Jack Nicklaus Hospitalized for Intestinal Ailment

Golf great Jack Nicklaus was hospitalized this weekend at Jupiter Medical Center in South Florida. The 70 year old Hall-of-Famer was admitted Saturday morning for severe abdominal pain. He was diagnosed as having diverticulitis and was sent home with antibiotics. Nicklaus had apparently started having abdominal pain on Thursday, and his wife Barbara told reporters that doctors told her that if Nicklaus had waited at home much longer, he would have risked having to undergo major surgery.

What is Diverticulosis and Diverticulitis? (source: NDDIC)

Many people have small pouches in the lining of the colon, or large intestine, that bulge outward through weak spots. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans older than 40 have diverticulosis. The condition becomes more common as people age, with about half of all people older than 60 having diverticulosis. Diverticula are most common in the lower portion of the large intestine, called the sigmoid colon. When the pouches become inflamed, the condition is called diverticulitis. Ten to 25 percent of people with diverticulosis get diverticulitis. Diverticulosis and diverticulitis together are called diverticular disease.

What causes diverticular disease?

Although not proven, the main theory is that a low-fiber diet causes diverticular disease. The disease was first noticed in the United States in the early 1900s, around the time processed foods were introduced into the American diet. Consumption of processed foods has greatly reduced Americans fiber intake.

Diverticular disease is common in developed or industrialized countries—particularly the United States, England, and Australia—where low-fiber diets are consumed. The disease is rare in Asia and Africa, where most people eat high-fiber diets.

Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Some fiber, called soluble fiber, dissolves easily in water. It takes on a soft, jelly-like texture in the intestines. Insoluble fiber passes almost unchanged through the intestines. Both kinds of fiber help prevent constipation by making stools soft and easy to pass.

Constipation—or hard stool—may cause people to strain when passing stool during a bowel movement. Straining may cause increased pressure in the colon, which may cause the colon lining to bulge out through weak spots in the colon wall, causing diverticula.

There may also be a genetic component to diverticular disease, as it tends to run in families.

Doctors are not certain what causes diverticula to become inflamed. The inflammation may begin when bacteria or stool are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning.

What are the symptoms of diverticulosis and diverticulitis?

Diverticulosis: Most people with diverticulosis do not have any discomfort or symptoms. However, some people may experience crampy pain or discomfort in the lower abdomen, bloating, and constipation. Other conditions such as irritable bowel syndrome and stomach ulcers cause similar problems, so the symptoms do not always mean a person has diverticulosis. People with chronic symptoms should visit their doctor or health care provider.

Diverticulitis: The most common symptom of diverticulitis is abdominal pain. The most common sign on examination is tenderness in the lower left side of the abdomen. Usually, the pain is severe and comes on suddenly, but it can also be mild and become worse over several days. The intensity of the pain can fluctuate. A person may experience cramping, nausea, vomiting, fever, chills, or a change in bowel habits. Diverticulitis can lead to bleeding, infections, small tears (called perforations), or blockages in the colon. These complications always require treatment to prevent them from progressing and causing serious illness.

How is diverticular disease treated?

A high-fiber diet and pain medications help relieve symptoms in most cases of diverticulosis. Uncomplicated diverticulitis with mild symptoms usually requires the person to rest, take oral antibiotics, and be on a liquid diet for a period of time. Sometimes an attack of diverticulitis is serious enough to require a hospital stay, intravenous (IV) antibiotics, and possibly surgery.

For more information, click here to go to the Resounding Health Casebook on Diverticulitis and Diverticulosis.