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The majority of adult Americans “carry around” 10 to 20 lb of impacted stools inside their bowels instead of the 1 to 2 lb of
semi-soft feces as the mother-nature meant it to be. This pathology is behind the
raging epidemics of bowel disorders and colorectal cancer in the
United States. Thus,
reducing the size, weight, and density of stools to the norm, and
keeping them this way for the rest of your life, is the
most important and effective step toward the goal of preventing
colorectal cancer.
 Large and
heavy stools cause bowel disorders that precede colon cancer for
the same reasons large and deep potholes ruin your car's
suspension — accelerated wear-and-tear.
While your body is still young and resilient, it can handle the
“potholes” with relative ease. But as it ages and loses its
firmness and suppleness, the bowel transforms itself to
accommodate “heavy luggage.”
This transformation, though, comes with a heavy price:
bowel enlargement, diverticular disease, enlarged internal
hemorrhoids, anorectal nerve damage, motility inertia, and
the ensuing accumulation
of impacted stools inside the colon that leads to
irregularity and/or constipation. The colorectal polyps, lesions, and tumors complete
this chain of events, with the brunt of the “breakdowns”
commencing after the age 50.
Alas, you can't replace the colon to support the aging body the
same way you can replace the shock absorbers to support
the aging car. You can, however, “extend the warranty” by
reducing stool size, weight, and density in the same way driving around potholes extends the life of your
car.
To check out what stools qualify as “large,“ and what not, look
at the chart on the left. If yours looks like type 2
or 3, you are in “deep shit”, literally and figuratively. It means that your feces
are impacted throughout the entire length of
your large intestine all the way up to the blind gut, especially
type 2. You can learn more about
the Bristol Stool Chart, and what it means
here.
Impacted stools require substantial physical effort (straining) to eliminate
them. The resulting pressure on the delicate and narrow anal
canal causes anal tears (streaks of blood on stools), nerve damage
(loss of urge sensation), and enlarged internal
hemorrhoids (pain during defecation) as these large stools pass
the anal canal.
As these conditions progress, defecation
becomes more and more difficult, painful, and incomplete,
increasing the size of stools even more. As the stools' size and
volume grows further, impacted stools stretch out the colon, and cause
diverticulosis.
Near permanent contact of large stools such as
type 2 and 3 with the inner wall of the large intestine causes
inevitable inflammation, strips down the mucus lining when
moving down and out, and contributes to the formation of polyps
and lesions.
Bloating, cramping, severe flatulence, and
occasional diarrhea are markers of this condition. Normally, the
colon absorbs most of the fermentation-related gases back into
the blood stream for release via the lungs. Inflammation of the
mucosal membrane, however, blocks their absorption. Lacking an
immediate escape, trapped gases expand the colon. This
expansion, in turn, causes outward bloating and painful
cramping.
A more severe bowel inflammation also blocks
the absorption of fluids that continuously drip down from the
small intestine. When the volume and pressure of fluids
exceeds the holding capacity of the large intestine and they
reach the rectum, the victim experiences profuse diarrhea. The
resulting release of impacted stools allows temporary respite
until the vicious cycle of irregularity —> more fiber
—> stool enlargement —> mucosal inflammation —>
diarrhea resumes again.
While all these drudgery is taking place, one
day you may end up in the doctor's office with a sharp abdominal
pain, most likely related to diverticular disease. After
reviewing the results of your colonoscopy report or CT scan
(adding yet another dose of cancer-causing radiation), your
doctor will recommend more fiber to bulk up your already large
stools, and more exercise to strengthen your abdominal muscles,
so you can strain with even more force!
I am not making any of this up. Here is a
verbatim description of this protocol courtesy of The Merck
Manual [link]:
If you follow this
advice, you are practically guaranteed to end up one
day in the hospital with acute diverticulitis, or colon
perforation, or appendicitis, or a prolapsed rectum, or internal
bleeding, or something else just as bad.
