Diverticulosis and diverticulitis are two conditions that occur in the large intestine (colon).

Diverticulosis and diverticulitis are two conditions that occur in the large intestine (colon). 

Together they are known as diverticular disease. Both share the common feature of diverticula. Ageing and heredity are primary factors in the development of diverticulosis and diverticulitis, but diet also plays a role.

What is diverticulosis?

Diverticulosis is a condition whereby small pouches, or sacs, known as diverticula, form in the inner layer of the intestine and push outward through naturally weak areas in the outer wall of the intestine.

Diverticula can range from pea-size to much larger. Although they can form anywhere in the inner lining of your colon, they are most commonly found in your lower left side, in the S-shaped segment of your colon called the sigmoid colon.

Once diverticula form they do not disappear by themselves but if there are no symptoms (diverticulosis) then no treatment is required. Because most people do not have symptoms, diverticulosis is often found incidentally during evaluation for another condition or during a screening exam for polyps.

What causes diverticulosis?

There is no clear evidence as to what causes diverticulosis, however, because it is uncommon in regions of the world where diets are high in fibre and rich in grains, fruits and vegetables, it is thought this condition is due in part to a diet low in fibre. Fibre helps to make your stools softer so they put less pressure on the walls of your intestines. A low-fibre diet can cause a buildup of waste, constipation, which increases pressure within the digestive tract with straining during bowel movements. The combination of pressure and straining over many years likely leads to diverticulosis.

What are the symptoms of diverticulosis?

Usually diverticulosis does not cause any troublesome symptoms. However, some people report:

• Tenderness over the affected area
• Mild abdominal cramps
• Swelling or bloating
• Constipation

Keep in mind that having one or more of these symptoms doesn’t mean you have diverticulosis. These symptoms are common symptoms of other gastrointestinal disorders such as irritable bowel syndrome, coeliac disease, inflammatory bowel disease, appendicitis, gallstones and stomach ulcers.

How common is diverticulosis?

Diverticulosis is very common in Western populations and occurs in 10% of people over age 40 and in 50% of people over age 60. The rate of diverticulosis increases with age, and it affects almost everyone over age 80.

Diverticulitis

Diverticulitis occurs when one or more of the diverticula become infected or inflamed.

What causes diverticulitis?

Again, the causes of diverticulitis are uncertain, but evidence suggests that inflammation and infection develop when a hard piece of stool or undigested food gets trapped in one of the diverticula. This gives bacteria the chance to multiply and spread, triggering an infection.

Another theory is that the walls of the diverticula themselves erode from the increased pressure on the colon walls.

Diverticular disease can also be hereditary.

What are the symptoms of diverticulitis?

The symptoms of diverticulitis include:

• Pain, tenderness or sensitivity in the left lower side of your abdomen. Pain can start out mild and increase over several days or come on suddenly. (Pain is the most common symptom.)
• Fever
• Mucous on the stool
• Bloating
• Nausea and/or vomiting
• Chills
• Constipation
• Diarrhoea

Diverticulitis can be a serious, and even a potentially life-threatening complication. Health problems that can arise from diverticulitis include:

• Rectal bleeding
• Abscesses and fistulas
• Obstructions and strictures
• Perforation, leading to peritonitis

Who is at risk of having diverticulosis and diverticulitis?

You are at increased risk of diverticular disease if you:

• Are over 40 years of age
• Are male
• Are overweight
• Eat a low-fibre diet. You don’t eat a lot of fruits, vegetables, beans and legumes, breads and grains or nuts
• Eat a diet high in fat and red meat
• Don’t exercise
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen ; steroids; or opioids
• Smoke

How is diverticulitis diagnosed?

Diverticulitis is usually diagnosed during an acute attack. If you have symptoms of diverticulitis, it’s important to be seen by your healthcare provider to get the correct diagnosis.

Tests to confirm the diagnosis of diverticular disease include:

• Medical history – including dietary habits
• Physical examination – including rectal examination
• Colonoscopy – a slender flexible tube inserted into the anus so that the doctor can look at the entire length of the large intestine
• Barium enema – a special contrasting dye flushed into the bowel via the anus and x-rays are taken
• CT scan – to detect abscesses outside the bowel lining
• Blood tests – to check for signs of infection
• Stool tests – to check for the presence of blood in the faeces or the presence of infections, which may mimic the symptoms of diverticulosis and diverticulitis

How can diverticulosis be prevented?

Having regular bowel movements and avoiding constipation and straining is important to prevent diverticular disease and reduce its complications.

Self-care suggestions include:

• Take digestive enzymes and/or probiotics as supplements which help the breakdown of food and support the digestive system
• Increase daily intake of green vegetables. Introduce fibre gradually to avoid unpleasant symptoms such as flatulence
• Drink plenty of fluids to ensure your stools are soft, moist and easy to pass
• Exercise regularly to encourage bowel function and peristalsis

How much fibre should I eat?

Government guidelines say our dietary fibre intake should be 30g a day, as part of a healthy balanced diet. As most adults are only eating an average of about 20g day, we need to find ways of increasing our intake.

What foods are high in fibre?

High-fibre foods include:

• Whole grain foods such as breads, pasta, crackers, barley, brown rice and oatmeal
• Berries and other fruit
• Vegetables, such as broccoli, cabbage, spinach, carrots, asparagus, squash and beans
• Bran products, made from rice, corn, wheat, oats, barley rye and millet
• Cooked dried peas and beans

Besides preventing constipation, eating a high-fibre diet helps lower blood pressure, reduces blood cholesterol, improves blood sugar and reduces the risk of developing certain intestinal disorders such as colorectal cancer.

What’s most important is to figure out what foods do and don’t cause symptoms and avoid the foods that cause symptoms or make your symptoms worse.

Treatment of diverticulitis

The conventional medical treatment for diverticulitis is most often antibiotics taken by mouth along with rest, taking over-the-counter medications for pain and following a low-fibre diet. When pain is worse, a clear liquid diet to allow the colon and bowel to recover may also be prescribed.

Whilst antibiotics may be needed in the short term, they can also bring with them unwanted side effects. Antibiotics cannot distinguish between good and bad bacteria so indiscriminately wipe out both. Once both good and bad have been wiped out, harmful bacteria quickly proliferate and problems can soon start to arise.

To help minimise disturbances to the gut microbiome should you need to take an antibiotic, it is important to supplement with a high quality probiotic supplement. The combination of strains used in a recent study, taken at the same time as antibiotics, was shown to minimise disturbances to the gut microbiota, and reduce those all-too-frequent side effects.

How BioMed can help

Establishing your individual requirements is an essential part of optimising your health.

Here at the BioMed Natural Health Clinic, we offer a specialised testing service that can help support not only gut health but overall health and wellness.

We offer Bioresonance and Quantum Analysis Screening services which analyse all your body’s different systems, creating reports which highlight any deficiencies or imbalances. This is particularly important in maintaining and supporting a healthy digestive system.

Following the screening an individualised Health Plan can then be created. This may include recommending vitamins and/or supplements, Bioregulatory remedies and various other treatments.