DEAR DR. DONOHUE: I need information on how to avoid flare—ups of diverticulitis. I am a 53—year—old female. I was diagnosed with diverticulitis in November 2008, after suffering for months from discomfort that finally became unbearable. The doctor gave me an antibiotic that cleared the problem up. 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, or the day before that? — D.F.
ANSWER: You need a clearer picture of what causes diverticular pain. You’re barking up the wrong tree. 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 causes 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 are grains that haven’t been refined. They 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 of diverticulitis 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 as the cause of a diverticulitis attack, I’ll give you the rough time sequences 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 days. Anything beyond that time is abnormal.
The booklet on diverticulosis explains this common malady in detail. To order a copy, write: Dr. Donohue — No. 502, Box 536475, Orlando, FL 32853—6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Tonight my wife choked on a piece of corn. She jumped up gasping, and looked at me as if I should have done something. Her gasping stopped, and she could breathe. She asked me why I didn’t jump up and hit her back. I heard if you hit somebody choking on the back, it could force the food farther down. Did I do the right thing? — R.M.
ANSWER: The Red Cross has changed its instructions on how to handle a choking adult. They now recommend leaning the person forward and giving five blows to the back between the shoulder blades with the heel of the hand. If that doesn’t dislodge the food, then start the Heimlich maneuver, a subject I just covered.
Dr. Heimlich was never in favor of back thumps. He believed it could cause the food to drop farther down the windpipe — the trachea.
DEAR DR. DONOHUE: I am a 59—year—old man. About five years ago, I had my spleen removed due to a traumatic injury. I was vaccinated with the pneumococcus vaccine. I was told that it would last a lifetime. Does that apply to a person without a spleen? — J.K.
ANSWER: 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 (NEW—moe—KOK—us) causes pneumonia and potentially lethal blood infections. People without a spleen need a second dose of the vaccine five years after the first dose. The pneumococcal vaccine is popularly called the pneumonia vaccine.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853—6475. Readers may also order health newsletters from www.rbmamall.com.
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