Friday 30 October 2015

Olive leaf was used to treat Malaria in the Middle East and Arab countries, why does Western medicine insist that we use drugs, sheer madness

NaturalNews) The use of olive leaf, whether in leaf or in teas, has been used for thousands of years to treat wound infections and many other diseases, by the people in the Middle East and Arab countries. In the 19th century, olive leaf was used to treat Malaria and was successful against some of the worst cases. One of the best ways to treat Candida Albicans is with olive leaf, according to many researchers. Through the use of olive leaf's anti-microbial properties, the disease is treated.

Candida is a naturally occurring yeast found in the body. It occurs when the balance of bacteria is disturbed. This can occur from an over use of antibiotics, a diet high in sugar, emotional stress and environmental influences. This condition has become epidemic in the world with many doctors not knowing how to treat this illness. There are literally thousands of cures for Candida and many costing thousands of dollars on the internet. The patient becomes extremely depressed with brain fog and allergies, and in some cases the person becomes incapacitated.

Candida is usually attributed to yeast infections, but it may attack the throat and the mouth also. It attacks both men and women and many patients have such symptoms as a "White Tongue" or thrush. Many doctors state that cancer is caused by a fungus and that Candida is a major cause of cancers, so treating Candida is imperative.

With this simple cure, the elimination of Candida is achieved in as little as 4 weeks. Olive leaf has been shown successful in improving the immune system. Olive leaf has been proven to be an excellent anti-fungal herb in the fight against many diseases to include toe fungus, athlete's foot and jock itch.

When treating Candida, the patient is given large doses in the beginning to attack the disease full force. Then you need to take three capsules, three times a day of the extract and the dried leaves are to be taken three times that amount. After Candida is cured, it is recommended to continue taking small amounts of the olive leaf daily to assure that it does not return.

Candida is aggravated by the consumption of sugar and yeast, so a diet eliminating these items should be used along with the suggested protocol. Candida may be completely irradiated in as little as 4 weeks according to some studies. Keep in mind that many fruits contain sugar, so a diet for Candida should limit the consumption of fruits.

A study was conducted by Upjohn Pharmaceutical Company in 1970 and they discovered that taking more of olive leaf did not cause any adverse side effects, even in very large doses. But when the person starts treating Candida, they may suffer from "die-off" or the famous Herxheimer's Reaction. As the body begins to detoxify it might have some symptoms such as headaches, diarrhea, fatigue and flu like symptoms. If this happens, discontinue the olive leaf temporarily until your symptoms subside. After the body has been able to rid itself of some of the toxic waste, you may begin the treatment again.

Olive leaf through many trials has shown its ability to fight any and all attacking viruses. Olive leaf has anti-viral, anti-fungal and anti-inflammatory properties. It has 400 percent more antioxidants than Vitamin C and double the antioxidants of green tea. Olive leaf should be taken daily to achieve the maximum effect.

Although little was known about olive leaf in the past other than through the biblical reference, olive leaf is becoming more and more popular today. It is a powerful antioxidant which is more powerful than Vitamins C and E, green tea and grape seeds. Olive leaf reduces the LDL in cholesterol, increases blood flow, and helps in reducing blood pressure levels.

This article will go into more benefits of the olive leaf and how to prepare the fresh dried leaves. The leaves need to washed and dried and then placed in capsules for consumption. As always, fresh is better.

http://www.naturalnews.com/026950_olive_leaf...

Olive Leaf benefits:

- Traditionally used to fight off colds and the flu.

- Treating yeast infections and Candida.

- Viral infections, Epstein Barr, shingles and herpes.

- Heart conditions.

- Lowering cholesterol and LDL levels.

Please Note:

When purchasing olive leaf extract or any form of olive leaf other than the dried fresh leaves, look for the analysis to state that it has 20 percent natural oluropein standardized extract. There are many ways to extract the value of the leaves and many companies are creating shortcuts. There are many types of olive leaf trees and many countries from which the best leaf is available. So as a word of caution, be aware of this sometimes used practice.

http://www.health-answers.co.uk/olive_leaf.h...

http://www.naturalnews.com/026950_olive_leaf...

http://www.candida-albicans-cure.com/olive-l...



