Diverticulosis & Diverticulitis

For those that have been diagnosed with Diverticulosis or Diverticulitis, following a diet high in fiber is recommended to reduce symptoms. In addition, a diet supplement may be recommended.

What are diverticulosis and diverticulitis? 

Many people have small pouches in the lining of the colon, or large intestine, that bulge outward through weak spots. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans older than 40 have diverticulosis. The condition becomes more common as people age. About half of all people older than 60 have diverticulosis. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment. For example, diverticulosis is often found during a colonoscopy done to screen for cancer or polyps or to evaluate complaints of pain or rectal bleeding. Diverticula are most common in the lower portion of the large intestine, called the sigmoid colon. When the pouches become inflamed, the condition is called diverticulitis. Less than 5 percent of people with diverticulosis get diverticulitis. 

What are the symptoms of diverticulosis and diverticulitis?

Diverticulosis 

Most people with diverticulosis do not have any discomfort or symptoms. However, some people may experience crampy pain or discomfort in the lower abdomen, bloating, and constipation. 

Diverticulitis 

The most common symptom of diverticulitis is abdominal pain. The most common sign on examination is tenderness in the lower left side of the abdomen. Usually, the pain is severe and comes on suddenly, but it can also be mild and become worse over several days. A person may experience cramping, nausea, vomiting, fever, chills, or a change in bowel habits.

What causes diverticular disease?

Although not proven, the dominant theory is that a low-fiber diet causes diverticular disease. Doctors are not certain what causes diverticula to become inflamed. The inflammation may begin when bacteria or stool are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning. Some potential factors that may increase your chances of getting diverticulitis are Western dietary patterns (high in red meat, fat, and refined grains), obesity, and smoking. On the other hand, dietary fiber intake and diets high in fruits, vegetables, and whole grains, and physical activity is associated with decreased risk. 

How is diverticular disease treated?

Diverticulosis

Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber keeps stool soft and lowers pressure inside the colon so that bowel contents can move through easily. The American Dietetic Association recommends consuming 20 to 35 grams of fiber each day. The doctor may also recommend taking a fiber product such as methylcellulose (Citrucel), psyllium (Metamucil), or wheat dextrin (Benefiber) one to three times a day. These products are available in powder, pills, or wafers and provide 2 to 3.5 grams of fiber per dose. Fiber products should be taken with at least 8 ounces of water. Avoidance of nuts and seeds has been recommended by some physicians out of fear that food particles could enter, block, or irritate the diverticula. However, no scientific data support this treatment measure. Eating a high-fiber diet is the only requirement highly emphasized across the medical literature. Eliminating specific foods is not necessary. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify what foods may cause symptoms. 

Diverticulitis 

Uncomplicated diverticulitis with mild symptoms usually requires the person to rest, take oral antibiotics, and be on a liquid diet for a period of time. Sometimes an attack of diverticulitis is serious enough to require a hospital stay, intravenous antibiotics, and possibly surgery.