What Are Diverticuli and Diverticulitis?
Some people can develop little bulging pouches in the lining of the large intestine. These are called diverticula, and the condition is known as diverticulosis.
When the pouches become inflamed or infected, it leads to a sometimes very painful condition called diverticulitis.
What are the symptoms of diverticulitis?
Diverticulosis usually causes no or few symptoms; leaving many people unaware that they even have diverticula present.
Abdominal pain is the most common symptom and this can occur in any part of the abdomen depending on where the diverticuli are present. Bleeding per rectum is another common symptom of diverticular disease. This can be mild or in some cases severe. People with diverticulitis may also experience nausea, vomiting, bloating, fever, constipation, or diarrhea.
What are the causes of Diverticular disease?
Diverticular disease can be either congenital or acquired. Some people are born with it and these are usually present in the small intestine or right side of the colon.
Low-fiber diet can lead to diverticulosis and diverticulitis. This may be why people in Asia and Africa, where the diet tends to be higher in fiber, have a very low incidence of the condition.
Diverticulitis is usually treated with antibiotics. Most of the time it subsides with conservative treatment. In severe cases this inflammation may lead to perforation and this may require either a drainage procedure or, in even more severe cases, surgery to resect a part of the colon.
After a bout of diverticulitis, there are various ways in which one can prevent recurrence of the symptoms.
Diet for Diverticulitis
If you're experiencing severe symptoms from diverticulitis, your doctor may recommend a liquid diverticulitis diet as part of your treatment, which can include:
• Fruit juices
• Ice pops
Gradually you can ease back into a regular diet. Your doctor may advise you to start with low-fiber foods (white bread, meat, poultry, fish, eggs, and dairy products) before introducing high-fiber foods.
Fiber softens and adds bulk to stools, helping them pass more easily through the colon. It also reduces pressure in the digestive tract.
Many studies show that eating fiber-rich foods can help control diverticular symptoms. Women younger than 51 should aim for 25 grams of fiber daily. Men younger than 51 should aim for 38 grams of fiber daily. Women 51 and older should get 21 grams daily. Men 51 and older should get 30 grams daily.
Here are a few fiber-rich foods to include in meals:
Whole-grain breads, pastas, and cereals
Beans (kidney beans and black beans, for example)
Fresh fruits (apples, pears, prunes)
Vegetables (squash, potatoes, peas, spinach)
If you're having difficulty structuring a diet on your own, consult your doctor or a dietitian. They can set up a meal plan that works for you.
Your doctor may also recommend a fiber supplement, one to three times a day. Drinking enough water and other fluids throughout the day will also help prevent constipation.
Probiotics are beneficial bacteria that help the gut stay healthy. Some studies have shown that certain probiotic strains may be effective in the treatment of diverticular disease.
People interested in probiotics can take them as a supplement, but they also occur naturally in some foods. These foods include natural yogurt and fermented foods such as:
Foods to avoid
A typical Western diet is high in red meat and refined grains and often includes lower fiber content.
In the past, doctors had recommended that people with diverticular disease (diverticulosis or diverticulitis) avoid hard-to-digest foods such as nuts, corn, popcorn, and seeds, for fear that these foods would get stuck in the diverticula and lead to inflammation. However, recent research has noted that there is no real scientific evidence to back up this recommendation.
It is generally safe for people living with diverticulitis to eat nuts, popcorn, and seeds, including pumpkin and sesame seeds.
It may also be ok to eat the seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries. In the past, doctors may have advised people to remove these foods from their diets.
But each person is different, and some patients especially with a sensitive colon may find that particular foods worsen their symptoms.
Anyone who notices that a certain food causes pain or a change in symptoms should eliminate that food and talk with their doctor about it.
High FODMAP foods
FODMAP is an abbreviation for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are types of carbohydrates that can cause digestive symptoms, such as bloating, gas, and diarrhea in some people.
Low intake of FODMAP foods might help to lower the risk and alleviate symptoms of diverticular disease.
Some high FODMAP foods include:
onions, mushrooms, cauliflower, and garlic
apples, apricots, dried fruits, pears, peaches
dairy foods, including milks, yogurts, and cheeses
legumes and pulses
bread and cereals
sugars and sweeteners
As some of these foods also contain beneficial fiber, a person should discuss their food choices and elimination with a doctor or nutrionist before making drastic changes.
Each person will have different dietary needs and sensitivities, so doctors recommend individualized professional guidance.
There is an association between higher intakes of red meat and processed meat with diverticulitis.
Studies have shown that higher intakes of red meat, particularly unprocessed red meat, were associated with an increased risk of diverticulitis. It may be good to substitute red meat with poultry or fish to help reduce risk of diverticulitis.
Other factors to consider
Diet and other lifestyle factors play an essential part in the development of diverticulitis. Obesity, decreased physical activity, and smoking might all play a role in its development.
The review also linked several medications with an increased risk of diverticulitis. Regularly using non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or opioid analgesics may increase a person’s risk.
Also, low levels of vitamin D, which people mainly obtain through exposure to sunshine, may link to diverticulitis.
Genetic factors account for about 50% of a person’s susceptibility to the condition. A person with a family history of diverticulitis may have an increased risk of developing the condition.
Summary A person living with diverticulitis should always consult their healthcare professional or a registered dietitian to discuss how best to manage their symptoms through diet and lifestyle changes.