Q.I had my first colonoscopy today, and my discharge paperwork states that I have no polyps, but I have diverticulosis. My age is 54, and I am a black male. Do I have an increased risk of colon cancer even with a high-fiber diet?
A.Diverticulosis is a condition in which small pouches (diverticula) develop in the wall of the colon. It is thought these pouches occur because of chronic high pressure in the colon, possibly caused by constipation and poor emptying of the colon related to a low-fiber, high-fat diet. Diverticula become increasingly common with age, and by age 60, approximately half of the U.S. population has diverticulosis.
A.A condition known as diverticulitis occurs when a pouch develops a small perforation, often because it is filled with stool. The small perforation will wall itself off, but the surrounding tissues will become inflamed, leading to severe pain and fever. Most cases of diverticulitis are treated with antibiotics. More complicated cases may also require drainage of infected fluid from around the colon and surgery to remove the diseased section of colon. Diverticula can also bleed if an erosion occurs at the tip of a pouch that contains a small blood vessel. In most patients, the bleeding will stop on its own. In more severe cases, the patient may need to go to the hospital for emergency surgery and transfusions.
Diverticulosis is usually detected during a colonoscopy. Even if patients are experiencing no problems, they are often prescribed a high-fiber diet. Fiber bulks the stool and helps to maintain muscle function in the colon. Also, this diet is thought to slow the development of further diverticula.
A.It is important to note that there is no increased risk of colon cancer in people who have diverticulosis. Assuming you have no polyps and have no other risk factor for colon cancer, you should be at the same risk for colon cancer as other people in your age group. You should discuss your cancer-risk profile with your doctor, as well as talk about the high-fiber diet and the need for further screening in the future.
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