Diverticula: what they are
The diverticula they are small and multiple pockets that develop in the walls of the colon, usually in the sigmoid, although they can also affect the entire large intestine. When they are present, we speak of diverticulosisa mostly misunderstood condition that affects around 10% of the population and rarely causes problems.
Although it is more frequent among the elderly, it can appear at any age and its prevalence (prevalence) under the age of 30, currently very low (1-2%), is destined to increase due to the continuous worsening of the population’s eating habits. give it they have one double probability than men to develop diverticula.
“The diverticula – explains the prof. Pier Luigi Rossimedical specialist in nutrition sciences and preventive medicine – are formed when the muscles of the colon weaken and the intestinal wall undergoes an increase in pressure due to the constipationa risk factor for the development of these ‘pockets’.
Their presence is a sign of aging of the intestine, the expression of a bad diet low in fiber food and an altered microbiota.
The process of forming diverticula is this:
– You follow an incorrect diet with an insufficient intake of dietary fiber contained in foods of plant origin and in those integral.
– Insufficient fiber intake modifies and reduces the presence of bacteria with positive action on intestinal microbiota and the fecal mass in the colon.
– The reduction of fecal and bacterial mass causes a narrowing of the colonic canal which causes an increase in pressure inside it and is responsible for a breakthrough on the intestinal wall, with the appearance of diverticula “.
Since diverticulosis is especially asymptomaticmost people discover that they have diverticula completely randomly, usually during radiological or endoscopic examinations of the colon carried out for other reasons.
In 10% of cases, however, the diverticula they become inflamed: this condition is called diverticulitis and represents the main cause of the onset of symptoms, generally represented by spasms of the colon, very often in the lower abdomen on the left, which lead to aching or real pain in correspondence of the sigma. Sometimes diarrhea can be associated and, when the inflammation is more severe, the pain becomes more intense and this is accompanied by fever and chills.
“Who wants to check if any of his diverticula are inflamed – continues prof. Pier Luigi Rossi – can press with his hand on the left side of the abdomen. If you feel pain when releasing your hand from the abdominal wall, you should talk to your doctor, as it is a sign of inflammation in progress”.
In the most demanding cases of inflammation it can be reached perforation of the diverticula, which requires immediate surgery. This involves, most frequently, a resection of part of the colon (to the left of the sigmoid) which is then reattached to the rectum.
Although, as a rule, it guarantees total recovery of intestinal function after 2-3 weeks from surgery, it is not a simple operation and must be performed by specialized surgeons and with the most recent techniques, such as laparoscopy.
In general, however, the disease is not to be underestimated. In fact, in the case of complicated acute diverticulitis, generally in emergency conditions, a two-stage intervention may be necessary with the packaging of an artificial anus first and with the restoration of intestinal function with an operation after.
The diet for those suffering from diverticula
Per prevent its onset of diverticulosis and diverticulitis it is essential to follow a varied and balanced diet with a sufficient presence of dietary fiber.
“The recommended dose is at least 30 g per day: 20 g water-soluble dietary fiber + 10 g water-soluble dietary fiber ”, advises prof. Pier Luigi Rossi. Green light, therefore, to seasonal fruit and vegetables, probiotics and prebiotics and lots of water to promote intestinal transit, bearing in mind that the increase in fiber content in the diet must be gradual to minimize abdominal swelling and to facilitate the adaptation of the intestine to changes in eating habits.
Yellow light, on the other hand, due to an excessive introduction of Red meat. “A diet rich in red meat – explains the expert – changes the bacterial metabolism of the colon, leading to changes in the microbiota that can cause the production of molecules favoring the spasm of the intestinal wall, with consequent weakening of the colon wall and the formation of diverticula . Red or processed meat (cured meats, sausages, sausages …), precooked meat-based foods, such as cordon bleu and other similar foods cause a 2-4 times increase the risk of developing diverticula compared to vegetarians or vegans “.
“Red meat obtained from intensively reared animals with grains, soybeans, and housed – continues prof. Rossi – also contains a considerable dose of saturated fatty acids (palmitic, stearic, myristic, arachidonic, omega 6 …), also associated with a greater risk of diverticulitis “.
What to eat and what to avoid if there is active diverticulitis? “If the diverticula are inflamed – suggests the doctor – instead, it is necessary to reduce the daily dose of dietary fiber and all those foods that may occur in the digestive processes ferment excessively increasing the amount of intestinal gas (an example are some types of vegetables such as artichokes and cabbage, summer fruit, grapes, citrus fruits and legumes). Attention also to the use of tea and coffee “.
Does fruit with seeds cause diverticulitis?
No, concludes the expert. “The thought that the cause of diverticulitis may be the taking of seeds contained in some foods such as tomatoes or kiwis is devoid of any scientific basis. There is no scientific publication, published in series of international journals, which blames some foods with seeds ”.