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Q: backpain and diverticulitis ( Answered,   1 Comment )
Subject: backpain and diverticulitis
Category: Health
Asked by: mortoni-ga
List Price: $20.00
Posted: 28 Jun 2005 21:34 PDT
Expires: 28 Jul 2005 21:34 PDT
Question ID: 538187
is there any coorelation between lower back pain and diverticulitis?
Subject: Re: backpain and diverticulitis
Answered By: crabcakes-ga on 29 Jun 2005 01:02 PDT
Hi Mortoni,

   Yes, there is a small correlation between diverticultis and lower
back pain. Diverticulitis can cause lower back pain, but most back
pain is not caused by diverticulitis. Accordingly, there is not much
reference online to diverticulitis causing low back pain.

While back pain is not a common complaint in folks with
diverticulitis, it IS seen in a small number of people. Not all
doctors are aware that back pain can indeed be a symptom of

?Extraperitoneal presentations of complicated diverticular disease are
unusual. The initial clinical presentations of these extraperitoneal
manifestations have been described in the perineum, scrotum, buttock,
hip, joints, thigh, lower extremities, mediastinum, and neck. These
presentations render the diagnosis difficult and may lead to the delay
of the proper therapy. The purpose of this report is to call attention
to these unusual extraperitoneal presentations of complicated
diverticular disease to describe the routes of spread and to present a
case in point. Reviewing the literature, we have concluded that these
unusual presentations occur more commonly in women and the elderly,
that a delayed diagnosis significantly increases the mortality rate,
and that the most common site of an extraperitoneal presentation is in
the area of the hip.?

?It is very important to realize the most common symptom produced by
diverticulae is is none! In other words, diverticular disease of the
colon most often causes no difficulty and no symptoms.?

?Diverticulitis typically causes pain in the left lower abdomen where
most colonic diverticuli are located.?

?Recurrent attacks of diverticulitis can result in the formation of
scar tissue, leading to narrowing and obstruction of the colonic
lumen. Diverticulitis can occur anywhere in the gastrointestinal tract
but is most commonly observed in the colon. Small bowel diverticulitis
is far less common than colonic diverticulitis. Asymptomatic
diverticulosis is a common condition, but few patients with
diverticula develop symptomatic diverticulitis.

 While diverticulitis is generally considered a disease of the elderly
population, as many as 20% of patients with diverticulitis are younger
than 50 years. Diverticulitis may be a more severe illness when
observed in younger patients; however, some controversy exists about
this, and the apparent increased severity may be an artifact of
delayed diagnosis.?

?Not all back pain is due to disorders of the spine. Back pain can
also be the result of trouble with the organs of the abdomen or chest.
Kidney disorders (renal stones), inflammation of the large intestines
or bowel (diverticulitis) and pain from blood vessels (dissection of
the aorta) are a few examples of diseases not related to the spine
that can produce sudden and severe onset of back pain. Tumors of the
internal organs, as well as a number of other medical problems, can
lead to a slow, progressive deep back pain that can sometimes be hard
for a doctor to separate from spine problems.?

?Colonic diverticula are related primarily to two factors: increased
intraluminal pressure and a weakening of the bowel wall. Patients with
known diverticula have been found to have elevated resting colonic
pressures. The Western diet, which tends to be low in dietary fiber
and high in refined carbohydrates, is also believed to be a
contributing factor. Once the pockets of diverticula form between the
mesenteric and lateral taeniae coli, particles of undigested food may
become inspissated within them. This results in obstruction at the
neck of the diverticulum, allowing for increased mucus secretion and
overgrowth of normal colonic bacteria, which produces overdistention
of the diverticular sacs and microperforations. What follows is
clinical disease, which may range from small pericolonic abscesses to
fecal peritonitis. Colovesical fistulae formation is the most common
complication; colovaginal and colocutaneous fistulae are less common.
The clinical diagnosis of diverticulitis is suggested by abdominal
pain that is initially hypogastric but then localizes to the left
lower quadrant. Urinary symptoms may occur if the affected colonic
segment is close to the bladder. A lower quadrant abdominal or rectal
mass may be palpated, but associated rectal bleeding is uncommon and
suggests an alternative diagnosis. About 85 percent of cases of acute
diverticulitis involve the descending or sigmoid colon; however,
right-sided disease may also occur and is reported more frequently in
persons of Asian descent. Sigmoid diverticulitis may mimic acute
appendicitis if a redundant colon is in the suprapubic region or lower
right quadrant.?

?Fibroids in the uterus and disorders of the ovaries can lead to low
back discomfort, as can diverticulitis, an inflammation of the

?Low back pain is very common, costing millions in lost work, as well
as millions in medical, state and insurance resources every year. Most
back pain does not signify any serious underlying problem, and will
sort its self out within a few days to a few weeks.?

?The main cause for low back pain is a strain of the muscles, or other
soft structures (eg ligaments and tendons) connected to the back bones
(vertebrae). Sometimes it is the cushion between the bones
(intervertebral disc) which is strained, and which bulges out
(herniates) and presses on the nearby nerves (as in sciatica).

