Netflix Documentary "Sugar Coated"

[Corporal Lance Boil]

Originally Posted by irv

There seems to be more and more of these diseases/disorders popping up all the time.
I have diverticulitis (For those that want to know: http://www.emedicinehealth.com/diver...article_em.htm) and it is the reason I am off of work today.

3-4 years ago, I had my first attack and I had no idea what was going on? Long story short, after being off work 4 1/2 months, heavily medicated, for a majority of that time, I now only have flare ups, like today, and a couple weeks ago.

When I seen a specialist, he told me this use to be an old mans disease/disorder but year after year, the people coming in, more frequently, to see him are getting younger and younger. He also informed me more and more women are also now getting this.

Not sure if it's one particular thing, but my gut tells me it is everything we are now eating and the air we are breathing. Hormones in food, MSG, the list goes on and on.

I try to control it the best I can with diet, and it has worked, for the most part, but the only thing to get rid of it is to have an operation. I have considered it, but there is a slight chance (3-5%) that I will have to wear a colostomy bag the rest of my life too!

I try never to talk medicine on the internet, but this is kind of my wheelhouse. The purpose of my response is to educate, as best I can. I'd like to make clear from the get-go that I am not refuting anything your specialist (I assume either a general surgeon or a colo-rectal surgeon) has said. I'm hoping my response might be of benefit to you and your understanding of your problem.

Diverticular disease, diverticulosis as it is known, or diverticulitis when inflammation/infection is present, IS a disease of diet. The human body is designed for high-fiber diet, which the western diet is not, hence the prevalence in our society as opposed to someplace like Japan. The colon has to generate pressure to move stool through it, and it is far easier on the colon to push a single, well-formed stool through then to push loose, low-fiber stool or diarrhea. Hence greater pressures are required for low-fiber stool. The colon, where both blood vessels and nerves perforate the wall, has areas where they are technically "weaker", and these are the areas that bulge out with higher pressures, aka diverticula. The sigmoid colon is far and away the most common site of diverticula, as it is the storage site for stool before defecation.

I would estimate 30-40 million people are walking around with diverticula. I also believe that our propensity to go to CT imaging much quicker now has to do with the increased finding of this condition.

Now on to diverticulitis. Of people who have a first bout, only 30% will have another. Of that 30%, only 30% will have another bout. So, you see, it is far more rare to have recurrence than not.

Diverticulitis used to be something where at your second bout, you would have the area resected, often with what is called a Hartmann's procedure (resection of the segment, bind rectal pouch and end colostomy, to be reversed in 1.5-6 months). Nowadays we treat it on a case-by-case basis, as some people are OK with intermittent flare-ups treated with antibiotics (cipro/flagyl or levaquin/flagyl or zosyn) and basically a liquid diet, whereas others are not. I will tell you this: the chances of you having a permanent colostomy (which is rare and mainly determined by the location of the disease) is exponentially higher if you need an emergency operation for serious perforation (Hinchey Class 3 or 4), as opposed to a planned, scheduled operation for resection when inflammation is not currently present. It is not unusual to have the segments re-connected and a diverting loop ileostomy brought up, to be reversed at a later time.

As a caveat, I perform this operation and am a general surgeon. I also have had a sigmoidectomy 3 years prior for perforated diverticulitis, so I've seen it from a patient's side as well.

I wish you all the best,

Tony Colacino