My best friend is in the next room, writhing in agony because of the pain from diverticulitis. It was only yesterday that we found out what it is, from a friend who is a nurse; however, when I asked him what they do for it, he said, “Learn to live with it.”
I looked it up on wikipedia – obviously, there is surgery to repair this. But I’m hoping someone else who suffers from this can tell me something that they do which helps. Prevention, and especially management of acute pain. My friend does not have access to prescription painkillers because he is uninsured, and does not have the ID required to fill a prescription for opiates.
Nothing helped my mother once she had it, but she learned to manage which foods triggered it and which didn’t. Chick peas are ok so long as they’ve been peeled, kidney beans are a no-no (some varieties are worse than others), lentils are ok.
Eventually it got solved by a full replacement of her intestinal flora plus a change in her diabetes medication (metformin is definitely not for her). The diverticule is still there but hasn’t so much as peeped in two years, except for this one time she got put on metformin again by a doctor who couldn’t be arsed read her medical history (damnit, even if the original on paper is on its third volume, the computer version is a lot more compact!).
Wow … peeling chickpeas … poor lady, that’s a bit of work! But Jeff hates chickpeas, fortunately for me, I guess.
Funny thing is, last night he had an attack. I gave him some naprosyn, and about an hour later, he was able to eat a giant taco with corn tortillas, spicy salsa, and Peruvian beans. Tonight, he ate a grilled cheese sandwich, and he’s in pain again. Guess it’ll take awhile to gather data, and dial it in.
The pain won’t go away until the infection has cleared up. He needs to go to a doctor for antibiotics. That said, he should be on a low fiber diet for now.
Once it’s cleared up, a high fiber diet is supposed to help, but I get good results just from a normal diet while avoiding nuts, sunflower seeds, etc. I eat limited amounts of corn.
My sister and mother have each had such extreme cases that part of their colons were removed.
Thanks, Frank, in fact I went in just now and asked him if he could handle a couple of days on a liquid diet. To my amazement, he said yes. (Ordinarily, Jeff is a chow hound like unto myself.)
You’re right about checking for appendicitis; although he has no tenderness in the spot where you’d expect it for that. It’s basically severe pain just below his solar plexus, nausea, and vomiting. A couple of years ago, he had surgery to repair a hernia, which is what made our nurse friend think it was likely diverticulitis.
Mom differentiated “hard” and “soft” fiber, but I don’t know how much would that be reproducible. “Hard” had to be avoided and would be stuff such as seeds (no strawberries, no kiwis) or noticeable “skins” (apples and chickpeas shall indeed be peeled); “soft” is things such as the fiber in any properly-cleaned vegetable. Your friend’s dinner for last night reminds me of the coworker who’d complain of his stomachaches while popping Tums by the handful over his huevos rancheros.
Does he still have his gallbladder? Because that sounds too high up to be a colon problem. Based on the recent gallbladder threads this month, that really sounds like a gallbladder attack.
I suspect not, but you do ask a very good question which exemplifies why a medical examination is always the best choice. When it is possible.
I have had diverticulitis. 200mm (8 inches) of my large bowel was cut out and the remainder joined together. That isn’t a big deal given that the large bowel is nearly a meter (3 feet) long. But of course we need to be realistic - abdominal surgery, in fact any deep surgery can lead to death. Not a pleasant experience.
A diverticula is an expansion, a bubble, a pouch, in any part of the digestive tract. From mouth to derriere (bum).
It can manifest as acid reflux. A swelling or out-pouching of the esophageal sphincter. (Yeah got that too) Having been under the knife before, I have spurned the procedure and live on ant-acids.
Forgive me for my obsessive-compulsive explanation but I’m conscious that many may read this but never comment.
The digestive tract in humans has has four (or more) sections. The esophgeous - mouth to stomach interrupted by the hiatus sphincter, then the small intestine. This is best known as the small bowel and believe me herein trouble lies.
It is highly unlikely that pain which causes a stoic adult to writhe is diverticulitis.
Diverticulitis, as the term is typically used, is an inflammation in one of the small pouches formed where vessels penetrate the large intestinal wall. Inflammation in the bowel tract produces pain upon movement, bouncing and so forth. So we don’t see people with inflammatory conditions (at least, any which irritate the peritoneum) writhing around. We see very quiet people moaning and holding still as quietly as possible.
Writhing around brings up a whole other set of diagnoses related to things like colicky conditions (biliary or ureteral colic, e.g.), mechanical conditions (bowel obstructions and the like), peptic ulcer disease, or other such things that are not primarily inflammatory in nature.
Opiates are not appropriate outpatient therapy for undiagnosed abdominal pain.
Hernias and diverticulosis are not related conditions.
In general, prior intrabdominal surgery increases the risk for small bowel obstruction, but not for a diverticulum to either develop or become inflamed.
Please keep a very close eye on him, and check his temperature frequently. If this is an obstruction (and I agree with Chief Pedant that obstruction sounds more likely from your description) it may rupture, and that’s a life threatening emergency. The good news is that if it does turn out to be a rupture, then the hospital will admit him and do the required surgery without looking for payment up front. They will do what needs to be done, help him apply for charity care (most likely) to pay for it, and work out a reduced fee and/or payment plan for the rest.
Signs of a rupture or other emergency include increased pain, fever, a rigid “board like” abdomen, addled thinking or “altered mental status,” or just a vague sense that things are not right here. Don’t ignore that vague sense; it’s right surprisingly often. Honestly, you’ve already got enough going on here to have him at least evaluated in an emergency room without upfront payment. If this was my friend, that’s where we’d be headed now.
Acute diverticulitis can definitely cause pain, extreme pain. What it doesn’t tend to cause is writhing, tossing and turning, or even a whole lot in terms of groaning and moaning. It tends to be the kind of pain that makes people very quiet and very still. YMMV, of course.
I should add that many causes of abdominal pain are benign–that is; they do not have lethal outcomes.
I should also add that many diagnoses are rather casual and not necessarily correct. So it might be common for a patient to have been told (incorrectly) that their pain was due to “x” without proper confirmatory evidence.
A med school professor of mine put it well when asked what was causing a patient’s pain: “Well, Pedant; no one has silent bowels.” What he meant by that is that we all get assorted pains at some point or other, and unless the underlying event progresses to a definitive diagnosis (made at surgery, say), those various pains get ascribed to something which may not have been the underlying cause at all.
