Talk:Diverticulitis

just

just so you guys know, i made those previous changes. i used some surgical textbooks as a source.

Please sign your comments and learn better surgery.TuppenceABag (talk) 16:14, 15 May 2008 (UTC)

rude (69.66.30.170 (talk) 19:35, 5 November 2008 (UTC))

Deleted link to 'Diverticulitis Diet Info from Diverticulitis-Diet.info' - this is SPAM site selling products, there is no information there that isn't covered in the main article. —Preceding unsigned comment added by 76.179.97.55 (talk) 19:05, 14 January 2010 (UTC)

Relationship to Alcohol

My understanding is that sustained, heavy drinking sharply increases the risk for developing diverticulitis. Any thoughts? --bamjd3d

Famous Sufferers?

I think it would give this subject just the kind of pizazz it's currently lacking. Does anyone know any? I think RnB sensation Usher may have it.

Detroit mayor Kwame Kilpatrick was recently treated for it. But isn't it a bit inappropriate to list famous patients? Cholerashot 21:16, 2 August 2006 (UTC)

Isn't this the condition that the World's longest serving leader Fidel Castro is currently being treated for?

--

I question why we need any referance to "famous" people, this dosn't provide any information about the condition, it's just tabloid fodder. DCwom (talk) 12:10, 7 April 2008 (UTC)

Quite. Why does an encyclopaedia article abou a medical condition require "pizazz"? I came looking for it for the information, not to be entertained. 77.102.101.220 (talk) 22:50, 23 March 2011 (UTC)

Brock Lesnar, UFC Heavyweight Champ, just had a bout with this. —Preceding unsigned comment added by 99.74.177.103 (talk) 05:41, 21 January 2010 (UTC)

There is no need to cite famous people with this disease. It does nothing to educate, only entertain. It is not necessary. — Preceding unsigned comment added by 173.65.240.225 (talk • contribs) 00:24, 31 March 2011

Very right. Note that the list of celebrities was removed back in September 2008[1], and I think that it should stay removed. --Enric Naval (talk) 11:03, 31 March 2011 (UTC)

deleted current event

i deleted the current event status along with the fidel reference. a medical disease is obviously not a 'current event' nor does figuring castro so prominently in the article make sense. if he's going to be in there, then yes, at least create a famous sufferers section and place it at the bottom.

External link

I find the external link http://www.medstudents.com.br/gastro/gastro2.htm to be of negligible value and most of the information is already incorporated in the article. Anyone object if I delete it? Webquest 18:24, 14 February 2007 (UTC)

Laws of Laplace

I don't know where this nonsense came from--I hope they don't teach this in medical schools. Laws of Laplace apply to fast flowing fluids, and they would lead to the lowering of the pressure in narrower passages. I removed this pseudo-scientific explanation. — Bartosz 07:19, 6 June 2007 (UTC)

Right-sided diverticular disease

I am not sure how accurate this statement is "Left-sided diverticular disease (involving the sigmoid colon) is most common in the West, while right-sided diverticular disease is more prevalent in Asia and Africa". The sigmoid colon is the weakest part of the colon with the most pressure that may cose diverticula. Why would Asia and Africa develop right-sided diverticular disease? Thanks for an explanation. Worldedixor 18:30, 18 August 2007 (UTC)

Absolutely. I suffered from it in the middle, however medically it probably just appeared as one or the other side most of the time, so the assumption was made. —Preceding unsigned comment added by 60.242.170.179 (talk) 07:32, 13 March 2008 (UTC)

NEJM

Clinical practice article. JFW | T@lk 02:00, 29 November 2007 (UTC)

And one from Am J Gastro: doi:10.1111/j.1572-0241.2008.01879.x JFW | T@lk 10:31, 14 May 2008 (UTC)

Celebrities

Why are people now listing Celebrities for medical articles??? is this how trivial wikipedia is becoming, this is an encyclopedia not Heat or Closer. —Preceding unsigned comment added by 80.101.224.15 (talk) 19:55, 24 September 2008 (UTC)

