By one estimate, 3 in 5 Americans older than 70 have the abnormal bulges called diverticula somewhere in the wall of their intestinal tract. Yet only 20 percent will ever experience a complication like diverticulitis (inflammation of a pouch), a tear, or an abscess.
Doctors have long advised people with diverticula to avoid nuts, corn, and popcorn for fear those foods would get lodged in a pouch during digestion and wreak havoc. But in 2008, research published in the Journal of the American Medical Association found that regular consumption of these foods did not boost the risk of diverticular complications. In fact, eating plenty of nuts and popcorn seemed to lower risk.
When diverticulitis does arise, it's very likely to make its presence known through abdominal pain—typically in the lower left quadrant in westerners, but often on the right side in Asians—and possibly fever; antibiotics can treat the condition. In extreme cases, a tear can lead to an abscess, which can cause nausea, vomiting, fever, and intense abdominal tenderness that requires a surgical fix. Some experts believe a diet too low in fiber may trigger the condition, which grows increasingly common with age and is most prevalent in western societies.
Inflammatory Bowel Disease
People with Crohn's disease or ulcerative colitis, the two most common inflammatory bowel diseases, complain of abdominal pain and diarrhea and sometimes experience anemia, rectal bleeding, weight loss, or other symptoms. No definitive test exists for either disease, and patients endure two initial misdiagnoses on average, says R. Balfour Sartor, chief medical adviser to the Crohn's & Colitis Foundation of America. With Crohn's, he says, appendicitis, irritable bowel syndrome, an ulcer, or an infection is often wrongly suspected.
Both disorders may arise from a wayward immune system that leads the body to attack the gastrointestinal tract. Crohn's involves ulcers that may burrow deep into the tissue lining at any portion of the GI tract, leading to infection and thickening of the intestinal wall and blockages that need surgery. Ulcerative colitis, by contrast, afflicts only the colon and rectum, where it also causes ulcers; colitis is characterized by bleeding and pus.
Treating either disease requires beating back—and then continuously holding in check—the inappropriate inflammatory response. Both steps are achieved through some combination of prescription anti-inflammatories, steroids, and immunosuppressants. Crohn's patients may also be given antibiotics or other specialized drugs. Of current hot debate is whether Crohn's sufferers benefit if given highly potent drugs early in the course of treatment as opposed to escalating potency over time from milder initial treatments, as is traditionally done, explains Themos Dassopoulos, director of inflammatory bowel diseases at Washington University in St. Louis.
Surgery "cures" ulcerative colitis by removing the colon but means patients must wear a pouch—internally or externally—for waste. IBD patients should take special care when popping NSAIDs like aspirin, as these painkillers can trigger further gut inflammation in 10 to 20 percent of patients, says Dassopoulos.
[See IBS? Could be the FODMAPs.]
About 1 percent of the U.S. population has celiac disease, an autoimmune and digestive disorder. Sufferers are unable to eat gluten—a protein found in rye, barley, wheat, and more—without triggering an attack on their small intestine. Symptoms vary from person to person, but include: abdominal pain and bloating; chronic diarrhea; vomiting; constipation; and pale, foul-smelling, or fatty stool. Doctors typically diagnose it with blood tests and stool samples.