Q: I need information on how to avoid flare-ups of diverticulitis. I am a 53-year-old female. I was diagnosed with diverticulitis after suffering for months from discomfort. The doctor gave me an antibiotic that cleared up the problem. What I need to know is this: How long after eating a problem food does discomfort ensue? I’ve tried to tie discomfort to a particular food. I just can’t figure out which ones cause the problem.
For instance, if I have a problem on Tuesday afternoon, would that be from food I ate Tuesday morning, or the day before?
A: You need a clearer picture of what causes diverticular pain. Diverticula are small bulges on the colon’s outer wall. The bulges are the lining of the colon that has been pushed through the muscular colon wall and has popped out on its outer surface. They are pea-size to marble-size. When the necks of diverticula become obstructed, bacteria within the diverticula cause swelling and pain. Prevention of diverticula formation and diverticula obstruction centers on a high-fiber diet.
A particular food isn’t usually the culprit. A lack of fiber is the troublemaker. Fiber holds on to water and keeps the food residue soft. If the residue hardens, the colon has to generate great force to move it along, and that force is responsible for diverticula formation. You need to get 25 grams to 30 grams of fiber daily. Fruits, vegetables and whole grains are fiber sources. Whole grains retain their outer coat — bran. Bran is excellent fiber.
Diverticulitis — inflamed diverticula — produces pain, most often felt in the lower left side of the abdomen. Sometimes it leads to rectal bleeding. An attack calls for a change in diet, either to a liquid one or one with soft foods. If you still want to track a particular food, I’ll give you the rough time sequence of food passage. It takes one to two days for food to pass from mouth to the end of the colon. At most, it takes three. Anything beyond that time is abnormal.
Q: I am a 59-year-old man. About five years ago, my spleen was removed after a traumatic injury.
I received the pneumococcus vaccine. I was told that it would last a lifetime.
A: The spleen is an integral part of the immune system.
People who don’t have one are more susceptible to infections and, in particular, to pneumococcal infections. The pneumococcus bacterium causes pneumonia and potentially lethal blood infections. People without a spleen need a second dose of the pneumonia vaccine five years after the first.
Dr. Donohue answers letters only in his North America Syndicate column but provides an order form of available health newsletters. Write him at P.O. Box 536475, Orlando, Fla. 32853-6475.