About the author

Barbi Trejo is a natural hygiene foodist and loves the medicine of the earth. After being diagnosed with MS and early onset dementia last year, she cured herself using herbs and juicing from the earth. She now spends her time helping others.
Barbi Trejo lives in Jordan with her cat, Baby. Barbi is writes for Suite101, Break Studios and Associated Content. She moderates four forums and six blogs in her spare time.
Barbi has just released her first eBook entitled, "Everything You Would Ever Want to Know About Black Seeds (Nigella sativa) and more. It can be seen at http://nigellasativa.weebly.com
Barbi is also a Twitter Manager for many of the top Natural Health Writers here on Natural News.com and Corporations. To learn more about how Twitter can benefit you, contact her at sarassoupkitchen@yahoo.com and make sure to put Twitter as the reason for the email.


Learn more: http://www.naturalnews.com/027184_olive_leaf_candida_disease.html#ixzz3q6dMoeji

10 foods that fight Candida

10 Foods That Will Fight Your Candida

onions and garlic
I have included 10 of my favorite Candida-fighting foods in this list. You can make some delicious recipes with these ingredients, safe in the knowledge that the food you are eating is helping with your Candida treatment too.
My Ultimate Candida Diet program contains a larger list of 25 Candida-fighting foods that you can find in your local store. It includes some surprising probiotic and antifungal foods, as well as some that will help your body’s own detoxification processes.

coconut oil1. Coconut Oil

Coconut oil is a potent Candida killer, and one of the most potent antifungals there is. It contains Lauric acid and Caprylic acid, which both help prevent Candida overgrowth and strengthen your immune system.
Coconut oil is very heat stable, so it’s an ideal oil to use for frying and cooking. It is also cheap to buy and has a much longer shelf life than other oils, so there’s no excuse! You can 2-3 tablespoons per day.

garlic2. Garlic

Garlic has powerful antifungal properties to attack Candida, while also preserving and boosting the good bacteria in your digestive system. Garlic stimulates the liver and colon, giving it a potent detoxifying effect on the body.
If you love garlic, then use it liberally to flavor your food. You can also drink 2-4 cloves per day, crushed and mixed with water as an anti-Candida tonic. Avoid taking it on an completely empty stomach, and try it with a tablespoon of coconut oil to cut down on the stomach burn.

onions3. Onions

Onions have strong anti-fungal, anti-bacterial and anti-parasitic properties. They also help to flush excess fluids out the body – this is useful because many Candida sufferers experience water retention. Onions along with garlic can give you breath issues, so a handy tip is to eat them with a bit of parsley to counter the smell.

seaweed-salad4. Seaweed

Seaweed is a nutrient-dense healing food that will help the body in the fight against Candida. It is rich in Iodine to help balance your thyroid gland – Candida sufferers often experience hypothyroidism and its many symptoms. Seaweed flushes toxic pollutants and heavy metals from the body, and cleanses your intestinal tract.
Kelp extract supplements are one of the most potent sources of Iodine, but you should also try eating lots of different types of seaweed.

Swedes at the Greengrocers.5. Rutabaga

Rutabaga is one of the most potent antifungal foods that you will find. Although you might think it falls into the same category of foods to avoid as sweet potatoes and yams, it actually has some very strong antifungal properties. Try it in small amounts first – if you find that it causes Die-Off symptoms then you might want to try a milder antifungal like turnip instead. Rutabaga is a versatile vegetable – you can make a rutabaga mash, cut up some rutabaga fries or mix it into your vegetable soup.

ginger6. Ginger

Ginger has a detoxing on the body by increasing circulation and detoxifying the liver, in addition to stimulating the immune system. It has a positive effect on the digestive system and helps reduce intestinal gas. It also has a soothing effect on any inflammation that the Candida overgrowth may cause in your intestinal tract.
Ginger tea is incredibly easy to make – here’s how you do it:
Ingredients:
1 square inch piece of fresh Ginger root
Squeeze of lemon
2 cup of water

Cut off the outside of the ginger root, then grate it and add to boiling water. Boil for 20 minutes. Strain and serve with a slice of lemon.

