Diverticulosis

Scene ( Birthday Party )

F1: Hi Guys!! How’s life treating you?

F2: Hi Amiga ! I’m all good and as usual pretty and sexy!

Patient: That’s good to hear, ladies! While me, well, I’m feeling kinda under the weather lately.

F3: But Why? How are you feeling? Have you tried consulting with your Nurse already?

Patient: Nope, not yet not yet as I’ve been too busy lately, but I think I really need to

The Following Morning

Patient: Hi, Good morning is Doc in already?

Nurse: Good morning Mrs.Takai, Long time no see! Yes Doc is here already. How are you feeling today?

Patient: Argh, I’m not feeling well lately and have been bloated and constipated for some time.

Nurse: No worries Mrs. Takai let me do your initial check-up then send you over to Doc.

Patient: Sure sure

Nurse: Aside from feeling bloated and constipated, are you feeling any pain in your stomach? If so
where? Right or Left Side?

Patient: there’s no pain, but the feeling of being bloated just annoys me.

Nurse: Noted. Have you tried taking medications already? Laxatives and the like? Any changes in diet?

Patient: So far, no medications, but I did try begerlai tea but it’s still the same, as to my diet nothing
changed; still eating the usual fastfood near my office.

Nurse: You did say fastfood diet right? How about green Vegetables? Any vices; Alcohol, smoking? When
was the last time you were sick? And what for?

Patient: Sad to say, but I’m not a fond of vegetables. Vices are alcohol, but only on occasion, smoking
no, and so far I had not been sick.

Nurse: How bout exercise? Or any other activities?

Patient: I’m already busy with work at the office, making reports and everything, where will I find the
time for exercise?

Nurse: Food Allergies?

Patient: None

(nurse taking vitals)

Nurse: Ok Mrs. Takai, kindly please wait for your name to be called.

( Nurse went to the doctor and reported to the doctor the patients case)

Nurse: Doc, Next Patient is 28 YO Male Nursing Diagnosis: Infrequent bowel movement r/t Sedentary
lifestyle and low fiber diet as manifested by abdominal distension and constipation

Doc: Okay, I’ll do my best with her, go and prepare health teaching with her after, okay?

Nurse: Sure doc, good luck.

( Nurse Called Patient)

Doctor: Goodmorning Mrs. Takai, was it? I was told you were not feeling good, Tell me what seems to be
the problem?

Patient: Goodmorning too doc, Yes I’m not feeling well lately, Its been 3 weeks that I feel bloated and
constipated.

Doctor: Ok Mrs. Takai Lets check what’s going on. Please come up here and I’ll check your Stomach.

( DO IAPP)

( Doctor Percusss then palpate

Putting pressure points on the quadrants while asking the patient if she feels pain.)

Doctor: Just let me know if you feel pain.

Patient: ok Doc.

( Doctor done )

Doctor: Thank you for your cooperation Mrs. Takai, So here’s what we have to do. We need to run some
test and laboratory work-ups to confirm what you are feeling as it can be an indication of many things,
and as your doctor I would want to give you assumptions without the test results. Also one of the
confirmatory test is colonoscopy and abdominal x-ray if you are ready you can sign the necessary
documents for the colonoscopy.

Patient: is that when the camera would be inserted inside my rectum to my stomach?

Wouldn’t that be painful?

Doctor: No no, that won’t be painful as you will be sedated then we will show you the results
afterwards.

Patient: Ok Doc.

Doctor: Please complete the following requests and the nurse would assist you.

Our next appointment is after all lab results came out.

In the meantime, for your stomach bloating and constipation I’ll be giving the list of to-do’s to relieve
yourself from bloating and constipation. Don’t worry, the nurse will explain it to you thoroughly

Patient: Ok Doc, Thank you!

Nurse: Hi Mrs. Takai, Let’s hope and do our best to get all the things done today, okay?

Patient: Sure, let’s do it. I’ll do my best to finish this today.

Nurse: That’s Awesome Mrs. Takai… Meanwhile here’s a list to do to rel ieve your bloating and
constipation.

Please avoid the following

 Behaviors
o Talking while eating
o Eating when upset
o Using a straw or sports bottle
o Overloading your stomach
o Deep sighing
o Drinking very hot or cold beverages
o Chewing gum or eating hard candy
o Drinking from a water fountain
o Tight-fitting garments
 Foods
o Carbonated beverages
o Spicy, fried or fatty foods
o Broccoli, cabbage, onions
o Beans
o Apple or prune juice
o Dried fruits
o Anything containing sorbitol, mannitol or maltitol, found in many low-carb or
sugar-free foods

And for your constipation please take Bisacodyl (dolculax) and please drink a lot of water not sodas.

