Netflix Documentary "Sugar Coated"

[Corporal Lance Boil]

To answer your specific questions:

The combination of a fluoroquinolone (either levofloxacin (Levaquin) or Cipro (Ciprofloxacin) with the addition of metronidazole (Flagyl) is a broad-spectrum antibiotic regimen, with good activity against a majority of bacteria that would be causative in diverticulitis. I absolutely agree to not use these unless you need them. Why? They will suppress your normal colonic flora and perhaps you might wind up with an overgrowth of a different bacteria which normally inhabits your bowels, Clostridium Difficile come to mind (C diff). Plus, we are poor antibiotic stewards in general and by indiscriminate use we promote resistance.

Can it come back? Yes, and no. Bear in mind I have not examined you, and do not know the location of your disease. It is not uncommon to have disease "upstream" of the resected area which can become problematic, though this is rare. Some people have pan-colonic disease, i.e. disease all over there colon which make resection problematic, but most resections take place along known anatomic vascular supplies, and the colon is rich in arcades which co-distribute blood. Plus, this is not a cancer operation so the dividing of vessels takes place much closer to the colon, thus providing accessory blood supply. There are tenets to the operation which any surgeon would adhere to (Where are you Frank?) but generally I would resect the area in question and perform primary anastomosis, without diversion (think temporary bag.) My own pathology report shows they reconnected my bowels through a diverticula...I am fine.

Do you need another colonoscopy? No. Unless you like the prep, in which case I question your sanity. Colonoscopies, which I do, will not fix your issue, but maybe confirm it, and rule out malignancy as a cause.

Should you have an operation? Well, that's up to you. The body wants to get stool away from the site of inflammation and irritation, and if you want to try and avoid surgery I would recommend switching to clear liquid diet, something high in electrolytes like Gatorade when you experience significant symptoms like (I assume) serious left lower abdominal pain, and considering antibiotics if you run a fever or you think this may be serious. It would not be unusual to consider a CT scan at this point. Constipation I like to manage with Docusate Sodium (Colace), and over-the-counter stool softener. I usually prescribe 100 mg (2 50 mg pills) twice daily WITH water, as a stool softener doesn't work if there's no water to put into stool. I do not love laxatives in this situation, but would lean towards Senna as opposed to Miralax if forced. Cook all your vegetable well if you are experiencing symptoms, as you want things absorbed before they hit the colon. And for god's sake don't eat mushrooms, as the body does not absorb them, period, and they will irritate the hell out of your colon.

By the way, nuts/seeds/corn being bad for diverticula is a wive's tale. Bank on that.

OK, so long winded reply in a public place but there it is. I wish you health, good collecting, and if you have any issues feel free to contact me.

Tony

[irv]

Originally Posted by Corporal Lance Boil

To answer your specific questions:

The combination of a fluoroquinolone (either levofloxacin (Levaquin) or Cipro (Ciprofloxacin) with the addition of metronidazole (Flagyl) is a broad-spectrum antibiotic regimen, with good activity against a majority of bacteria that would be causative in diverticulitis. I absolutely agree to not use these unless you need them. Why? They will suppress your normal colonic flora and perhaps you might wind up with an overgrowth of a different bacteria which normally inhabits your bowels, Clostridium Difficile come to mind (C diff). Plus, we are poor antibiotic stewards in general and by indiscriminate use we promote resistance.

Can it come back? Yes, and no. Bear in mind I have not examined you, and do not know the location of your disease. It is not uncommon to have disease "upstream" of the resected area which can become problematic, though this is rare. Some people have pan-colonic disease, i.e. disease all over there colon which make resection problematic, but most resections take place along known anatomic vascular supplies, and the colon is rich in arcades which co-distribute blood. Plus, this is not a cancer operation so the dividing of vessels takes place much closer to the colon, thus providing accessory blood supply. There are tenets to the operation which any surgeon would adhere to (Where are you Frank?) but generally I would resect the area in question and perform primary anastomosis, without diversion (think temporary bag.) My own pathology report shows they reconnected my bowels through a diverticula...I am fine.

Do you need another colonoscopy? No. Unless you like the prep, in which case I question your sanity. Colonoscopies, which I do, will not fix your issue, but maybe confirm it, and rule out malignancy as a cause.

