assessment of ultrasound, CT and contrast enema studies was undertaken.
We wanted to see how we were treating our patients and if it was treatment according to the guidelines," Dr. Williams said in an interview. Ten patients were excluded from the outcome analysis, he said, because although they were diagnosed with diverticulitis on admission they were later found to have a different problem.
The researchers found only 60% of patients had the correct diagnosis made at presentation. The sensitivity and specificity of CT was better than any of the other tests. Patient - reported pain was a reliable marker of diverticulitis but had no specificity.