And for your colonoscopy here are the papers and waivers you would need to sign..

When do you want this scheduled?

Patient: Tomorrow If possible.

Nurse: Ok then, that’s about it. See you tomorrow!

--The next appointment---

Nurse: Good Day Mrs. Takai! How Are you.

Patient: Im good and was able to complete the Xray and Blood test doctor required yesterday.

Nurse: That’s Good. Let’s inform Doc that you’re here.

Patient: Let’s Go!

Doctor: Hi Mrs. Takai How are you?

Patient: Here are the resuts.

Doctor: Ok your results on the blood test are good, but looking at the Xray im seeing white spots and
these are indicators of pouches on your divertimculum.

Patient: Is that Bad Doc?

Doctor: Let’s see it through the colnospy for sure.

Patient: Ok Doc.

( The patient and doctor did went through the colonoscopy)

Doctor: Mrs. Takai Here is the video of your colonoscopy earlier. As you can see this is what we call
Diverticolosis, there are pouches visible but so far they are not yet infected based from your blood test
and based from your colonoscopy results.

Diverticulosis is common in people over age 60. It doesn’t happen often to those younger than 30.
Experts think the pouches show more with age. Men might get it more than women.

For Treatment: Our main goal here is to keep the pockets from causing problems. A high-Fiber diet or
some fiber supplements will help reduce gas and pain in your stomach. You will also need to increase
probiotics intake to help fight Diverticulosis symptoms.

As your Doctor I will prescribe fiber supplements, a Citrucel or Metamucil and you’ll take it with lots of
water. It is a good thing that we have detected it earlier to prevent diverticulitis, which is the infected
diverticulosis causing fever, pain and many more discomforts.

Patient: whew! Thank you so much doc.

Doctor: Our nurse will give you full health education as to how you can prevent the infection and he she
also has the prescription for your supplements.

Patient: Ok Dok thanks again!

Doctor: No worries! Be healthy Always.

Nurse : Hi Mrs. Takai, I have prepeared here a list which you can keep for you to be able to prevent the
infection of your diverticulosis.

Patient: Great! Thanks Nurse.

Nurse: Hi Mrs. Takai, as what the doctor had informed me you do have diverticulosis, well it’s really
going to be a change in lifestyle and we have 6 things that you really have to do to prevent diverticulitis.

Here are some tips:

1. Eat more fiber by adding whole-grain breads, oatmeal, bran cereals, fibrous fresh fruits, and
vegetables o your diet. However, take care to add fiber gradually. A sudden switch to a high-fiber diet
can cause bloating and gas.

2. Bulk up your diet by adding an over-the-counter preparation containing psyllium, derived from the
plant Plantago psyllium. You can also try ground psyllium seed: Once a day, add 1 teaspoon ground
psyllium seed over any cold liquid and drink within a few minutes of preparing, before the mixture gels.

3. Drink plenty of fluids (at least eight 8-ounce glasses of water a day) if you increase your intake of
fiber.

4. Avoid refined foods, such as white flour, white rice, and other processed foods.

5. Prevent constipation by trying over-the-counter stool softeners. However, don't use suppositories or
laxatives for constipation on a long-term basis without consulting your doctor. Prunes, prune juice, and
psyllium seed are all good natural laxatives. Specially formulated teas to fight constipation are available
in health food stores, but some may be very strong, so use them only as directed. Avoid products
containing senna (Cassia senna), which is an especially strong herbal laxative and can be habit forming.
Also, senna can cause staining of the lining of the colon, which may result in a condition called melanosis
coli. Polyethylene glycol (MiraLax) is a useful laxative for short-term use in constipation. Prescription
drugs, such as Amitiza, are available for long-term constipation. Talk to your doctor about these
medications.

6. Exercise regularly. Exercise can help the muscles in your intestine retain their tone, which encourages
regular bowel movements. If you have the urge to move your bowels, don't delay or ignore it.

Do you have anymore clarifications?

Patient: No I think Im all good, im glad we detected the diverticulosis early.

Nurse: Allright then! Here’s your prescription and a copy of the things you can do to prevent the
infection. Be healthy now Mrs. Takai. Take care..

Patient: Thank you again Nurse! I’ll go ahead and buy these supplements.