“What do I do without opioids? My diverticulosis hurts like hell”

A Headline Health reader is looking for non-opioid relief from a painful digestive disorder. Here’s the best help we were able to find today. Other readers are welcome to add their suggestions and insights in the comments area below.

10 tips to keep your digestive health in tip-top shape

Apr 28, 2019

Health24.com – A healthy digestive system is important to help us get proper nutrition from our food.

The digestive system starts at the mouth as you chew and swallow food, and ends at, well, the other end.

Unfortunately, there are many things which could go wrong in between.

Common digestive disorders include constipation, diarrhea, Crohn’s disease, diverticulosis, diverticulitis and cancers of the colon and bowels.

Digestive health can be affected by lifestyle factors such as diet and exercise, but many digestive issues can also be genetic.

Heartburn

This is a burning sensation in your chest. It is related to your digestive system. Most people experience heartburn occasionally and have only mild discomfort. But for some, it can be a chronic and painful problem.

We rounded up our best tips:

1. Avoid certain foods

Food is important to keep your digestive system going as it should, but not all foods are equally beneficial. Certain foods do not digest as well as others and can cause various symptoms of indigestion, such as bloating, gas and nausea. Here are a number of foods you should cut back on for good digestion.

2. Practice good food hygiene

Many digestive issues arise from foodborne parasites and bacteria that can make you seriously ill. Your risk of getting food poisoning can increase if food is exposed to higher temperatures, if you cook food in a large batch, or if you cross-contaminate raw meat and vegetables. Food poisoning can be avoided with the help of these tips.

3. Consider using a probiotic

Probiotics have become an important topic in health conversations as scientists and the public become more aware of the importance of a healthy digestive system. Read more. 

Understanding Diverticulosis

American Society for Gastrointestinal Endoscopy

What is diverticulosis?

Diverticulosis is a condition in which there are small pouches or pockets in the wall or lining of any portion of the digestive tract. These pockets occur when the inner layer of the digestive tract pushes through weak spots in the outer layer. A single pouch is called a diverticulum. The pouches associated with diverticulosis are most often located in the lower part of the large intestine (the colon). Some people may have only several small pouches on the left side of the colon, while others may have involvement in most of the colon.

Who gets diverticulosis?

Diverticulosis is a common condition in the United States that affects half of all people over 60 years of age and nearly everyone by the age of 80. As a person gets older, the pouches in the digestive tract become more prominent. Diverticulosis is unusual in people under 40 years of age. In addition, it is uncommon in certain parts of the world, such as Asia and Africa.

What causes diverticulosis?

DiverticulosisBecause diverticulosis is uncommon in regions of the world where diets are high in fiber and rich in grains, fruits and vegetables, most doctors believe this condition is due in part to a diet low in fiber. A low-fiber diet leads to constipation, which increases pressure within the digestive tract with straining during bowel movements. The combination of pressure and straining over many years likely leads to diverticulosis.

What are the symptoms of diverticulosis?

Most people who have diverticulosis are unaware that they have the condition because it usually does not cause symptoms. It is possible that some people with diverticulosis experience bloating, abdominal cramps, or constipation due to difficulty in stool passage through the affected region of the colon.

How is the diagnosis of diverticulosis made?

Because most people do not have symptoms, diverticulosis is often found incidentally during evaluation for another condition or during a screening exam for polyps. Gastroenterologists can directly visualize the diverticula (more than one pouch, or diverticulum) in the colon during a procedure that uses a small camera attached to a lighted, flexible tube inserted through the rectum. One of these procedures is a sigmoidoscopy, which uses a short tube to examine only the rectum and lower part of the colon. A colonoscopy uses a longer tube to examine the entire colon. Diverticulosis can also be seen by other imaging tests, for example, computed tomography (CT) scan or barium x-rays.

What is the treatment for diverticulosis?

Once diverticula form, they do not disappear by themselves. Fortunately, most patients with diverticulosis do not have symptoms, and therefore do not need treatment. When diverticulosis is accompanied by abdominal pain, bloating or constipation, your doctor may recommend a high-fiber diet to help make stools softer and easier to pass. While it is recommended that we consume 20 to 35 grams of fiber daily, most people only get about half that amount. The easiest way to increase fiber intake is to eat more fruits, vegetables or grains. Apples, pears, broccoli, carrots, squash, baked beans, kidney beans, and lima beans are a few examples of high-fiber foods. As an alternative, your doctor may recommend a supplemental fiber product such as psyllium, methylcellulose or polycarbophil. These products come in various forms including pills, powders, and wafers. Supplemental fiber products help to bulk up and soften stool, which makes bowel movements easier to pass. Your doctor may also prescribe medications to help relax spasms in the colon that cause abdominal cramping or discomfort. Read more. 

Report highlights the dangers of opioid painkillers

Daniel Pendick, Oct 29, 2015

Former Executive Editor, Harvard Men’s Health Watch

Whenever I read or write about the overuse of so-called opioid painkillers it is with mixed feelings.

As a lifelong back-pain patient who once depended on them for pain relief, I appreciate the challenge posed by opioids to people in pain and their doctors. People in agonizing pain want it to stop, but opioids are often a poor long-term solution.

Doctors want to help their patients, so they may prescribe opioids for extended periods despite well-founded reservations.

At the same time, the epidemic of abuse of these painkillers has led to numerous deaths.

Like many Americans, I know people whose lives were destroyed—who ended up in rehab, the legal system, or the grave—because of prescription painkiller abuse. An article this week in the New England Journal of Medicine pegs the toll at nearly 17,000 fatalities in 2010.

Hydrocodone (Vicodin) and oxycodone (Oxycontin, Percocet, Percodan) are the most widely used and abused of the opioids. Others in this family of drugs are codeine, fentanyl (Duragesic patch), hydromorphone (Dilaudid), meperidine (Demerol), morphine (MS Contin), and tramadol (Ultram). These drugs block pain perception in the brain.

Doctors are learning to say no to opioids, but at the same time have limited scientific guidance on when and how to best use opioids for chronic pain, according to a report published online in the Annals of Internal Medicine this week by a National Institute of Health expert panel. It follows on the heels of a position statement published in September 2014 by the American Academy of Neurology, stating that the harms of opioids often outweigh the benefits for treating chronic noncancer pain.

Dr. James Rathmell, the Henry Knowles Beecher Professor of Anesthesia at Harvard-affiliated Massachusetts General Hospital, sums up the doctor’s dilemma this way: “The patient is in terrible pain and wants to try it. Who am I to say no?”

At the same time, Dr. Rathmell emphasizes that whenever opioids are prescribed, the focus needs to be on limits … Read more. 

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