The moment you are
admitted, doctors begin treatment by immediately putting you on
a fiber-free, liquid diet, so you can (finally) recover. If you
are really messed up, CT scans are ordered again, or surgery to
cut out the affected portions of your large intestine [link]:
As you leave the hospital, your doctors will recommend that you
resume a high-fiber diet again as soon as you heal:
And so it goes on until colectomy or colorectal cancer,
whichever comes first, assuming you don‘t succumb first to
stroke, heart attack, chest infection, kidney failure, or any
other cancer as a result of blood loss, surgeries, general
anesthesia, radiation, medication side effects, severe stress,
or medical errors.
To
avoid these risks, simply normalize your stools to
the proper
type 4 or 5 by following my recommendations in
Restoring Natural Bowel Movement and Normalizing Stools
page.
I accorded a disproportionate amount of
attention to the discussion of diverticular disease for a simple
reason: a localized inflammation of diverticulum is the most
likely point of origin for precancerous lesions, polyps, and
tumors. Correspondingly, diverticulosis is a marker for large
stools, and represents one of the highest degree of risk for
colorectal cancer.
According to the National Institute of
Health, about half of all people over the age of 60 have
diverticulosis [link].
The same age group happens to be affected by
colorectal cancer the most. Do you see any connection?
If you have been already diagnosed with
diverticular disease, and would like to spare yourself from
related complications, follow my recommendations in the
Diverticulosis and
Diverticulitis page.
Author's Note
The following sentence was added to the
Diverticulosis section of The Merck Manual in 2007 to, I
believe, specifically respond to my analysis of the
fiber-diverticulosis connection in Fiber Menace published
two years earlier.
“The intuitive injunction to avoid seeds or other dietary
material that might become impacted in a diverticulum has no
established medical basis.”
The “no established medical basis” claim
is incorrect. The fact is, by the time the affected colon is
checked out by a radiologist or endoscopist for damage, it has
already been thoroughly lavaged (cleaned out) from all stool,
including impacted, hence the doctors will see nothing, but an
unsoiled colon, whistle-clean intestinal walls, and empty
diverticula.
Fiber Menace,
actually, distinguishes between small and large diverticula, as
well as soft and hard stools. Impaction of “dietary material”
is only possible when either the affected diverticulum is large
or the stools are hard and large. In all other cases, indeed,
nothing can “become impacted.” Here is an actual
excerpt from my book:
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Diverticulosis starts
developing during the latent stage of
fiber-related constipation which, as you may
recall, is primarily characterized by
straining, hemorrhoids, and type 1–3 large
stools on the Bristol Stool Form Scale. The
smaller diverticula range in diameter from 3
mm to 3 cm, and are usually multiple. The
ones that are really large are most likely
single (the singular is diverticulum), and
range in diameter from 3 to 15 cm. When
fiber-laden feces get “diverted” into
diverticula, they tend to get lodged there,
and then lump together and harden up.
Diverticulosis can be
reliably seen and diagnosed by radiography
(X-ray, nuclear scan) or colonoscopy long
before most patients experience any
symptoms. Overall,
smaller diverticula are harmless, as long as
feces remain small, soft, and moist, because
fecal matter with these properties won‘t get
trapped inside small crevices.
But
when feces are continuously large, hard, and
dense, they may keep even tiny diverticula
clogged indefinitely for the same
reasons a tight cork keeps liquid inside a
vessel turned upside down, even if the neck
has multiple crevices on the inside.
As more and more fecal
matter gets jam-packed inside each
diverticulum, they may enlarge further by
the sheer force of outward pressure.
Eventually, the epithelium inside one or
more diverticulum gets lacerated and
infected. The infection may cause
inflammation, ulceration, rectal bleeding,
excruciating pain, and/or the perforation of
the colon wall—collectively called
diverticulitis.
Chapter 7, Diverticular Disease;
Fiber Menace, page 146 |
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