Diverticulitis

Diverticulosis is a condition in which the inner lining layer of the large intestine or colon bulges out
(herniates) through the outer, muscular layer. These ‘outpouchings’ are called diverticula.

Diverticulitis is the term for inflammation and infection in one or more diverticula.

A person having diverticulosis (the condition), and perhaps diverticulitis (the inflammation) as well, is said to
have diverticular disease.

Diverticulosis Symptoms, Causes and Management

Diverticula occur in a colon weakened by age, when increased pressure inside the colon (usually due to constipation) causes little pea-shaped pouches of weakness in the intestine wall. The chance of developing diverticula increases with age, so that by age 50 between 20 and 50 percent of all people will have some diverticula, and by age 90 virtually everyone will.

Treatment

This diverticulosis is usually symptom-free, so that most people do not realize they have it. However, a few people will experience spasms and pain. Relieving the constipation, primarily by increasing fiber in the diet, can reduce the problems associated with diverticulosis. If cramps, bloating, and constipation are problems, the doctor may prescribe a short course of pain medication. However, many medications cause the colon to empty, an undesirable side effect for people with diverticulosis.

Diverticulitis Symptoms, Causes and Management

A person with diverticulosis may get diverticulitis when waste matter and bacteria are trapped in a pouch (diverticula). This blockage interferes with the blood supply to the area, and infection sets in. The tissue then becomes inflamed or infected, and in severe cases may even rupture. An attack of diverticulitis can result in fever, pain and tenderness around the left side of the lower abdomen.

The infection and irritation of nearby tissues within the abdomen may cause the abdominal muscles to spasm. About 25 percent of all patients with diverticulitis will have some rectal bleeding, although this rarely becomes severe. Diverticulitis is three times more likely to occur in the left side of the large intestine, and men are three times as likely as women to suffer with diverticulitis.

Treatment

Treatment for diverticulitis focuses on clearing up the infection and inflammation with antibiotics, resting the colon with a liquid diet plus a pain reliever or a drug such as propantheline (Pro-Banthine) to control muscle spasms, and preventing or minimizing complications. Acute or repeated attacks with severe pain or severe infection may be serious enough to require a hospital stay and possibly surgery.

High Fiber Diet Recommendations

High Fiber Diet for Diverticular Disease

This diverticulitis diet is a high fiber diet for managing diverticulosis, and for reducing effects of diverticulitis. The increased fiber (the American Dietetic Association recommends 20 to 35 grams daily, including 6-8 grams of soluble fiber) in this diverticulitis diet plan produces more bulk in the stool, reducing pressure in the colon and assisting the more regular and complete elimination of waste, thereby preventing the formation of further diverticula.

Build up consumption of fiber in your diet gradually - rapid fiber increase may result in gas, cramping, bloating, or diarrhea. There are other benefits in having different kinds of fiber in a balanced diverticulitis diet: it helps to protect against cancer of the colon and rectum, and assists in preventing heart disease and a number of other health problems. Foods containing fiber also tend to comprise nutrients like vitamins A, C, and E and selenium, useful in fighting cancer.

Increase Fluid and Fiber

Anyone with diverticulitis who increases their fiber intake under this diverticulitis diet plan, should drink at least 1.5 liters (3 pints) daily. Insoluble fiber needs fluid to form stools that are easily passed. Medical advice may be to take a fiber product or supplement such as Metamucil daily (for soluble fiber from psyllium), and to use a cholesterol-lowering spread or margarine containing plant sterols. Fiber supplements provide about 2 to 3.5 grams of fiber per tablespoon, which is mixed with a quarter liter (8 ounces) of water before consuming.

Should Seeds Be Eaten?

Until recently, many doctors suggested avoiding foods with small seeds because it was believed that particles could lodge in the diverticula and cause inflammation. However, this is now a controversial point and no evidence supports this recommendation. So the seeds in tomatoes, zucchini, cucumbers, strawberries and raspberries, as well as poppy seeds, which are part of your diverticulitis diet, are generally considered harmless.

Diverticulitis Diet Guidelines

Foods to Eat

• Breads and grains (6-11 servings daily)
• Bread, pastas, pizzas, pancakes, muffins, bagels, pita bread (use whole-grain, whole-wheat flours, and
  add 2-3 tsp of unprocessed wheat bran to, or substitute oat bran for one third of all-purpose flour in homemade
  breads, muffins and other baked goods)
• Whole-wheat, whole-grain and bran cereal products
• Buckwheat and stone-ground cornmeal
• Rye bread
• Whole wheat crackers or crisp breads
• Oatmeal, oat bran, or grits
• Barley, dry
• Wheat germ
• Whole wheat pasta
• Brown rice

Eat raw or dried fruits and raw vegetables if possible - chopping, peeling, cooking, pureeing, juicing, and processing
fruit and vegetables may reduce fiber content.

Vegetables (3-5 servings daily)

• All vegetables such as asparagus, broccoli, Brussels sprouts, cabbage, carrots, greens (such as beet greens, kale,
  collards, Swiss chard and turnip greens), green beans, green pepper, onions, peas, potatoes with skin, Romaine,
  snow peas, green snap beans, pole beans, broad beans, spinach, squash, sweet potatoes, turnips.

Fruit (2-4 servings daily)

• All fruits such as apple, apricot, banana, blackberries, blueberries, cherries, dates, fig, grapefruit, nectarine,
  orange, peach, pear, pineapple, prune.

Milk/dairy (2-3 servings daily)

• Increase fiber in yogurt or cottage cheese by adding fresh fruit, whole grain or bran cereals.

Meat/meat substitutes (2-3 servings or total of about 180 gm or 6 oz daily)

• All beans and peas such as aduki, baked beans, black beans, fava, garbanzo beans, kidney beans, lentils, lima beans,
  pinto beans and split peas.
• Smooth peanut butter and other smooth nut butters.
• All meat (increase fiber in meat dishes like meatloaf, casseroles, by adding 2-3 tsp of unprocessed wheat bran
  or pinto beans, kidney beans, black-eyed peas, or oatmeal), poultry, fish, and eggs

Fats and snacks

• Whole-wheat pretzels, baked tortilla corn chips or trail mix made with dried fruits.
• Cakes, breads, and cookies made with oatmeal or fruit.
• Bean dip

Foods to Avoid

Any hard or difficult-to-digest foods, such as nuts, corn, popcorn hulls, and sunflower, pumpkin, caraway, and sesame seeds