Should you have an operation? Well, that's up to you. The body wants to get stool away from the site of inflammation and irritation, and if you want to try and avoid surgery I would recommend switching to clear liquid diet, something high in electrolytes like Gatorade when you experience significant symptoms like (I assume) serious left lower abdominal pain, and considering antibiotics if you run a fever or you think this may be serious. It would not be unusual to consider a CT scan at this point. Constipation I like to manage with Docusate Sodium (Colace), and over-the-counter stool softener. I usually prescribe 100 mg (2 50 mg pills) twice daily WITH water, as a stool softener doesn't work if there's no water to put into stool. I do not love laxatives in this situation, but would lean towards Senna as opposed to Miralax if forced. Cook all your vegetable well if you are experiencing symptoms, as you want things absorbed before they hit the colon. And for god's sake don't eat mushrooms, as the body does not absorb them, period, and they will irritate the hell out of your colon.

By the way, nuts/seeds/corn being bad for diverticula is a wive's tale. Bank on that.

OK, so long winded reply in a public place but there it is. I wish you health, good collecting, and if you have any issues feel free to contact me.

Tony

Thank you very much again, Tony!

And no fear of me eating mushrooms. I like the taste, with butter and salt added, but for as long as I can remember, they don't like me!

Good going down the couple/three times I tried them but not once did they ever stay down. (Maybe an early sign of troubles years ago?)

I also had, for as long as I can remember, trouble keeping cooked cabbage down as well.

[samosa4u]

I also used to have serious problems with my intestines and some of my flare-ups would land me in the hospital. I decided that I had to make some changes in my life and here is what I did:

- I used to drink one can of pop daily, but now I drink two cans every month.

- I don't touch chocolate or sweets.

- I used to eat a lot of deep-fried crap, but now I eat it once a month.

- I used to smoke whenever I hung out with my friends, but I quit it 100%

- I used to drink like a m***f**er (about 5 - 6 oz a night), but now I drink 1.5 oz a night (beer).

- I never used to work-out, but now I jog at least twice a week. I race on my bike too and do lots of walking.

I have not been to the hospital in 8 years.

[irv]

Originally Posted by samosa4u

I also used to have serious problems with my intestines and some of my flare-ups would land me in the hospital. I decided that I had to make some changes in my life and here is what I did:

- I used to drink one can of pop daily, but now I drink two cans every month.

- I don't touch chocolate or sweets.

- I used to eat a lot of deep-fried crap, but now I eat it once a month.

- I used to smoke whenever I hung out with my friends, but I quit it 100%

- I used to drink like a m***f**er (about 5 - 6 oz a night), but now I drink 1.5 oz a night (beer).

- I never used to work-out, but now I jog at least twice a week. I race on my bike too and do lots of walking.

I have not been to the hospital in 8 years.

Was it ever diagnosed to be be diverticulitis or was it something else?

Glad to hear you are doing well.

I was never placed in the hospital, but looking back, I probably should have admitted myself. (before I seen my specialist and my regular Dr. saying it wasn't diverticulitis!)

[2dueces]

Forgive my failing memory and the bits that I remember in this post.
Not long ago I read a few articles about the low fat, low carbs diets that where supposed to end obesity in Americans. At the time (1970's) the "in" scientists were blaming fats and carbs for obesity and heart disease. That is why all the diets were based on these. But there was one scientist that claimed sugar was the real killer. The "in" scientists ruined his career. The diets were based on bad science and numbers to make it look like the problem was fats. Now almost 50 years later, with obesity and heart disease and almost double the Numbers in the 70's, scientists are looking at the research again. The #'s and data were false and we all bought it hook line and sinker.
What else do the "in" scientists lie to us about? Meat is bad in the 70's. Meat is good in the 2000's. Milk is bad in the 80's. Milk is good again. eggs., etc.

[irv]

Originally Posted by 2dueces

Forgive my failing memory and the bits that I remember in this post.
Not long ago I read a few articles about the low fat, low carbs diets that where supposed to end obesity in Americans. At the time (1970's) the "in" scientists were blaming fats and carbs for obesity and heart disease. That is why all the diets were based on these. But there was one scientist that claimed sugar was the real killer. The "in" scientists ruined his career. The diets were based on bad science and numbers to make it look like the problem was fats. Now almost 50 years later, with obesity and heart disease and almost double the Numbers in the 70's, scientists are looking at the research again. The #'s and data were false and we all bought it hook line and sinker.
What else do the "in" scientists lie to us about? Meat is bad in the 70's. Meat is good in the 2000's. Milk is bad in the 80's. Milk is good again. eggs., etc.

I agree, it is confusing what is good to eat and what isn't.
Just last year, or 2 years ago now, they were talking about the hazards of salt and that too much can kill you or cause varying problems. In there new released info about it, and continuing further talking about the hazards they raised it from 1500 mg per day to 2000.

Everyone is different, and has to gauge their own tolerance levels based on blood work and the like, but there are always those, no matter how much they eat, drink or smoke, seem to outlive all others.