Can we be personal for a moment?
Good. Thank you.
We want to discuss a particularly grievous condition that plagues millions of people in our culture from midlife onwards. It is a condition known to be culture-specific, suffered by affluent Westerns more than by any other group of people. And its cause is said to be unknown to modern medicine. It's called diverticulitis.
Diverticulitis is a pain in the butt for millions of people, literally, since it involves the colon and rectum. What happens is that the wall of the colon, or large intestine, becomes weakened over time from increased pressure of unknown cause. The pressure within the colon causes weakened areas to pocket outwards, creating sacs for digested matter to collect and fester. These sacs are called diverticula. When you have these sacs you are said to have diverticulosis. When diverticula become infected and inflamed, the condition is called diverticulitis, which can be as painful as appendicitis and can lead to rupture of the colon wall, a very dangerous situation. The key issue involved in this condition is the creation of increased pressure within the large intestine. It is the force of this pressure that causes the sacs to form.
Knowing what causes the increased pressure, then, is essential to the prevention and treatment of this condition. At one time it was thought by medicine that the diet might be too high in fiber, causing a blockage of digestion and the increased colon pressure. But lowering the fiber of the diet did not significantly alter the condition. Then it was thought that too little fiber prevented proper elimination, and high fiber diets were recommended. Unfortunately, this did not help the condition, either. Diverticulitis is also equally common among vegetarians as it is among meat eaters. While special interest groups promoting certain diets present research supporting their dietary view as preventive of diverticulitis, there is contrasting research to balance it. So, the overall research on diverticulitis has been inconclusive regarding the cause of increased colon pressure that creates this dreadful condition. And in the absence of knowing the cause, medicine can merely offer pain relief with drugs, antibiotics for the infections, and surgery for particularly nasty, abscessed pockets. As for prevention, the current suggestion is to eat more fiber, making th bowels need to eliminate more frequently.
Of course, one thing was overlooked in the medical research on diverticulitis. The most common reason for increased colon pressure is not really a medical issue, but a cultural one. That is why medicine has missed it. Furthermore, this cultural practice causes the medical profession to suffer from diverticulitis to an even greater extent than their patients.
It all has to do with answering Nature when it calls.
We live in a society that trains us from birth to hold in our waste products. From the pressures of diaper training, to the pressures of using public toilets at school, to the pressures of working without the choice of taking needed potty breaks, or where a toilet is simply not available, our culture has pressured us into holding it in. Of course, this creates pressure in the colon. After all, one of the simplest ways to increase colon pressure is to close the anal sphincter while the intestine is contracting.
Everyone has experienced this one time or another. Perhaps the urge came when you were involved in a social situation that you could not conveniently stop simply because you had to answer Nature's call. Or it could have been while driving, and a rest stop or service station was nowhere to be found. Even if there was a convenient restroom, some people are uncomfortable defecating in a public restroom and prefer holding it in until home. Whatever the reason, the fact is that our culture makes personal waste management an issue that is not always easily resolved, promoting procrastination rather than elimination. The result is increased colon pressure and diverticula formation.
In addition to holding in waste, there is the even greater problem of holding in gas. The technical term for this is flatus retention. It's what most people are trained to do in public, from school days onward. This is why diverticulitis is more prevalent among professional, affluent Westerns, than among the poor of third world countries. The higher your status, the less acceptable your flatus. It seems that poverty buys a right to pass wind when needed, while affluence creates the need for greater discretion. Yet, the sad fact is that the pressure of the fart must go somewhere. Either pass wind or have your intestine blow up. The choice is yours.
Now you can see why medicine says the cause of diverticulitis is unknown. A cultural taboo enshrouds this topic, preventing its unbiased and honest consideration. Interestingly, there was one article connecting diverticulitis with holding in gas. It was in the British medical journal, Lancet, in 1975. The article is entitled, "Flatus retention is the major factor in diverticular disease". But the information was ignored. Medicine seems more comfortable prescribing drugs and surgery for diverticulitis than simply telling people to poop and fart more often.
For those who suffer from diverticulosis or diverticulitis, you can perform your own self study. Over the next three months, note how often you feel the urge to eliminate, but find yourself choosing, for one reason or another, to hold it in. Pay particular attention to your need to pass wind, and how often you don't. Make every effort to allow your body to do what it wants to do. If you have a partner, you may want him or her to try this self study at the same time.
Sydney Ross Singer is a medical anthropologist and director of the Institute for the Study of Culturogenic Disease, located in Hawaii. His unique form of applied medical anthropology searches for the cultural/lifestyle causes of disease. His working assumption is that our bodies were made to be healthy, but our culture and the attitudes and behaviors it instills in us can get in the way of health. By eliminating these causes, the body is allowed to heal. Since most diseases of our time are caused by our culture/lifestyle, this approach has resulted in many original discoveries into the cause, and cure, of many common diseases. It also makes prevention possible by eliminating adverse lifestyle practices. Sydney works with his co-researcher and wife, Soma Grismaijer, and is the author of several groundbreaking health books.