Haha, you are totally right, man. My bad for not thinking of this and deleting it myself months ago. --Enric Naval (talk) 01:56, 25 September 2008 (UTC)

is it hereditary

Hi, can anyone tell me if this is hereditry —Preceding unsigned comment added by 121.220.17.116 (talk) 09:11, 9 October 2008 (UTC)

"Hereditary factors may play a small role in the development of diverticulosis."[2]. Disclaimer: wikipedia doesn't give medical advice, so take this with a grain of salt. --Enric Naval (talk) 14:10, 9 October 2008 (UTC)

nuts, corn, popcorn

took out the claim that nuts, corn and popcorn cause the disease since that has been disproven. Also, why are we allowing references from NBC??? (69.66.30.170 (talk) 19:35, 5 November 2008 (UTC))

It's probably just that the editor didn't find a better reference. There is a new guideline called WP:MEDRS that tries to solve this sort of situations by explaining which are the best sources for articles on medicine subjects. --Enric Naval (talk) 19:59, 5 November 2008 (UTC)

This is a particularly ridiculous claim. As a person who suffers from diverticulosis, I know (and anyone else with the disease will corroborate this) that I can live a quite normal, pain-free life as long as I DON'T ingest any nuts or seeds. Whether this "causes" the disease is irrelevant. To someone who has diverticulosis it causes great pain and suffering. To spread the idea that people with diverticulosis should eat nuts and seeds is to encourage much pain and misdiagnosis of this very difficult disease. — Preceding unsigned comment added by 59.92.191.11 (talk) 15:20, 28 November 2011 (UTC)

Despite your personal experience, the evidence simply doesn't support this claim. There's simply no good evidence that consumption of nuts, popcorn, or seeds increases the risk of having a diverticulitis attack. The idea behind why nuts and seeds would make it worse hasn't really been borne out and the pathophysiology of the disease is being refined. TylerDurden8823 (talk) 01:39, 20 June 2017 (UTC)

Fat

Being obese increases the risk of diverticulitis and diverticular bleeding: doi:10.1053/j.gastro.2008.09.025 JFW | T@lk 13:41, 31 December 2008 (UTC)

how to fix

Referenced or not this statement near the end of the page is mathematically contradictory. You can't have at least half against something and a majority in favor of it... I'd rather not delete referenced statements, but this is clearly false.

"Further, in a survey of fellows of The American Society of Colon and Rectal Surgeons at least half of the surgeons responding to the survey saw no value in avoiding such foods, however adherence to a low residue diet was still favored by the majority." —Preceding unsigned comment added by 24.126.150.35 (talk) 01:51, 11 February 2009 (UTC)

I reworded it. It is clearer now? --Enric Naval (talk) 02:46, 11 February 2009 (UTC)

Diagnosed

Iwas diaginosed by this at the age of 15 I was not over weight and was told most likely I was born with it. I had stomach pains most of my life on Feburary 16 2000 I went to the er complaining of stomach pains on the right side the did blood work and CT scans and said it was apendix and rushed me to the er when the surgeons got in my apendix was fine when they removed it the found the pouch inflamed and very enlarged I never drank and was only4'9 76 pounds and yes it can be heritery and does not mean you can get it because you are overweight —Preceding unsigned comment added by Without hesitance (talk • contribs) 00:07, 10 August 2009 (UTC)

Hi! and welcome to Wikipedia! I am trying to make sense of your message above, and am struggling slightly.. The article doesn't seem to say anything about it being due to being overweight and mentions that it can be due to genetic factors.

If you are trying to add 'evidence' to the article, unfortunately personal anecdotes don't count as 'references', it tends to be papers or reports written on the subject that are used.

This article obviously means something to you, if you need any help, or have a question, feel free to write a message here!