Exactly what is injured varies from person to person, but you may also
get differing theories depending on whom you ask. Thus the poor
sufferer may become confused and worried.
Although the experts may not agree on what is causing the problem,
there is a surprising amount of agreement on how best to improve the
Various other conditions can cause back pain, and if in doubt about
what is causing your pain, you should consult your doctor.?
Medinfo goes on to say beware the following symptoms:

·You are younger than 20 or older than 55 when you get back pain for
the first time.
·The pain follows a violent injury, such as a road traffic accident. 
·The pain is constant and getting worse. 
·The pain is in the upper part of the spine. 
·You have had cancer in the past or at present. 
·You are on steroids. 
·You are a drug abuser, or have HIV. 
·You are generally unwell in yourself. 
·You have lost significant weight. 
·You continue to have great difficulty bending forwards. 
·You have developed a number of problems in your nervous system (eg
numbness, loss of power, etc).
·You have developed an obvious structural deformity of your spine. 
· You should also see your doctor (either for a first visit, or for a
follow-up) if the pain is continuing for more than 4-6 weeks.

More symptoms to investigate further:
Call your family doctor if:
·Pain goes down your leg below your knee. 
·Your leg, foot, groin or rectal area feels numb. 
·You have fever, nausea or vomiting, stomachache, weakness or sweating. 
·You lose control over going to the bathroom. 
·Your pain was caused by an injury. 
·Your pain is so intense you can't move around. 
·Your pain doesn't seem to be getting better after 2 to 3 weeks.

Unusual causes of lower back pain:

Spinal Stenosis is a common cause of  lower back pain;
?Classically, the symptoms of lumbar canal stenosis begin or worsen
with the onset of ambulation or by standing, and are promptly relieved
by sitting or lying down. Thigh or leg pain typically precedes the
onset of numbness and motor weakness. Along with numbness and
weakness, these symptoms and signs constitute the syndrome of
neurogenic intermittent claudication. Patients commonly complain of
difficulty walking even short distances and do so with a
characteristic stooped or anthropoid posture in more advanced cases.?

NIH says this about lower back pain:
Common Causes    
You'll usually first feel back pain just after you lift a heavy
object, move suddenly, sit in one position for a long time, or have an
injury or accident. But prior to that moment in time, the structures
in your back may be losing strength or integrity.
The specific structure in your back responsible for your pain is
hardly ever identified. Whether identified or not, there are several
possible sources of low back pain:
·Small fractures to the spine from osteoporosis 
·Muscle spasm (very tense muscles that remain contracted) 
·Ruptured or herniated disk 
·Degeneration of the disks 
·Poor alignment of the vertebrae 
·Spinal stenosis (narrowing of the spinal canal) 
·Strain or tears to the muscles or ligaments supporting the back 
·Spine curvatures (like scoliosis or kyphosis) which may be inherited
and seen in children or teens
·Other medical conditions like fibromyalgia 
Low back pain from any cause usually involves spasms of the large,
supportive muscles alongside the spine. The muscle spasm and stiffness
accompanying back pain can feel particularly uncomfortable.

You are at particular risk for low back pain if you:
·Work in construction or another job requiring heavy lifting, lots of
bending and twisting, or whole body vibration (like truck driving or
using a sandblaster)
·Have bad posture 
·Are pregnant 
·Are over age 30 
·Smoke, don't exercise, or are overweight 
·Have arthritis or osteoporosis 
·Have a low pain threshold 
·Feel stressed or depressed

Many sites mention nothing at all about diverticulitis causing back
pain, as in this John C. Lincoln Hospital site:

And this American Family Physician site:

Baylor College of Medicine never mentions lumbar pain:
?What is diverticulitis?
Diverticula are small pouches that bulge outward from the colon.
Diverticulitis is the condition in which these pouches become
Diverticula occur at weakened spots in the colon wall. As pressure
within the colon increases, bulging occurs. This increase in pressure
may be caused by constipation, which could result from a low-fiber
diet. When diverticulitis develops, there is an increased risk of
perforation, bleeding, and blockage.
What are the signs and symptoms of diverticulitis?

The signs and symptoms of diverticulitis may include, but are not
limited to, the following:
? Abdominal pain 
? Constipation
? Fever
? Chills
? Nausea
? Vomiting
? Blood in stool

I hope this answer has helped you confirm the correlation between
lower back pain and diverticulitis. If not, please request an Answer
Clarification, before rating.
Regards, Crabcakes

Search Terms
lumbar pain + diverticulitis
lower back pain
Subject: Re: backpain and diverticulitis
From: consulting-ga on 02 Aug 2005 03:23 PDT
What a great and thorough answer!

Just two small bits to add for more general information, one about
digestive diseases, and one about lower back pain -- both from the
'chronic pain' section of the mental health site

-- <a href=""></a>

-- <a href=""></a>

Note that, like many of the references suggested by Crabcakes, these
do NOT address the correlation question directly, but rather provide
more general background information.

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