olive oil7. Olive Oil

Olive oil contains a plant chemical named Oleuropein, which is found in both olive oil and olive leaf extract. It contains powerful anti-fungal properties and stimulates your immune system response to Candida. It has also been shown to help stabilize blood sugar levels – this is important for Candida sufferers because elevated blood sugar levels can feed your yeast overgrowth.

lemon water8. Lemon and Lime Juice

Lemon and lime juice stimulate the peristaltic action of your colon, increasing the efficiency of your digestive system.
Both lemons and limes are great options for seasoning your vegetable, fish and meat dishes.

pumpkin seeds9. Pumpkin Seeds

Pumpkin Seeds are high in Omega-3 fatty acids, which have anti-fungal, anti-viral and anti-parasitic properties. ‘Omega-3’s also help combat depression and symptoms of Candida inflammation such as pain and skin conditions. It is a well established fact that most of us do not get enough Omega-3 oils in our diet to maintain optimum thyroid health. Deficiencies in this fatty acid have been linked to lower thyroid hormone levels. For an easy Omega-3 boost, add these pumpkin seeds to cereal, smoothies, salads or even use them as a portable snack.

cayenne pepper10. Cayenne Pepper

Cayenne pepper gives natural support to your digestive system and immune system. It helps to digest food and reduces constipation by cleansing the bowel of Candida and other toxins. Cayenne also increases metabolism and circulation, which will help to reduce one of the most common Candida symptoms, fatigue. Use cayenne pepper liberally to spice up your favorite foods.
For the full list of my 25 top Candida-fighting foods, check out my Ultimate Candida Diet treatment program.

It's the sulphur that kills the Candida fugus "bingo"