Best regards Captain n00dle ^T/_C 09:06, 10 August 2009 (UTC)

If you read under Epidemiology it does say it has been found in people as young as 20 due to them being obesied! SO I was making a connection there and was just explaining that you do not have to be an older person or a young person overweight —Preceding unsigned comment added by 24.151.161.144 (talk) 23:04, 10 August 2009 (UTC)

error?

three words after note 11, there is the word reaction. Should it be resection? Rebele | Talk ^{The only way to win the game is to not play the game.} 04:10, 16 May 2010 (UTC)

It looks like an error, I changed it. --Enric Naval (talk) 08:50, 16 May 2010 (UTC)

The third sentence, in the beginning of the article, states the following "In North America and Europe pain is usually on the left side while in Asia it is often on the right." In general, I'm pretty sure anatomy is relatively the same in Asia as it is in Europe and North America. Every other article I have read says the pain will generally be on the left and geographical area does not change this.

Treatment disparity

The article talks about a "low residue diet" being a treatment method, but the official advice in the UK is the opposite of that, with a high fibre diet being advocated.

See...

http://www.patient.co.uk/health/diverticula-including-diverticulosis-diverticular-disease-and-diverticulitis

and

http://www.nhs.uk/conditions/diverticular-disease-and-diverticulitis/Pages/Introduction.aspx

... Shouldn't this alternative view be acknowledged in the article, and if possible, the disparity explained? Moreover which view is correct?!

--WikiStuart (talk) 19:25, 1 May 2014 (UTC)

Update: A bit more clarity on this point. A lot of patient information in the US and UK seems not to make a clear distinction between what to do in order to manage the condition generally, and what to do if you have an acute episode of the condition - i.e. a "flare up".

According to official UK guidelines, during a flare up...

"Recommend clear liquids only. Gradually reintroduce solid food as symptoms improve over 2–3 days." Source: http://cks[.]nice[.]org[.]uk/diverticular-disease#!scenariorecommendation:3

(Well that seems in keeping with what the Wikipedia article currently says and what several US patient info sites I've seen say).

Whereas for general management and prevention, the official UK line is...

"Advise a high fibre diet, if tolerated, to reduce the risk of developing symptomatic diverticular disease. In general, the diet should be balanced and contain whole grains, fruits, and vegetables. This is beneficial for health in general, as well as for reducing the risk of developing diverticular disease. Fibre intake should be increased gradually (to minimize flatulence and bloating) and a high-fibre diet should be maintained for life. Fibre from fruit and vegetables may be preferable to cereal fibre. Adults should aim to consume 18–30 g of fibre per day... Although the effects of a high fibre diet may be seen in a few days, it may take as long as 4 weeks. Adequate fluid intake is particularly important with a high fibre diet".

Source: http://cks[.]nice[.]org[.]uk/diverticular-disease#!scenariorecommendation

and

Source: http://cks[.]nice[.]org[.]uk/diverticular-disease#!scenariorecommendation:1

That's quite a significant distinction, is it not? - the difference between what to do during an acute episode and what to do for general management of the condition. I suggest it should probably be made clearer in the Wikipedia article.

(I presume US advise on general management and prevention outside of a flare up is the same as the UK. If so, it seems hard to find that info on the web, and if not, such country-to-country disparities should probably be highlighted).

--WikiStuart (talk) 19:25, 1 May 2014 (UTC)

Gender-related prevalence

I'd always had the anecdotal notion that diverticulitis was more prevalent in women than in men. I'm no expert on WP:MEDRS but a little bit of digging shows this, which is not quite what I'd understood. Is there any merit to including a comment about gender-related prevalence and, if so, are there any MEDRS-compliant sources that would do the job? - Sitush (talk) 15:25, 8 February 2015 (UTC)

One could summarize that in the epidemiology section. Doc James (talk · contribs · email) 11:12, 9 February 2015 (UTC)

Relationship to Milk, Cheese, Dairy Products

I have been unable to find any clear information about the effects of dairy products, in relation to the management of this disorder. Clear fluids are universally recommended in response to an acute episode, but I don't understand why milk would be contraindicated. I would appreciate an explanation or clarification of the effects of milk and dairy products. Janice Vian, Ph.D. (talk) 07:06, 26 April 2017 (UTC)

Were do we mention dairy products? Doc James (talk · contribs · email) 17:40, 26 April 2017 (UTC)

Description misspelling

In the description that appears directly below the article title on the mobile app, it reads "Digestive disease caused by an imflammation of a herniating pouch..." I am not sure how to edit this or I would fix it.

