Diverticulosis is a condition whereby abnormal sacs, pockets, or pouches called “diverticula” are formed in weakened areas of the wall of the gastrointestinal tract, most prominently in the colon. Although these diverticula are present, they are not inflamed, and the condition is usually asymptomatic.
This condition is one of the most common gastrointestinal disorders among people today. [1-2]
Diverticulitis, on the other hand, is a condition whereby one or more of these sacs (diverticula) become inflamed, causing bowel function disturbances and pain, especially left lower quadrant abdominal pain, which affects 70% of people with diverticulitis.
Between diverticulosis and diverticulitis, another diverticular disease exists called symptomatic uncomplicated diverticular disease (SUDD). This condition appears in 20% of people with diverticulosis and leads to persistent non-specific symptoms but no inflammation. The symptoms involve bloating and sudden attacks of abdominal pain that can last several hours but without inflammation. The pain usually disappears after a bowel movement. [3]
The pathogenesis of diverticular disease is multifactorial and includes environmental and genetic factors, age, diet, obesity, a sedentary lifestyle, and changes in the colon microbiome.
As you age, you become more susceptible, with 65% of people over 80 suffering from diverticulosis and 7% suffering from diverticulitis. [4]
Diverticulitis is more common in developed countries, especially the U.S. It is still rare in developing countries. Still, there has been a rapid increase in the last few years in some developing countries, presumably due to recent modifications in diet and lifestyle in these countries. [5]
When left unmanaged, diverticulitis may result in rectal bleeding, abscesses, sepsis, ruptured bowel (a hole in the wall of the gastrointestinal tract), or intestinal obstruction requiring surgery. Immunocompromised people with diverticulitis have higher morbidity and mortality rates. [6]
Changes in dietary patterns can help manage the disease, boost digestive health, help the colon heal, and reduce or eliminate symptoms.
Here are dietary, lifestyle changes, and supplements that can help treat or lower your risk for diverticulitis, especially if you have diverticulosis.
1. Eat More Fiber and Lower Meat Intake
Fiber helps maintain digestive health by promoting good bacteria and making stools easier to pass.
Several studies have shown that a high dietary fiber intake can help reduce the risk of diverticular disease. In an extensive analysis that involved 19,282 cases and 865,829 participants, researchers concluded that consuming 30 grams or more fiber daily can help lower your risk of diverticulitis by 41%. [7]
Another systematic review that examined eight research articles found that a high intake of dietary fiber decreased the risk of diverticulitis and hospitalization from diverticular disease. This study found that fruits and cereal fiber had the most protective effect and vegetable fiber had the most negligible impact. [8]
This same study also found that high red meat consumption was associated with an increased risk of diverticulitis. Another study stated that higher red meat consumption was associated with a mild increase in acute diverticulitis risk. [9]
A large population-based prospective study found that diverticulosis was more frequent in non-vegetarians (33%) than in vegetarians (12%), independent of fiber intake, suggesting that meat consumption leads to an increased risk of diverticulosis. [10]
The same research found that women consuming less than 9.6 grams of fiber daily were at higher risk of diverticulitis than those consuming 17.6 grams or more daily.
A prospective cohort study of 46295 men found that a higher Western dietary pattern score was associated with an increased risk of acute diverticulitis. [11]
I recommend reducing meat intake to once a week or less and consuming at least two portions of whole grains and fruits daily.
Some of the best high-fiber foods to include in your diet are bran cereals, whole grains and their products, beans, lentils, green peas, chickpeas, and fruits like pears, berries, apples, pomegranates, and dates.
2. Increase Fluid Intake
Constipation which can happen when you don’t have enough fluids to promote healthy bowel movements is also a major trigger for diverticulitis.
Dehydration leads to excess buildup of waste products and bacteria in the colon, triggering a diverticulitis flare-up. [12]
Mild diverticulitis should initially be treated with sufficient hydration and dietary regimen adjustments. [13]
Beyond a high-fiber diet, you should drink ample water. See the chapter on hydration (#6) for more details on how much water you should consume daily.
If you suffer an acute diverticulitis attack, you may need to go on a liquid diet made of clear broth, freshly prepared fruit juices with no added sugar, and water. This will ensure you increase your fluid intake while getting sufficient nutrients allowing your gut to heal. This will help diminish the bleeding and diarrhea while providing antioxidants from fresh foods to help reduce inflammation. Ice pops made of fruit juices are also an excellent way to increase fluids in your body.
You also want to reduce alcohol intake, which was found to be associated with diverticular bleeding. [8,14]
3. Maintain a Healthy Weight
A population study revealed that there is a higher incidence of diverticulitis in people who are obese. [15]
People with excess weight have more visceral and subcutaneous fat, which increases the risk of diverticulitis. [16] Obese people also have an elevated risk for bleeding diverticula, which may cause sudden and severe bleeding from the rectum. [16] Therefore, losing weight if you are overweight or obese is crucial in lowering your risk of diverticulitis. Eating a healthy diet, such as the Guerrilla Diet, and exercising regularly is the best way to achieve a healthy weight. See the Guerrilla Diet & Lifestyle 12-Week Program on the Guerrilla Health website to help you lose weight in a proven and healthy way.
4. Exercise
A prospective study of physical activity and symptomatic diverticular disease risk in men found that running and jogging showed a statistically significant opposite relationship with diverticular disease risk. [17]
Other studies confirm an inverse relationship between vigorous physical activity and diverticular disease in both men and women. [18]
Vigorous exercise, such as running, has been shown to reduce the risk of developing complicated diverticulitis by 25%. [19]
Data from a large prospective cohort found that physical activity lowers the risk of diverticulitis and diverticular bleeding. [20]
5. Probiotics
Probiotics may modify the gut microbiome balance leading to health benefits. Probiotics have anti-inflammatory effects; thus, maintaining healthy bacterial colonization in the gut is a promising treatment option. [21-22]
An alteration in the gut microbiome can also lead to muscular dysfunction and diverticula development. Also, the translocation of bacteria to the diverticula is known to be involved in the pathogenesis of acute diverticulitis. [23]
Therefore, I recommend taking probiotic supplements daily during an acute attack and regularly if you have diverticulosis. The best probiotic supplements will have at least ten different healthy bacterial strains and a minimum of 100 billion microbes (colony-forming units). Take such a supplement daily in the morning.
To conclude
A high fiber diet, low in animal products, sufficient hydration, exercise, and weight loss, supplementing with probiotics is the best way to prevent diverticular disease and the regression into inflammation of the diverticula.
NOTE: A colonoscopy is recommended six to eight weeks after an acute episode of diverticulitis. [24]
All references are found at this link: https://bit.ly/guerrillahealthref I keep this list updated.
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