Mid Wales Spas & Mineral Springs


Why Spas and Mineral Springs? 
Most spas are either rich in iron (chalybeate), sulphur (with hydrogen sulphide gas) or saline (mainly sodium chloride). The iron and sulphur probably come from the breakdown of fool's gold (pyrites) resulting from water movement through the highly faulted local rocks. The high levels of sodium chloride are difficult to explain but may be due at Builth (as in parts of the West Midlands) to salt deposits in the nearby Downtonian rocks. 
Although Powys has most of the Welsh spas, there are others scattered throughout Wales. Most are iron, sulphur or saline, but Taff's Well, near Cardiff, produces water at about 20°C. There are many Holy Wells, only a few of which produce any mineral rich waters. 
Llandrindod Wells 
Llandrindod Wells contains many different mineral springs, some of which were probably used by the Romans. The first documented discovery occurred in 1736 when a Mrs. Jenkins found a saline spring and a sulphur well. After curing her daughter's ulcerated head with one of the waters, her cures became famous and she treated many local people with various ailments. The spas grew in popularity due to the publication in 1747 of "A Journey to Llandrindod Wells in Radnorshire", and a poem in the Gentleman's Magazine in 1748, both of which praised the mineral waters of Llandrindod Wells. A hotel was built at Llandrindod Hall near the parish church in 1749, and was crowded with visitors from Easter to November every year until in closed in 1787. 
Llandrindod's popularity declined from then until the 1820's when several large boarding houses were built. In the second half of the nineteenth century, more mineral springs and wells were found and bath houses and pump rooms were built at the Rock Park Hotel and Pump House Hotel (now Powys County Council offices). Thus, at the turn of the century, Llandrindod Wells could supply a large number of medicinal waters "with every form of spa treatment, high class accommodation, concerts, entertainments and dramatic attractions" Charges for the spa water were then 6d per day for any amount, ld per glass, 2/6d per week or 1/11d per gallon with 11d back on the bottle. A regular visitor of the time was Lloyd George. The spas declined after the 1950's although the Rock Park stayed open until 1972. This spa is now being renovated by Radnor District Council. 
Builth Wells 
A saline spring was said to have been discovered in 1830 by a party of mowers. The steamlet formed by the spring was called 'Nant yr Halen' (Salt Brook). The waters were soon exploited commercially and eventually two wells were set up, one at Park Wells and one at Glannau. Saline, chalybeate (iron) and sulphur vvaters were present; the saline, being exceptionally strong, contained barium and lithium. 
Llangammarch Wells 
This spring is supposed to have been discovered one dry summer when a cotter was out looking for a pig. He noticed it welling up from the dry bed of the River lrfon, drank some but found it had a vile taste. A well was constructed to elevate the water to a bath house and provide a supply for drinking. The barium well has recently been rebored to provide a better supply of  spa water to the Lake Hotel. 
Llandegley 
This spa was popular in the second half of the eighteenth century and first half of the nineteenth century when it was almost as well known as Llandrindod Wells. The Cambrian Balnea (1825) recorded that the very strong sulphurous spring lies in a meadow opposite the inn, whilst the chalybeate is a few yards to the west on the bank of a brook, and canopied by the trunk and branches of an old alder clump. The spa fell into disuse in the 1930's and all that now remains is an old wooden shack and a ditch containing the white filaments of sulphur bacteria. 
Llanwrtyd Wells 
This was discovered in 1732 by the Reverend Theophilous Evans who was looking for a cure for his 'radicated scurvy' ' Having been told of the existence of the sulphur spring, he found it easily because of it's strong smell. He was cured of his scurvy after taking the water for two months. 
Originally called 'Ffynnon Drowllyd' (Stinking Spring), it was renamed Dolycoed Well after the spring had been diverted into a well and bath houses were built. Another sulphur well was built at Victoria Wells in Llanwrtyd Wells. Both wells were very popular in Victorian times but closed earlier this century. Although derelict, the spa buildings at Dolycoed are still standing in the grounds of the Dolycoed Hotel, and the impressive wellhead can still be seen. As 1982 is the 250th anniversary of the spa's discovery, some restoration work is taking place to enable the public to visit the Dolycoed site. 
Other Notable Welsh Spas 
Many mineral springs were of only local significance and some, such as the chalybeate spa at Aberystwyth now known only as a street name, never made a lasting impact. Two in North Wales do, however, have an interesting history and are worthy of mention:- 
Caergwrle Wells, Flintshire 
Caergwrle Spa became a popular resort with people from Manchester and Liverpool at the beginning of the twentieth century. However, like many other Welsh watering places, nothing is left of the spa, except one very solid, but boarded up, red brick building. 
Trefriw Wells, Gwynedd 
This was first discovered between 190 and 250 A. D. by a Roman Legion, but the first bath house was not built until 1743. Trefriw Wells closed in 1952 but was reopened in 1977 and visitors are able to see the ancient caves and purchase bottles of iron and sulphur water. 
Claimed Medicinal Properties 
Although some claims were undoubtedly exaggerated (e.g. the ability to cure plague), others were based on fact. Although sulphur is probably good for some skin complaints and possibly iron for anaemia, and saline for constipation, mineral waters were often used to treat scurvy, ulcers and eye troubles with varying degrees of success. They were also recommended for asthma, debility, and generally washing out the system. Some contained barium which was claimed to be good for heart trouble.
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Tenby Welshpool Wrexham Photos Old Photos Chester Oswestry

Tuesday 27 October 2015

Today I cried

Today I cried, but not because things were hard, but how easy they have become.

                                       This will be my last blog, so Thank you.

Thursday 22 October 2015

Dr. de Vries director of 7 health clinics in Britain - Stomach and bowel disorders

STOMACH AND BOWEL DISORDERS
by: De Vries, Jan, Dr.H.Med., Ph.D., D.Ac., D.O., N.D.
Dr. de Vries is the director of seven health clinics in Britain, including the Mokoiya Health Centre in Troon, Scotland, one of Britain's best known alternative medicine clinics. He uses a wide range of therapies to treat degenerative diseases including proper nutrition, homeopathy, acupuncture, osteopathy, special mineral baths and herbal medicine. He pioneered alternative medicine in Holland, and together with Dr. Alfred Vogel, established the very first alternative health clinic in that country. He is the author of a popular series of books which focuses on alternative treatments using herbs and diet for degenerative diseases. The accomplishments of Jan de Vries have won him international acclaim and he has been presented with the prestigious Dag Hammarskjold Award for outstanding contribution to humanitarian causes. He is a scientific member of the Cancer Research Board in Britain and is presently doing research in Arcen, Holland for the European Commission, investigating the effectiveness of herbal medicine. It was about 30 years ago that Dr. Vogel and I lectured in Amsterdam, and at that time we did not have the common problems that we do today, like diverticulitis, diverticulosis, irritable bowel syndrome, and Crohn's Disease. Dr. Vogel mentioned that there are four things we should look at in order to increase the quality of our health: quality of food, quantity of food, digestion of food and absorption of food. You don't get any quality from angel delight pudding or a tin of tomato soup which has never seen a tomato. You get quality of food from food which is cell renewing, because that is what life is all about, a renewing of cells and cell tissue.

