DEAR DR. GOTT: I’m at the point I am afraid to eat because my stomach has bloated so much in a year. I also have tingling in my fingers and toes. I can’t eat fiber, anything with seeds and so on. No lettuce. I’m just plain tired of pain and all the weight gain. What do you suggest I do? I have no more funds. I’ve had all kinds of tests, am now in debt, and the doctors couldn’t find anything. The only thing they said I do have is the beginning of something osis in the colon. Is there is a liquid diet that’s healthy or something?
DEAR READER: My guess is the osis you refer to is likely diverticulosis, a condition that affects the lining of the colon. Almost 10% of Americans over the age of 40 have small pouches in the large intestine that bulge outward through weak areas; that figure rises to almost 50% of all Americans older than 60. Each pouch is known as a diverticulum. More than one pouch is known as diverticula and the condition is known as diverticulosis.
Most sufferers don’t experience any symptoms, but for thost that day, they may include mild cramping pain or discomfort in the lower abdomen that may or may not be accompanied with bloating and constipation. Should one or more of the diverticula become inflamed or infected, the condition becomes known as diverticulitis. The most common symptoms are abdominal pain and tenderness in the lower left side of the abdomen. The pain can fluctuate, appearing mild or acute. It may be accompanied with vomiting, chills, nausea, cramping and a change in bowel habits.
The symptoms of diverticulosis can vary. Most people do not experience any discomfort, while others can have bloating, constipation and general discomfort in the lower abdomen. This does not imply that every person with the symptoms is suffering from diverticulosis.
Diverticular disease is believed to occur because of a low-fiber diet so common in our country, as well as in England and Australia. Fiber is referred to in two ways – soluble that dissolves in water and insoluble that passes through the intestines without a change in texture. Both forms prevent constipation because they aid in softening stools, making them easier to pass through the colon. Hard stool (constipation) can result in straining during bowel movements. That straining puts increased pressure on the colon and can cause bulging through weakened spots. Thus, diverticula. Diagnosis can be made through examination by a physician, the history presented and testing that may include a CT scan, abdominal ultrasound and colonoscopy.
The average person’s symptoms may lessen or disappear if they include between 20 and 35 grams of fiber in their diet each day. This can be done by including whole-grain cereals and breads, navy beans and more. Since you indicate you can’t eat fiber, consider taking an over-the-counter fiber water-soluble product such as Metamucil or Citrucel up to three times each day. The jury is out as to whether you should avoid foods with seeds, such as popcorn, sunflower or sesame seeds, and others. Some physicians endorse their discontinuation while others feel there is no scientific basis to discontinue them so long as food is chewed thoroughly. Oddly enough, the colon can accept cucumber, tomato and other seeds without harm, so I can understand why there is such confusion.
So, consider increasing fiber in your daily diet for several weeks. I don’t know your entire medical history so I cannot take you further but if your problems persist, head back to your physician for further instructions. If you don’t see any improvement, request a referral to a gastroenterologist or perhaps even an allergist to test you for food allergies.
Readers who would like related information can order my Health Reports “Irritable Bowel Syndrome” and “Constipation and Diarrhea” by sending a self-addressed, stamped number 10 envelope and $2 US (for each report) to PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
