Though diverticulitis can be a challenge, there are numerous natural and medical options available to the sufferer. And suffer is the keyword, as this disorder can erupt rather suddenly, showing up as an infection or inflammation. If left untreated, diverticulitis can lead to serious complications including abscess formation, obstruction and bleeding.

Abscesses may form locally at the site of the diverticulum. If the diverticular abscess is not treated, it may spread to other organs, particularly the liver. Symptoms usually involve some kind of acute abdominal pain, nausea, fever and a change in bowel habits. An elevated white blood cell count is usually present. The symptoms may mimic appendicitis, except that the pain is on the left rather than the lower right side.

An abdominal CT scan is helpful to determine whether a diverticular abscess is present. Most cases of diverticulitis are mild and respond well to antibiotic treatment and “bowel rest” during which intake of food is limited to clear liquids. It is frequently treated in the hospital with intravenous antibiotics and intravenous fluids. After the infection has stabilized, patients are advised to increase the bulk in the diet with high-fibre foods and over-the-counter preparations containing bulk additives.

Recurring attacks of diverticulitis, the presence of an intestinal perforation, or an abscess may require surgery with removal and-or drainage of the involved portion of the colon.

Since diverticulosis occurs so frequently in countries where a low-fibre diet is common, many physicians recommend diet modification to include whole-grain breads, cereals, fibrous fresh fruits and lots of vegetables, while avoiding low-fiber and refined foods, such as white flour, white rice and other processed grains.

Think diverticulitis if a patient presents with left lower quadrant abdominal pain, but be sure to rule out other possible diagnoses, Dr. Randy Crim advised at the annual meeting of the Texas Academy of Family Physicians.

Such pain usually results from appendicitis. Cancer should be ruled out in patients over age 50. Kidney stones, endometriosis, and pelvic inflammatory disease also should be considered.

Once other possibilities have been ruled out, differentiating diverticulitis from irritable bowel syndrome (IBS) is probably the biggest diagnostic challenge. Diverticulitis often can be distinguished from IBS based on how sick the patient seems. Patients with IBS don’t look very sick, but those with diverticulitis may have fever and white blood cell counts above 15,000-20,000.

Urinalysis can identify infection and aid in diagnosis. An abdominal x-ray is needed in very ill patients to look for bowel perforation. In patients with chronic diverticulitis-type problems, a barium enema is the best diagnostic tool because it helps in evaluating strictures. ACT scan can reveal pericolonic inflammation, wall thickening, the presence of an abscess, and air in the bladder that is diagnostic of a colovesical fistula.

Colonoscopy can help rule out cancer and assess stricture after the acute phase of diverticulitis. In acute illness, however, the pressure that colonoscopy puts on the colon may cause perforation.

Patients with uncomplicated diverticulitis generally can be treated as outpatients with antibiotics and a high-fiber diet. Bran cereals or supplements, such as Metamucil and Citrucel, have been shown to re duce recurrence rates by up to 30%.

If there’s one thing I’ve learned in the past several years about concierge medicine and researching this emerging health care market, it’s that people really don’t understand it’s not about price. I like to think of those pioneering doctors of the past who carry around a medical bag with a stethoscope inside and who come to the aid of my family and our bedside as visionary physicians who wanted to “normalize” their practice and get back to practicing medicine before 1950.

So, here are the top six (6) items every patient should truly understand about concierge medicine:

1) AVAILABILITY – Yes! It really is possible for a doctor to provide 24/7 access to his/her patients… and no — this is not just some marketing tactic that seeks to over promise and under deliver. There’s now evidence that when a doctor reduces his/her practice from its original size of 2,000 – 5,000 patients down to 300 – 600, he or she is choosing to “normalize” their practice and provide more availability and access to each patient. Inturn, that patient gets to really know the doctor and there is a bond and friendship that is formed.

2) COST – It doesn’t cost a lot… it actually costs less than my cell phone bill. Over 50% of current concierge medicine fees cost an average or $1,500 per year or less than $135 per month. (Source 1) The USANetwork’s breakout hit Royal Pains is entertaining — the overwhelming majority is that most concierge medicine or private medical plans cater to those who can’t afford the high health insurance premiums their used to paying with large health plan carriers.

3) CELL PHONE ACCESS – YES! They actually do pick up the phone and it’s not a nurse or staff person. If you are enrolled in a concierge medical practice, then you are paying an annual or monthly fee for “enhanced access” and a close relationship with your physician. That’s right, the unthinkable has become a true reality. Doctors are now giving their cell phone numbers to their patients and they are the ones picking up the calls.

4) SAME DAY APPOINTMENTS – Included in most membership medicine fees is same day appointments and enhanced access to you doctor. In fact, a recent poll conducted by the Collective found that 100% of concierge physicians promise and actually deliver “same day” appointments.

5) WHAT I REALLY NEED WILL BE INCLUDED – It’s a well known fact that approximately 88% of the average persons health care can be handled by their primary care or family physician. Thus, concierge medicine services typically offered inside these plans usually include: physical exams, blood work, unlimited office visits and other services. These annual or monthly fees typically cover basic services that include preventive care, routine physicals, longer appointments, next-day appointments, 24-hour-a-day phone access and e-mail, house calls, coordination of care when you travel, and an interactive medical ID bracelet in case of an emergency.

6) IS IT COMPATIBLE WITH MY INSURANCE? A recent study was conducted (Source 2) with this question in mind. The result of the study found that most concierge medicine physicians (nearly 80%) practice inside a business model called a “Hybrid” practice. Hybrid meaning these doctors accept most insurance plans along with offering the delivery or 24/7 cell phone access to your doctor, no wait appointments, call-in prescriptions and more via a monthly or annual retainer.