ACID-ALKALINE BALANCE

With all these digestive problems, the acid-alkaline balance of your system is very important. Diverticulitis, diverticulosis, peptic ulcers, gastric ulcers, duodenal ulcers, psoriasis, eczema are all born in an overly acid system. The worst food to eat is from the pig because it's the highest animal acid and highest animal fat - two things we could do without. You only need to take a sample of your urine. In all the thirty-five years I have been in practice, people with peptic ulcers, duodenal ulcers, gastric ulcers are all overly acidic. You must get rid of acid foods. Many ulcer conditions can be cleared up by the juice of a raw potato. You take a potato with the skin, wash it well and grate it. Then you push the juice out of it, you get just a little, and you take that first thing in the morning, and it is excellent for filtering acidity. It is a very good alkaline food. There is also a good remedy, a little blue flower called the corn flower. It is a very good acid binder and will even desensitize people who are allergic to wheat and some grains. It is available in health food stores as Centaurium from Dr. Vogel.

CANDIDA ALBICANS

We all have Candida Albicans, but thankfully it is not active in everybody. But you can make it active through eating the wrong kinds of foods and wrong food patterns. You can have a problem in a very short time. Many Chronic Fatigue Syndrome patients have started with the Candida because Candida will rob your immune system. Knowing how much harm it does, the first thing I will do is ask the patient to remove five foods from the diet, that's all: coffee, cheese, mushrooms, wine, chocolate, sugar and fermented food like yeast. Candida loves these foods. Now that's only five foods I ask them to remove. It is so important that you don't continue these foods because your immune system gets so depleted from the active Candida that you invite all kinds of invaders to cause even more problems. I have seen lately so often that many terminal cancer patients have an active Candida. Devil's Claw is a remedy that Dr. Vogel and I brought to Europe many years ago and it is a wonderful remedy to help Candida.

ALLERGIES

The allergy problem is very much related to stomach and bowel problems. When we have allergy problems, we have to learn to combine foods correctly, especially foods we might be allergic to. There is no point in eliminating a whole list of foods in trying to solve your problem. It is very often the combination of foods. If you get the combination right, you will be all right. For instance, you may be able to eat a banana, but when you combine it with other foods you may have a problem. There are two very jealous foods which you should always eat alone - the melon and the banana. If you strengthen the immune system, some of the allergies will disappear. I have outlined proper food combining in my book, Nature's Gift of Food.

IRRITABLE BOWEL SYNDROME

If you get plaquing of food which doesn't digest in the sigmoid colon, that is when health problems arise. That is what Candida loves the most. When you get plaquing, it is very difficult to remove it. That is the reason why it is so important that you have the right roughage in your diet. The most common cause of the irritable bowel problem is drinking coffee, number one. It is very important to remove coffee from the diet. Instead of drinking coffee, drink peppermint tea. I am a great believer in keeping things simple, and I have helped many irritable bowel problems with drinking peppermint tea and balancing the diet. It is very important that you get a good healthy mucous in the bowel. Some people take many colonic irrigations, many enemas, many laxatives. They think they can remove that old plaque that sits and ferments if they remove it with a lot of ammunition. No, you can't do it that way. You have to take action and do some simple things like drinking peppermint tea and flaxseed. The little insignificant seed of the flax fills your mouth with a good healthy mucous which is fantastic for the bowel because the bowel needs the right mucous for its processes. That is the right remedy. One of the finest flax remedies is Linoforce from Dr. Vogel. Watery stools and diarrhea are very often caused by a lack of friendly bacteria in the bowel. Healthy mucous and acidophilus should be present in the bowel. When watery stool and diarrhea appear, that is very often lacking. Take a jar of natural yoghurt and some acidophilus or bifidum every day. The herbal remedy Tormentavena is also very helpful.

