Surgery Protocol for Diverticulosis
The formation of an atrial bout of diverticulitis secondary to hydrocephalus due to colloid cyst of the third ventricle has not been described. In these 3 patients, CT and MRI examinations showed findings characteristic of colloid cysts of the third ventricle with hydrocephalus of lateral ventricles and formation of unilateral atrial diverticula.
The diverticula subsided when cerebrospinal fluid pressure fell after ventricular drainage. The formation of atrial diverticula in these cases was probably facilitated by the fact that hydrocephalus of lateral ventricles was not accompanied by an increase in pressure in the third ventricle or the posterior fossa. This may lead to herniation of the atrial wall, especially in patients with a tentorial defect. The absence of dilatation of the third ventricle in these cases is a further aid to the differential diagnosis, distinguishing these cysts from cysts in the area of the quadrigeminal and cerebellar cistern, which can lead to triventricular hydrocephalus.
In our view, the progressive or maintained increase in cerebrospinal fluid pressure in the lateral ventricles due to obstruction of the foramina of Monro in cases of colloid cyst of the third ventricle favors the, formation of atrial diverticula, especially in patients with shortening of the tentorial band.
Diverticulosis is a collection of hernias (pockets) along the wall of the colon. In its acute form, when the hernias are inflamed and infected, it is called diverticulitis. Symptoms include severe abdominal pain and chronic diarrhea. Diverticulosis is not an uncommon occurrence, affecting 50 percent to 75 percent of people older than age 80, but it is rarely seen in individuals younger than 40. People at greatest risk are those who have had a low-fiber intake for many years, a risk that increases when not enough fluids are consumed.
Fortunately, only about 15 percent of people with diverticulosis ever experience the more painful form, diverticulitis. When it occurs, however, nutrition therapy plays a strong role in treating the current infection as well as preventing recurrent episodes.
Before the 1970s, diverticular disease was treated with low-fiber diets, based on the premise that coarse, high-fiber dietary residue would lodge in the diverticular pockets and result in inflammation and infection. Doctors discovered, however, that eating a consistently high-fiber diet helps alleviate pressure on the colon walls and makes food’s transit time through the gastrointestinal tract more consistent, yielding bulkier stools. Bulkier stools pass more smoothly and are less likely to get caught in the hernia pockets, causing an infection.
Once the benefit of a high-fiber diet was established, people with diverticulosis who had been eating low-fiber foods daily had to make different food choices. While eating a high-fiber diet can be accomplished fairly easily, changing the opinions of patients who had been told to do the exact opposite was more difficult. Overall, a high-fiber diet is recommended daily, leaving the low-fiber choices as a short-term eating prescription if an acute flare-up of diverticulitis occurs. Make sure you understand the difference between the two conditions.
Many people are concerned that, because of the small but hard-to-digest nature of nuts and seeds, these foods could get caught in the hernia pockets and cause an infection. The National Institutes of Health acknowledge, however, that some people with diverticulosis can comfortably and safely consume these foods. If you are bold enough, try adding one type of nut or seed at a time to your diet to see whether you have any trouble. But unless any one of them is part of a favorite food you gave up for a long time (such as fresh berries with seeds), you may want to continue to avoid them all together.
