Relief From
Diverticular Disease

Recognizing Symptoms
Relieving Discomfort

Many of us haven't even heard of it, but an estimated 30-50 percent of Americans over the age of 60 have diverticular disease. This booklet will provide you with information about diverticular disease: what it is, what causes it, how it is diagnosed and treated, and what you can do to take care of your own digestive system.

Facts about Diverticular Disease
Diverticular disease occurs when small pouches, known as diverticula, form in the walls of the large intestine or colon. It is believed that diverticula form when pressure inside the colon builds and makes the wall bulge in spots where it's naturally weak. One of the causes of this pressure can be related to constipation. Normally your colon muscles move in waves, expanding and contracting as they move waste through your system When the waste material is hard and dry, the muscles may have to squeeze harder, with more force. There are many causes of constipation including medications, lack of exercise, stress, and inadequate intake of fluid and fiber. An adequate intake of fiber helps keep the stool soft and add bulk, so it takes less pressure to move through the colon.

Symptoms of Diverticular Disease

However, if the pouches become infected and inflamed, abdominal pain, fever, and nausea may result. This condition is called diverticulitis. It is estimated that as many as one in five people who have diverticula may develop the complication of diverticulitis.

Doctors are unsure of all the reasons for diverticular disease. But they think that the walls of the colon weaken during the normal aging process.

Diverticular Disease and Your Digestive System
To better understand the causes of diverticular disease, let's take a quick tour of your digestive system. A little information can go a long way in preventing difficulties.

The digestive process begins in your mouth. Your teeth break up the food into small pieces and your saliva mixes with the food, allowing it to pass through the esophagus into the stomach. Using muscular contractions, the esophagus sends food from the mouth to the stomach.

Like a giant processing center, the stomach churns the food into smaller pieces, preparing it to travel on to the lower part of the digestive tract.

After leaving the stomach, the food passes into the small intestine, where the food's nutrients are further broken down and absorbed into the bloodstream. By the time food passes through all 21 feet of the small intestine and reaches the colon, only water and waste products remain.

Now the colon begins the process of removing waste from the body. Here's how doctors think diverticular disease develops:

• A series of circular bands of muscle surround the colon. If two or more of these bands begin to contract at the same time, the colon cannot operate properly.
• What happens is that the contents of one section of the colon -- gas, liquid, and waste material -- cannot move on to the next section, as they should. so the trapped waste products press against the colon's wall, which is particularly dangerous for any weak spots.
• Through these weak spots, small sacs, or diverticula, bulge out of the intestinal wall in much the same way that a bicycle's inner tube can bulge out through a soft spot in the tire.

No one knows why the muscle contractions of the circular bands become strong enough to set this process in motion. But what is known is that it takes years for diverticular disease to develop.

Diagnosis and Treatment
You feel some of the symptoms of diverticular disease. What do you do?

First, see your physician. He or she will ask about your bowel habits and history. The doctor also will perform a physical examination, which may include a close look at the rectum and the lower part of the colon.

Sometimes, a procedure called a colonoscopy is performed. Using a long, tube-like instrument with fiberoptic lenses, the doctor can examine the entire colon.

In cases of diverticulitis, antibiotics usually clear up the infected diverticula within a few days. While the colon is healing, the doctor may keep you on a low residue diet for a period of time.

Managing Diverticular Disease
There are several ways to manage diverticular disease. The following tips will help keep your colon functioning normally:

• Eliminate foods and other substances that may be irritating to the colon.
• Maintain an ideal weight.
• Eat a diet that includes high-fiber foods.

Adding Fiber To Your Diet
If you have diverticulosis which includes symptoms of occasional constipation, it's important to include high-fiber foods in your diet. Although fiber does not contain vitamins, minerals, or nutrients, it serves a vital function. Fiber itself adds bulk to keep other foods moving along the digestive tract, and it holds water which, in turn, softens the stool for easy elimination.

Fiber comes in two different forms: soluble and insoluble. While they work differently, both are needed for proper bowel function. All fiber sources contain both kinds of fiber in varying amounts.

How can you get enough fiber in your diet? The secret is to eat a well-balanced diet that includes a variety of high-fiber foods.

You don't have to totally rearrange your diet to accommodate more fiber. One way to start is to substitute high-fiber foods for low-fiber ones. Switch your bakery habits from white bread and rolls to whole-grain breads. Try brown instead of white rice. Eat "whole grain" cereal. And most easily of all, add fruits and vegetables to your diet.

Your general rule of thumb should be at least one serving of whole grain in every meal. Try this sample menu:

Breakfast -- Cereal and/or toast. Make sure the first name on your cereals and breads is Whole Grain. Add banana slices to cereal.

Lunch -- Sandwich on whole-grain bread. Carrot sticks. Snack -- Apple or raisins. Skip the candy bar, or at least cut back.

Snack -- Apple or raisins Skip the candy bar, or at least cut back.

Dinner -- Broiled chicken and steamed broccoli. Wheat rolls. Salad.

Also, increase your intake of vegetables and fruit. You should be getting three servings of each every day. Try a sliced banana on your cereal, substitute carrot sticks for chips as a lunch side, and crunch on a salad for dinner. Wherever possible, eat the peels (you're off the hook with bananas and oranges).

There are possible downsides to increasing fiber. Some high-fiber foods, like beans, can produce excessive gas or bloating. Take in too much fiber too soon and you could suffer from bloating or abdominal cramps.

Remember, whenever you change your diet, for whatever reason, do it gradually. Let your body adjust. And check in with your doctor if you experience any discomfort.

A Fiber Solution: METAMUCIL®
If your physician has recommended increasing your fiber intake in order to treat constipation, he or she may suggest the convenience and effectiveness of Metamucil.

What does METAMUCIL add?
METAMUCIL contains psyllium, a 100%-natural fiber that helps you restore regularity, increase your fiber intake, and maintain regularity when recommended by your physician.

How much fiber can METAMUCIL add?
At 3.4 grams per dose, taken up to three times per day, you can add as much as 10.2 grams of psyllium fiber. That's about half of the minimum amount of fiber recommended for your daily consumption. And it's one of the most concentrated sources of soluble fiber. In fact, METAMUCIL's fiber contains more than eight times the amount of soluble fiber found in oat bran, gram for gram.

When can I take METAMUCIL?
You can take METAMUCIL in the morning, at noon or in the evening, with or without food with at least 8 ounces of liquid (one to three times a day). Laxatives, including bulk fibers, may affect how well other medicines work. If you are taking a prescription medicine by mouth, take this product at least 2 hours before or 2 hours after the prescribed medicine.

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