DIVERTICULITIS AND DIVERTICULOSIS

Once you have these problems, you probably have an incurable situation. But you can control it if you start to help yourself with a good diet. Make sure that you take the right remedies. Then it will often become non-active. Fibre must be increased in the diet. When flatulence and bloated feelings occur, patients can benefit from taking Arabiaforce, a herb preparation for stimulating stomach activity, and promotion of appetite. Garlic is a wonderful remedy and it has tremendous antiseptic properties and is of great benefit in these cases. The worst thing for either diverticulitis or diverticulosis is taking antibiotics. Friendly bacteria in the bowels are destroyed and the condition could easily go from bad to worse.

CHRONIC CONSTIPATION AND BLEEDING OF THE BOWEL

Constipation can lead to a lot of problems. Sometimes it's good to have a colonic irrigation, but don't get addicted to it. I have some patients who almost need it three times a week, and that's no good, because your bowel should do it itself. It's very important that once you have had a clean out to take things like Linoforce which is simple linseed, and follow a good diet. For chronic bleeding of the bowel you have to be very careful and see your doctor about it. Take the remedy Witch Hazel - Hamamelis Virginiana, which is excellent. And the constant bloating that you have can be helped with the remedy Tormentavena.

COLITIS

In treating colitis, raw vegetables are not very helpful until the colitis has cleared, not even juices. It is better to cook vegetables, although it is against my usual principles to say this. But years of practice have proved that it is a mistake for people with Candida or even thrush to eat a lot of fresh fruits and vegetables, but this keeps the thrush going all the time. You have to cook your vegetables and fruit or you will never really get completely rid of the thrush. It is also important not to eat fruits and vegetables together because fruit and vegetables together make a very indigestible food. You bombard you digestive system. It is better to eat them separately or leave 20 minutes between eating them.

HIATUS HERNIAS

I am terribly against an operation for a hiatus hernia. It is a very big operation and it is not always successful. Osteopathically I am usually able to adjust it and to give people the freedom they need. Hiatus hernias are often caused by wrong food patterns, such as eating too quickly and not mixing food with saliva as it is chewed. It is better to take six small meals than three big ones because you overload the system.

DETOXIFICATION

The alarm bells which tell you that you have digestive problems are swollen tummies, irregular bowel movements from constipation to diarrhea. These problems have increased lately and there is a very simple remedy that I prescribe 100 times more often than I did ten years ago. It's called Tormentavena from Dr. Vogel and it regulates the bowel movements and removes some of the toxicity. If foods really upset you, if you have any of these problems, detoxifying is very important. There are a lot of good cleansing foods like watercress, garlic, leeks, and onions. They will help you detoxify and there are detoxifying courses like the Rasayana Program from Dr. Vogel to cleanse the colon and stomach. Candida hates it, and all the viruses and bacteria hate it when you detoxify.

SORE THROAT

The throat is becoming almost a cesspool of bacteria. A throat infection affects the whole body and can lead to so many problems. So it is very important to use a good natural antiseptic. I am not a great friend of dairy food but there is one I do like and that is the leftover when you make cheese - the whey of the milk which is an excellent remedy for the pancreas, and for diabetes, but also a very good antiseptic for the throat. Molkosan from Dr. Vogel contains concentrated liquid whey and is available in health food stores. Take a teaspoonful twice a day and this will disinfect the throat beautifully. When you have chest congestion and don't breathe freely, drink a little extra peppermint tea, or some camomile tea and take Echinaforce, a good natural antibiotic.
* * *
Article Information
Volume 18 Issue 1
January,1995
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Diverticulitis


Diverticulitis

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Diverticulitis
Diverticula, sigmoid colon.jpg
Large bowel (sigmoid colon) showing multiple diverticula. The diverticula appear on either side of the longitudinal muscle bundle (taenium).
Classification and external resources
SpecialtyGeneral surgery
ICD-10K57
ICD-9-CM562
DiseasesDB3876
MedlinePlus000257
eMedicinemed/578
MeSHD004238
Diverticulitis is a common digestive disease which involves the formation of pouches (diverticula) within the bowel wall. This process is known as diverticulosis, and typically occurs within the large intestine, or colon, although it can occasionally occur in the small intestine as well. Diverticulitis results when one of these diverticula becomes inflamed.
People often have left lower quadrant abdominal pain and tenderness, fever, and an increased white blood cell count. They may also complain of nausea or diarrhea; others may be constipated. The severity of symptoms depends on the extent of the infection and complications. Less commonly, an individual with diverticulitis may have right-sided abdominal pain. This may be due to the less common right-sided diverticula or a highly redundant sigmoid colon. Some patients report bleeding from the rectum.