On Wikidata. Doc James (talk · contribs · email) 23:11, 21 June 2017 (UTC)

Asymptomatic

Diverticulosis has typically has no symptoms. Diverticulitis typically has symptoms. Doc James (talk · contribs · email) 09:08, 6 January 2018 (UTC)

WP:MEDMOS

Per MEDMOS pathology is part of pathophysiology. Doc James (talk · contribs · email) 16:10, 8 January 2018 (UTC)

Request for a better or annotated photo

The article uses File:Diverticula, sigmoid colon.jpg. The problem is that the average reader of this article has no idea what a normal large bowel (sigmoid colon) is supposed to look like. Are the descending yellow colored bulges nodules of normal fat or are they diverticula? Are all of the ascending bulges diverticula or are those part of the normal/expected structure of a sigmoid colon? A prominent bulge is visible on the far upper-right of the photo. I assume that's a roughly 1cm outside diameter diverticulum.

The photo caption mentions the taenium. I assume that's not visible in the photo but the visible lines running longitudinally are evidence of the taenium which is deeper in the structure.

An idea would be to create an annotated version of the photo for this article with arrows pointing at each of the diverticula.

The sigmoid colon article does not have any similar pictures. The Diverticulosis article uses a drawing, rather than a photo, which is better as the drawing seems to be of the entire sigmoid colon which matches up with drawings on the sigmoid colon. That drawing helped a bit with understanding the photo.

Unfortunately, a Google image search for "sigmoid colon" finds that people tend to only publish pictures when there's a problem. --Marc Kupper|talk 18:55, 21 November 2018 (UTC)

Problem in the first paragraph of the lead section.

The first paragraph in the lead of this article contains five sentences. The third sentence states: In North America and Europe the abdominal pain is usually on the left lower side (sigmoid colon), while in Asia it is usually on the right (ascending colon).

Attempting to establish geographical factors that are relevant to diverticulitus in the opening paragraph of the introduction to the article is too specific. It is incompatible with the guidelines at Wikipedia:Manual of Style/Lead section. In particular, it is incompatible with MOS:LEADPARAGRAPH which says The first paragraph should define or identify the topic with a neutral point of view, but without being too specific.

In one of my previous edits, I moved the offending sentence to a position later in the lead; to the 4th and final paragraph which addresses other geographical factors. See my diff. User:Doc James responded by restoring the offending sentence to its original position in the first paragraph. User:Doc James's edit summary says "Moved back to paragraph on symptoms and that is were (sic) the discussion of pain is occurring." See the diff.

It is misleading to describe the first paragraph of this article as "the paragraph on symptoms"; and to say "that is where the discussion of pain is occurring." The first paragraph of every Wikipedia article should conform to the guidelines at MOS:INTRO and should be identified as part of the lead. The guidelines expressly applied to the first paragraph of the lead cannot be avoided by calling the first paragraph by an alternative name such as “the paragraph on symptoms.”

I will revert the change made by Doc James for the reasons I have given above. I will be happy to discuss the situation. Dolphin (t) 03:39, 28 November 2019 (UTC)

I have moved the sentence from the first paragraph to the final paragraph in the lead section. See the diff. Dolphin (t) 03:43, 28 November 2019 (UTC)

The first paragraph discusses symptoms of diverticulitis which includes the location of the pain. In my opinion the sentence in question fits best with other details about the symptom. Rather than a paragraph about frequency.

It fits very well after the sentence "Symptoms typically include lower abdominal pain of sudden onset, but onset may also occur over a few days" Fairly important for our global audience and important to keep in mind for people who are of Asian decent.

