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Medikologia / Health  / Diverticulitis: What Might Happen When You Skip Your Veggies

Diverticulitis: What Might Happen When You Skip Your Veggies

It was a Monday morning when I took time off to look at a few medical cases. And as I sat down in the medical library marveling at the paradoxical scenery of bamboo trees and cruddy water stream beyond the glass wall, I realized how life would be if I did not establish certain dietary habits.

“What would they  possibly be?” you might wonder.

Well…

As I turned away from the scenery to graze at the medical compilation, the case of a 60 year old man complaining of abdominal pain and fever grabbed my attention. As mundane as it may sound, an old person with abdominal pain and concomitant symptoms sounds alarming, if downright ominous among the medical community. If fact, similar cases are pretty much common nowadays, particularly in western society.

We’ve all seen the typical bodybuilder’s bread and butter routine – the cutting and bulking dogma. In a fat loss phase, everything is meticulously measured. From protein, carbs, fat, and sometimes even fiber. On the other extreme, the bulking phase turns into an eat-all-you-can day job. Some binge on all kinds of junk under the sun. And I empathize with the latter, because I used to eat the same way. Eating whatever your hand can grab is fun. But you’ve got to take the wheel at some point, unless the idea of a colonoscopy excites you, it’d be a wise decision to taper those cravings.

Truth is, there’re various diseases paralleled with poor dietary habits. No matter how hard a training program is and how diligent you are weighing every single ounce of meat you’re no exemption from acquiring certain lifestyle-related diseases if calories and protein is all you got.

So if you’re the person who likes to skip the veggies and get to the meat,  here’s an interesting disease that you may possibly acquire when healthy habits aren’t established.

Let’s dive in.

Diverticulosis: A Quick Definition

Diverticulosis is the condition of having multiple non-inflamed pouches in the colon, called diverticula. Its prevalence increases with age by 20% at 40 years old, and 60% by age 60. However, despite the high prevalence, it’s asymptomatic in most cases. That means, most people walk around having no idea how many pouches their large intestines are carrying.

Needless to say, up to 30% of diverticulosis cases can turn up pretty bad. Half of that number proceeds to a simple painless bleeding, while half to a more painful, abdominal pain and fever caused by an inflamed pouch, namely — diverticulitis.

Basic GI Science

To give you a clearer understanding, I’d like to torture you a bit by reawakening the lost memories of elementary science classes.

The large intestine (a.k.a. large bowel or colon) is the last part of the digestive system where water is absorbed and remaining material (either food or junk you’ve been stuffing with) is stored as feces to later be removed through defecation.

It’s basically composed of 4 parts, namely: ascending, transverse, descending, and sigmoid colon. From a clinical standpoint, the formation of small diverticula (pouches, herniations protruding through the intestinal layers and smooth muscle) can occur on the right or left side of the large bowel (ascending, descending, or sigmoid). There’s actually more to it but I’ll gladly spare you the headache.

Now…

As mentioned above, diverticulitis is the inflammation of one or more diverticula said to be caused by fecal material or undigested food particles collected inside the herniation, leading to obstruction. This obstruction gives rise to production of mucus and bacterial overgrowth that, eventually compromise the vascular system, causing perforation. On top of it, some scientists believe that intraluminal pressure exerted by the colon cause erosion of the intestinal wall, leading to inflammation and focal necrosis (a fancy term for cellular death).

Here are two illustrations of a diverticula. On the right (Image 1.2) you can see the x-ray of sac-like pouches, while the other picture (Image 1.3) shows an endoscopic image (the tube like object gastroenterologists stick up your butt hole to visualize the colon) of the pouches’ margin. That’s where junk and dirty material can accumulate and cause inflammation with various complications.

I know, the idea of sac-like protrusions hanging all over your colon sounds gruesome. But fortunately, most cases are asymptomatic (unless you deliberately gratify yourself with all sorts of food pleasure). In spite of that, when complications arise it might turn into a big deal. For one, at age 50 you can start bleeding on your pants or two, abdominal pain ensues.

What happens after that?

Well, aside from making physicians wealthier, in worst case scenario a diverticulitis can cause obstruction, stricture, fistula formation or uncontrolled sepsis (a life-threatening condition where multiple organ failure occur due to a systemic inflammation set off by the infection).

But fear not. As far as treatment is concerned, it’s usually done through surgery, where wicked looking surgeons open up your abdomen and traffic those 20 feet long organic pipes to who-knows where (okay, joking aside, the well-meant surgeon will have to cut off part of the colon, a procedure called colectomy).  But, if you’re a lucky folk presenting with an uncomplicated case, a few pills of antibiotics and some medical imaging is all it takes to kick you out of the hospital.

 

What This Means to You

So I’ve spilled medical jargon and talked about the condition. What now? How will you benefit from it?

There are 3 things you can learn from the case of a 60 year old man:

 

1. Eat healthy 80% of the time

In this day and age, it’s almost impossible (or rather painful) not to eat processed food. We all have tendencies for junk every once in a while. Perhaps the irresistible cookies of your grandma, the potato chips of the local 7-11, or the blue berry cheese cake of your favorite bakery are your life’s greatest enemy. But you know what? Don’t fight it, but rather, restrict it.