Causes[edit]

The causes of diverticulitis are poorly understood. About 40% of the risk of disease is believed to be due to genetics while 60% is due to environmental factors.[1] Obesity is another risk factor.[1]

Diet[edit]

It is unclear what role dietary fiber plays in diverticulitis.[1] It is often stated that a diet low in fiber is a risk factor; however, the evidence to support this is unclear.[1]
There is no evidence to suggest that the avoidance of nuts and seeds prevents the progression of diverticulosis to an acute case of diverticulitis.[2] It appears in fact that a higher intake of nuts and corn could help to avoid diverticulitis in adult males.[2]

Pathophysiology[edit]

Diverticulitis is believed to develop due to changes inside the intestines including high pressures due to faulty contracting of the intestines.[3]
They often evolve from age-related diverticulosis and its associated pathologies resulting from increased intraluminal colonic pressure, including bleeding, abscess, perforation, stricture, fistula formation or impacted fecal matter.[4][5]
Most people with diverticulosis do not have any discomfort or symptoms; however, symptoms may include mild cramps, bloating, and constipation. Other diseases such as inflammatory bowel disease (IBD) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis.

Diagnosis[edit]

Diverticulitis in the left lower quadrant as seen on CT scan
Diverticulitis on CT scan in coronal view
People with the above symptoms are commonly studied with computed tomography, or CT scan.[6] The CT scan is very accurate (98%) in diagnosing diverticulitis. In order to extract the most information possible about the patient's condition, thin section (5mm) transverse images are obtained through the entire abdomen and pelvis after the patient has been administered oral and intravascular contrast. Images reveal localized colon wall thickening, with inflammation extending into the fat surrounding the colon.[7] The diagnosis of acute diverticulitis is made confidently when the involved segment contains diverticulae.[8] CT may also identify patients with more complicated diverticulitis, such as those with an associated abscess. It may even allow for radiologically guided drainage of an associated abscess, sparing a patient from immediate surgical intervention.
Other studies, such as barium enema and colonoscopy are contraindicated in the acute phase of diverticulitis due to the risk of perforation.

Differential diagnosis[edit]

The differential diagnosis includes colon cancer, inflammatory bowel disease, ischemic colitis, and irritable bowel syndrome, as well as a number of urological and gynecological processes.

Treatment[edit]

Most cases of simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest.

Diet[edit]

People may be placed on a low residue diet.[9] It was previously thought that a low-fiber diet gives the colon adequate time to heal. Evidence tends to run counter to this with a 2011 review finding no evidence for the superiority of low residue diets in treating diverticular disease and that a high-fiber diet may prevent diverticular disease.[10] A systematic review published in 2012 found no high quality studies, but found that some studies and guidelines favor a high-fiber diet for the treatment of symptomatic disease.[11]

Antibiotics[edit]

If bacterial infection is suspected, antibiotics may be used.[12] Despite being recommended by several guidelines, the use of antibiotics in mild cases of uncomplicated diverticulitis is supported with only "sparse and of low quality" evidence, with no evidence supporting their routine use.[13]

Surgery[edit]

