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Diverticulitis is a common problem that can occur due to diverticula inflammation in the intestine, which are tiny pouches or weak areas that bulge out from the lining of the wall of the intestine.

They look like small thumbs poking out of the side of the bowel. Unfortunately, you are more likely to have these pouches as you get older.

What are diverticuli, diverticulosis and diverticulitis?

Diverticuli are tiny pockets of weakness in the wall of the large intestine. When a person has diverticuli, this condition is diverticulosis. A third of the people over age 50 in the United States have it. Some have just a few diverticuli, while others may have 20 or more, but most people have no symptoms and only find out that they have diverticulosis when they have a colonoscopy.

Person with diverticulosis may get diverticulitis when stool is caught in one or more of these pockets, and they become inflamed or infected. This typically causes fever, pain and tenderness in the abdomen, bleeding and infection as major signs of a diverticular disease. Diverticulitis usually clears up within a week with antibiotics and a liquid or soft diet. This specific soft diet includes anything that does not require a lot of chewing: soup, mashed potatoes, cooked or pureed vegetables, bananas, Jell-O and pudding fit this category. After the acute infection clears up, patients should stay on a high-fiber diet. This includes nuts, seeds, whole grains, fruits and vegetables. They should drink plenty of fluids and avoid constipation at all costs. It is important to avoid it, even if that requires taking Metamucil or other fiber products daily. Hard stools or straining will either cause more diverticuli to appear, or the existing ones to enlarge, which is an unwanted consequence.

What are the symptoms?

Symptoms of diverticulitis may include alternating diarrhea and constipation, severe cramps in the lower left side that come and go, pain on the lower left side of the abdomen, chills or fever, nausea and vomiting, as well as rectal bleeding.

Diagnosing diverticulitis

Your health care provider will review your symptoms and examine you if there is any doubt you might have diverticulitis. You may also have tests such as sigmoidoscopy, which is exam of the rectum and lower end of the large intestine. Your doctor might order a colonoscopy, which is an exam of most of the intestine with a thin, flexible, lighted tube. Barium enema or lower GI x-ray, as well as blood tests are also valuable diagnostic methods.

Diverticulitis treatment

For an attack of acute diverticulitis, your doctor will probably want to hospitalize you. Depending on how bad the attack is, your treatment may include antibiotics, intravenous fluids, and nasogastric suction. The latter is a procedure that relieves pressure in the intestine. If attacks are severe or frequent, you may need surgery.
There are two types of surgery to correct the diverticulitis problem. In colon resection, a doctor will remove the problem area of the colon. The other type of surgery is a colostomy, which attaches part of the colon to an opening in the wall of the abdomen. Bowel movements then pass through this opening instead of the rectum, so they are collected in a bag outside the body. After the colon heals, the colostomy can be reversed, which means that you will have a second surgery to rejoin the ends of the colon to each other and will no longer have a colostomy.
In 15-20% of the patients, their bulging pouches or diverticula become infected and cause diverticulosis, typically associated with sudden abdominal pain on the left side of the abdomen. Most cases of diverticulitis are mild, and are typically treated with rest, diet modification, and antibiotics plus pain medication if necessary. Such treatment may include a liquid or low-fiber diet as an important part of diverticulitis treatment. This allows the colon to rest and heal, so within 3-4 days you can gradually start increasing fiber intake in your daily diet. Less often, serious cases may require a hospital stay and possibly surgery. Treatment of diverticulitis depends on the severity of your symptoms. Treatment also depends on whether this is your first attack or not.

Diet modification to prevent and relieve diverticulitis

The principal dietary approach to the prevention and relief of diverticulitis is the consumption of a high-fiber diet. This has specific health benefits for all diverticular conditions, including diverticulitis, because a high-fiber diet along with mild pain medications will relieve symptoms in most cases. To prevent attacks of diverticulitis you should learn these important tricks.

  • Eat more fiber, because high-fiber foods, such as fresh fruits and vegetables and whole grains, soften waste and help it pass more quickly through your colon. This reduces pressure within your digestive tract, so it would be good to aim for 25 to 35 grams of fiber a day. If you have a difficult time consuming this much fiber every day, consider using a fiber supplement as valuable nutrition.
  • Drink plenty of fluids since fiber works by absorbing water and increasing the soft, bulky waste in your colon. However, if you do not drink enough liquid to replace what is absorbed, fiber can be constipating and cause problems as well.

What is fiber?

Fiber is the indigestible parts of fruits, vegetables and grains, one type of which dissolves in water – soluble fiber. It forms a soft, jelly-like mass in the intestines, which could prevent diverticulitis. Another type of fiber passes almost unchanged through the digestive tract, and those are insoluble fibers. Both types help make the stoo
l soft and easier to pass, and fiber also prevents constipation.

How much fiber is necessary to prevent diverticulitis?

The American Dietetic Association recommends 20 to 35 grams of fiber each day, about 6-8 grams of which should be soluble fiber.

What about seeds?

Up until recently, doctors advised avoiding small-seed-containing foods, such as tomatoes, zucchini, cucumbers, strawberries, raspberries and poppy seeds. Doctors believed that particles from this food could lodge in the diverticula and cause inflammation. However, this now a controversial point as no evidence support this recommendation. According to so some doctors, there is no evidence to suggest that such food worsens diverticulosis. To the contrary, eating high fiber foods is the only treatment for diverticulosis. Many doctors say that how diverticulitis develops is a mystery. It could be from hard stool or bacteria alone, but it is probably not from a nut lodged in a pocket.
In any case, everyone should eat a diet high in fiber, but especially people with diverticulosis. Nuts are a good source of fiber and protein, and although nuts contain fat, it is mostly unsaturated - the good kind - so try to use this diet for diverticulitis.

What should a diverticulitis diet include?

If you get a diverticulitis diagnosis by your doctor, and if the diverticulitis is mild, your doctor will probably recommend some dietary changes. Although a shortage of fiber in the diet over a number of years may have caused the condition, once you have it, your doctor may ask you to cut down on fiber even more for a few days. The problem is in some cases it may aggravate the pain.
Your treatment is likely to include antibiotics to kill the infection, and it is vital you finish your course. In about half of the cases of diverticulitis, the patient will end up in a hospital under professionals supervising. The other half of the patients will receive treatment at home. Therefore, it is wise while you are home to stick to the diverticulitis diet recommended by your doctor. When the infection clears and the diverticulitis is no longer a problem, then you will be able to concentrate on prevention.

Diverticulitis prevention diet

The cause of diverticulosis is a diet too low in fibers. The prevention of the condition should therefore attempt to redress that balance of the food you eat. The diverticulitis diet should be well-balanced, but include high fiber foods such as fresh fruits, vegetables and whole grains. Such a diet can help prevent a number of chronic diseases, not just diverticulitis. A fiber supplement may be helpful as well. You could use psyllium for more than a decade, and find it an excellent source of soft fiber. It could be ideal for cleansing the digestive system, as the psyllium forms a gel like texture when mixed with water. The water itself plays an important role in producing a soft stool, and especially when mixed with fiber, as you have already learned. Therefore, you should have plenty of water in your diverticulitis diet. Throw in half an hour of exercise a day, and your bowel and digestive system should keep in good shape and prevent more problems.