This is part of a neutral point of view, including the discussion of a condition in a places other than Western countries. Doc James (talk · contribs · email) 05:42, 28 November 2019 (UTC)

@Doc James: Thank you for joining this discussion. In your edits above you have avoided acknowledging the guidelines at MOS:LEADPARAGRAPH. I see you have reverted my edit a second time so I have asked for a third opinion - see my diff 1 and diff 2. Dolphin (t) 23:18, 28 November 2019 (UTC)

I do not see how it was violating MOS:LEADPARAGRAPH. The lead can follow the flow of content in the body as acknowledged in WP:MEDMOS. The content flowed better in the lead as it was. Doc James (talk · contribs · email) 05:56, 29 November 2019 (UTC)

Response to third opinion request (Disagreement about the phrasing of the lede.):

I am responding to a third opinion request for this page. I have made no previous edits on Diverticulitis and have no known association with the editors involved in this discussion. The third opinion process is informal and I have no special powers or authority apart from being a fresh pair of eyes.

The lead should introduce the article, establish notability, and summarize its most important contents. I agree with Doc James that a NPOV is important and that the article should discuss the symptoms for all people. I agree with Dolphin that the lead should avoid being overly specific. I suggest that perhaps the lead is not the place to introduce regional variations on symptoms, and that this detail belongs in the actual paragraph on symptoms, in the article rather than the lead. PrimalBlueWolf (talk) 17:11, 30 November 2019 (UTC)

User:PrimalBlueWolf that the location of the pain is in one spot in 2 billion people and a different spot in another 2 billion people is fairly important, and interestingly not that well know. Doc James (talk · contribs · email) 23:30, 30 November 2019 (UTC)

Its notable, agreed. Is it significant enough that it belongs in the lead? The lead contains more information on symptoms than the section on symptoms. To me, that suggests that some of this detail belongs in the article and not in the lead. — Preceding unsigned comment added by PrimalBlueWolf (talk • contribs) 04:27, 1 December 2019 (UTC)

If another outside opinion helps at all: The sentence doesn't belong in the first paragraph, but it does belong in the lede. I agree that the sentence would be better placed in the fourth paragraph. As Doc James correctly pointed out, the sentence doesn't flow well in the fourth paragraph. However, I'd suggest that that is a result of the fourth paragraph already not flowing well.

"The disease is common in the Western world and uncommon in Africa and Asia. In the Western world about 35% of people have diverticulosis while it affects less than 1% of those in rural Africa, and 4 to 15% of those may go on to develop diverticulitis. The disease becomes more frequent with age, being particularly common in those over the age of 50.[1] It has also become more common in all parts of the world.[2] In 2003 in Europe, it resulted in approximately 13,000 deaths. It is the most frequent anatomic disease of the colon. Costs associated with diverticular disease were around US$2.4 billion a year in the United States in 2013."

There are related facts: different demographics' experience of the disease (where I think it's clear the disputed sentence falls within), but there's no effort into making it a paragraph where each sentence leads to the other. In short, consider redrafting the fourth paragraph (some of those facts may need to be dropped) and include the sentence - or a form of it - in it. Cjhard (talk) 08:04, 1 December 2019 (UTC)

This seems a good suggestion. On re-reading the lead, the third and fourth paragraph seem to not fit as well as the first two. Rewriting the both of those could improve the article. PrimalBlueWolf (talk) 08:49, 1 December 2019 (UTC)

Cjhard Thank you for your opinion. I agree wholeheartedly that the offending sentence doesn't belong in the first paragraph. The task ahead of us is to relocate the offending sentence to a more appropriate place, to ensure the first paragraph is compatible with MOS:LEADPARAGRAPH, and to re-work the third and fourth paragraph. Dolphin (t) 11:19, 2 December 2019 (UTC)

Cjhard, PrimalBlueWolf, Doc James: I have made a change to the lead to move the offending sentence from the first paragraph to the fourth. There has been criticism of the third and fourth paragraphs, suggesting these need to be improved. Do you have any suggestions as to how these paragraphs could be improved? Dolphin (t) 11:56, 4 January 2020 (UTC)