Fever, stabbing pain in the lower abdomen… Have you heard of ‘Gastroenteritis’? [건강+]

Patients more than doubled in 10 years↑

Ms. Lee, an office worker in her 50s, recently had a health checkup and was told that she had colonic diverticulitis after a colonoscopy. The hospital said, “There’s nothing special to do right now,” and “Just drink a lot of water.” She said, “There was no diverticulitis in the colonoscopy I had 7-8 years ago, but it suddenly appeared,” and “I heard from an acquaintance that they rolled around in pain and went to the emergency room, so I’m anxious, but I’m worried because there’s no treatment.”

Diverticular disease refers to a ‘small hole’ that appears as a hollow in the weakened wall of the esophagus, stomach, small intestine, or large intestine. While polyps, which are commonly found during colonoscopy, appear as a ‘bulge’ when viewed through a colonoscope, diverticula are shaped like grass that has sunken in.

When there are multiple pits without any specific symptoms, it is called ‘diverticular disease’, and when stool or food waste gets stuck in these and causes inflammation, it is called ‘diverticular inflammation’.

The number of patients with diverticulitis has been increasing over the past 10 years. According to the Health Insurance Review & Assessment Service, the number of patients with diverticulitis has more than doubled from 32,317 in 2010 to 67,557 last year.

◆Not everyone with cystitis experiences pain

Diverticulosis can occur in various organs, including the stomach, small intestine, large intestine, gallbladder, and bladder, but is particularly common in the large intestine.

When the protrusion of the colon wall is limited to the mucosa and other parts when viewed from outside the colon, it is called a ‘pseudo-diverticulum’, and when the protrusion of the entire wall layer including the muscular layer is called a ‘true diverticulum’. True diverticulum is mostly congenital, occurs on the right colon, and is common in Asians. On the other hand, pseudo-diverticulum is acquired, occurs in several cases on the left colon, and occurs mostly in Westerners.

Recently, the trend of pseudodiverticulum is increasing among Asians as well. The main reason is increased pressure in the large intestine. As the intake of high-protein and high-fat foods increases and fiber decreases, the amount of stool decreases, and constipation occurs, putting more pressure on the large intestine, increasing the probability of developing pseudodiverticulum. The increased intake of simple sugars such as carbonated drinks, sugar, and ice cream also leads to an increase in harmful bacteria in the intestines, resulting in intestinal gas and increased pressure in the large intestine.

Aging is also a cause of colonic diverticula. As we age, the colonic motility decreases, and the colonic wall ages and weakens, making it easier for colonic diverticula to develop. It is known that about half of people over 60 years old, and 60-70% of people over 80 years old, have colonic diverticula.

Professor Joo Yeon-wook of the Colorectal Surgery Department at Guro Hospital of Korea University said, “There are congenital causes for the formation of diverticula, and it can be broadly viewed as a result of intestinal pressure due to aging and westernized eating habits.” He explained, “When diverticula are present, abdominal distension and constipation may occur, but in most cases, there are no symptoms themselves, so diverticulosis is discovered through an endoscope or after fever and pain occur due to inflammation.”

◆Frequent recurrent gastritis

If you simply have a hernia in your colon without any pain, you do not need any special treatment.

The stage that requires treatment is the ‘diverticulitis’ stage, where the diverticulum becomes inflamed. In the case of diverticulosis, diverticulitis actually occurs in about 2 out of 10 people. Once diverticulitis occurs, most patients visit the emergency room with severe pain that stabs the lower abdomen along with fever.

Professor Joo said, “Patients with diverticulitis often say, ‘It feels like appendicitis’ because of the intensity and location of the pain.” He added, “When patients come to the hospital with diverticulitis, we first fast and take antibiotics and monitor the progress. We examine the lesion using a CT scan and provide treatment. The pain disappears within 2-3 days of taking antibiotics, but patients must continue to take oral antibiotics for a while even after discharge.”

30% of patients with diverticulitis experience recurrence. If diverticulitis recurs and abdominal pain recurs, surgery may be required to remove part of the colon where the diverticulum occurred. In particular, if diverticulitis becomes severe and perforation occurs, causing complications such as peritonitis, perianal abscess, and intestinal obstruction, emergency surgery is required.

To prevent this, it is important to avoid a Western diet that is high in protein and fat, consume about 20g of fiber per day, and prevent the pressure in the large intestine from increasing. In addition, you should avoid simple sugars, drink plenty of water, and exercise appropriately.

Professor Joo pointed out that “the possibility of patients with diverticulitis developing fatal outcomes such as peritonitis is low at around 5-10%, but it is important to be aware that if diverticulitis is not properly treated, it can lead to serious situations,” and advised that “managing obesity, constipation, etc. through appropriate exercise and changes in eating habits can help prevent diverticulitis.”

Reporter Jeong Jin-su jen@segye.com

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