Surgery is often not needed.[3] Complications, such as peritonitis, abscess, or fistula may require surgery, either immediately or on an elective basis. Whether the elective surgery should be performed is decided by external factors such as the stage of the disease, the age of the patient and his or her general medical condition, as well as the severity and frequency of attacks or if the symptoms persist after a first acute episode. In most cases, the decision to perform elective surgery is taken when the risks of the surgery are smaller than the ones resulting from complications of the condition. Elective surgery may be performed at least six weeks after recovery from acute diverticulitis.[14]
Emergency surgery is necessary for people whose intestine has ruptured; intestinal rupture always results in infection of the abdominal cavity.[15] During emergency diverticulitis surgery, the ruptured section is removed and a colostomy or ileostomy is performed. This means that the surgeon will create an opening between the large intestine and the surface of the skin. The colostomy is closed in about 10 or 12 weeks in a subsequent surgery in which the cut ends of the intestine are rejoined.
The first surgical approach consists in the resection and primary anastomosis. This first stage of surgery is performed on patients with a well vascularized, nonedematous and tension-free bowel. The proximal margin should be an area of pliable colon without hypertrophy or inflammation. The distal margin should extend to the upper third of the rectum where the taenia coalesces. Not all of the diverticula-bearing colon must be removed, since diverticula proximal to the descending or sigmoid colon are unlikely to result in further symptoms.[16]
Diverticulitis surgery can be done in two ways: through a primary bowel resection or through a bowel resection with colostomy. Both bowel resections may be done in the traditional way or by laparoscopic surgery.[17] The traditional bowel resection is made using an open surgical approach, called colectomy. During a colectomy, the patient is placed under general anesthesia. A surgeon performing a colectomy will make a lower midline incision in the abdomen or a lateral lower transverse incision. The diseased section of the large intestine is removed and then the two healthy ends are sewn or stapled back together. A colostomy may be performed when the bowel has to be relieved of its normal digestive work as it heals. A colostomy implies creating a temporary opening of the colon on the skin surface and the end of the colon is passed through the abdominal wall and a removable bag is attached to it. The waste will be collected in the bag.[18]
However, most of the surgeons prefer performing the bowel resection laparoscopically mainly because the postoperative pain is reduced and the patient's recovery is faster. The laparoscopic surgery is a minimally invasive procedure in which three to four smaller incisions are made in the abdomen or navel.
All colon surgery involves only three maneuvers that may vary in complexity depending on the region of the bowel and the nature of the disease which are the retraction of the colon, the division of the attachments to the colon and the dissection of the mesentery.[19] After the resection of the colon, the surgeon normally divides the attachments to the liver and the small intestine. After the mesenteric vessels are dissected, the colon is divided with special surgical staplers that close off the bowel while cutting between the staple lines.
When excessive inflammation of the colon renders primary bowel resection too risky, bowel resection with colostomy remains an option. Also known as the Hartmann's operation, this is a more complicated surgery typically reserved for life-threatening cases.
The bowel resection with colostomy implies a temporary colostomy which is followed by a second operation to reverse the colostomy. The surgeon makes an opening in the abdominal wall (a colostomy) which helps clear the infection and inflammation. The colon is brought through the opening and all waste is collected in an external bag.[20]
The colostomy is usually temporary but it may be permanent depending on the severity of the case.[21] Most of the time, several months later after the inflammation has healed, the patient undergoes another major surgery during which the surgeon rejoins the colon and rectum and reverses the colostomy.

Complications[edit]

In complicated diverticulitis, bacteria may subsequently infect the outside of the colon if an inflamed diverticulum bursts open. If the infection spreads to the lining of the abdominal cavity, (peritoneum), this can cause a potentially fatal peritonitis. Sometimes inflamed diverticula can cause narrowing of the bowel, leading to an obstruction. Also, the affected part of the colon could adhere to the bladder or other organ in the pelvic cavity, causing a fistula, or abnormal connection between an organ and adjacent structure or organ, in this case the colon and an adjacent organ.

Epidemiology[edit]

Diverticulitis most often affects middle-aged and elderly persons, though it can occur in younger people as well.[22] Abdominal obesity may be associated with diverticulitis in younger patients, with some being as young as 20 years old.[23]
In Western countries, diverticular disease most commonly involves the sigmoid colon – section 4 (95% of patients). The prevalence of diverticular disease has increased from an estimated 10% in the 1920s to between 35 and 50% by the late 1960s. 65% of those currently 85 years of age and older can be expected to have some form of diverticular disease of the colon. Less than 5% of those aged 40 years and younger may also be affected by diverticular disease.
Left-sided diverticular disease (involving the sigmoid colon) is most common in the West, while right-sided diverticular disease is more prevalent in Asia and Africa. Among patients with diverticulosis, 10–25% will go on to develop diverticulitis within their lifetimes.

References[edit]

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