I’ve always been fund of balancing things in life. It’s conventional wisdom that too much of a thing is bad. The same goes for dietary discipline. If you can stick to a diet plenty of whole foods 80% of the time, you can rest assured that you’ve decreased the risk of getting a nasty disease in the long run.

Obviously, genetics does play a role. But would you be willing to place a bet over your health just to prove the resiliency of your DNA?

Certainly not. The risk is too high.

 

2. Don’t emulate the hypermetabolic person

You’ve probably seen one of them. The person who won’t gain a quarter pound of fat no matter how much junk he stuffs in his gullet. But the reality is, you are YOU. You have a different set of genes, and most likely have a lesser tendency to burn more calories than him. But who cares? Focus on progress.

It’s not a competition. Dieting is not just about getting lean and looking good in clothing. It’s about building right habits, diligence, and mental toughness; because at the end of the day, the one who’ll benefit the most will be you.

So keep your envy at bay. Who knows, it might save you the expense of a colonoscopy for the next 10 or 30 years.

 

3. Abs are built in the kitchen

Can’t resist the quest for 6 pack abs? No problem. But remember, supplements aren’t the answer.

Too many magazines and commercials make it appear like their product stuffed with fat burning chemicals will turn you into a Henry Cavill overnight. Sure, the compounds alter metabolic rate and ramp up biologic processes to increase calorie expenditure, but at the same time you’ll neglect the most basic principle of all – building a healthy diet first.

No matter what celebrities or people paid to advertise may say, a strong foundation is key for success. Not just for ephemeral results, but long lasting achievements that will carry over to other aspects of life.

In fact, what good would it be to look good half naked yet predetermined for an operating room 10 – 20 years from now?

 

Instead, what can you do?

We’ve reached a point where awareness is critical for health. But what can you do now that the seed of fear mingles in your subconscious?

Well, I’ve got 2 easy things you probably know already. However they’re worth emphasizing to drive the point across and leave you with two actionable goals that’ll help you in the long haul.

 

1. Eat lots of fiber

Sure, fiber fills you up pretty good. It’s a mantra we’ve been hearing over and over again. And I agree. It does serve that purpose. But there’s more to it than simply sweeping dirty stuff from the intestine.

There are two additional reasons why you should eat more fiber: micro flora nourishment and cancer prevention.

One great thing about fiber is its high satiating effect and indigestible content, and in fact, those pesky friendly bacteria in your colon love indigestible fiber. They cherish it. Make an orgy out of it. And you know what else they do? They digest it and secrete a compound called short chain fatty acid (SCFA) that destroys cancer cells by activating apoptosis (cell destruction). Think of it like a suicide bomber specialized in tumor destruction.

In addition, when friendly bacteria populate the area, they become one of your strongest defenses against GI related infections. Thus, potentially decreasing the risk of gastroenteritis and other related diseases.

And that’s killing two birds with one stone.

Twenty to thirty grams daily is all you need. It’s not that much. Two or three cups of legumes are more than enough. Add in some low GI foods like berries, and then you’re good to go.

 

2. Exercise

Studies have shown that increasing exercise frequency decreases the risk of diverticulitis development in the future. And it can be any type of exercise: cardio, weight lifting, calisthenics, etc. As long as it gets your heart pumping and blood circulating at the right intensity, it’ll get the job done and keep you away from the danger zone.

 

Conclusion

Abs are awesome. Muscles are a sight to behold. And nice curves may break necks. But we often neglect the reason we endeavor for such goals. Is it for self-love? Pride? Admiration? Or for a nobler cause, like an ideal of health and longevity?

No matter the reason, a broader perspective gives more meaning behind every workout and motivation underneath that salad.

 

References

1.Douglas J. Morrison, Tom Preston. (2016). Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism. Gut Microbes, 189–200.

2.FL, C. (2014). Source of dietary fibre and diverticular disease incidence: a prospective study of UK women. BMJ Journals, 1450-6.

3.Gearhart, S. L. (2012). Diverticular Disease and Common Anorectal Disorders. Sa T. R. Harrison, Harrison’s Principles of Internal Medicine (mp. 2502-2503). New York City: McGraw-Hill.

4.Grundlingh, J. (2011 ). 2,4-Dinitrophenol (DNP): A Weight Loss Agent with Significant Acute Toxicity and Risk of Death. Journal of Medical Toxicology, 205–212.

5.John H Pemberton, M. (March 27, 2017). Acute colonic diverticulitis: Surgical management. Muling kumuha ng December 5, 2017, mula sa Uptodate.

6.LL, S. (2017). Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study. Gastroenterology, 1023-1030.

7.RS, M. (2017). Association of Dietary Patterns With Risk of Colorectal Cancer Subtypes Classified by Fusobacterium nucleatum in Tumor Tissue. JAMA Oncology, 921-927.

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