Diverticulitis diet and role of food and natural treatment
June 17 2015 by
Ray Sahelian, M.D.

Diverticulosis is a condition whereby diverticula  (small pouches) develop in the lining of the large intestine, extending into and through the muscular tissue surrounding the intestine. If these pouches become infected or inflamed, the condition becomes known as diverticulitis in which diverticula in the colon rupture. The rupture results in infection in the tissues that surround the colon.

Diverticulosis diet and foods - nuts, corn, popcorn, seeds
Eating seeds, nuts, corn and popcorn does not cause the bowel disease diverticulosis or its painful complications. In fact, one JAMA study found those eating nuts had a lower rate of diverticulitis.

Q. My husband has chronic diverticulosis. Cannot eat any size or type of seed at all. I just started using ground chia seed supplements and cannot taste or see any "seeds" in it. Would it be OK for my husband to use this supplement?
   A. It should be fine, but not having seen specific studies addressing this issue, it is difficult to be 100 percent certain.

Clinical Gastroenterology Hepatol. 2013 December. Diverticular disease: reconsidering conventional wisdom. Colonic diverticula are common in developed countries and complications of colonic diverticulosis are responsible for a significant burden of disease. Several recent publications have called into question long-held beliefs about diverticular disease. Nuts and seeds do not increase the risk of diverticulitis or diverticular bleeding.

Diverticulitis and obesity
Obese people are at increased risk for diverticulitis and for bleeding diverticula. Gastroenterology, January 2009.

Acute diverticulitis symptoms
Acute diverticulitis can cause fever, malaise, elevated white cell count and other symptoms, characteristics that should guide physicians when considering referral for a CT scan.
   The demographics of acute diverticulitis in the United States are changing. In acute diverticulitis, a common intestinal disease related to a low-fiber diet, increased pressure causes pouches, or diverticula, to bulge out in the wall of the intestines. Bacterial infections can develop and cause serious complications, such as perforations. Even though most medical textbooks suggest that acute diverticulitis is primarily confined to elderly patients, the majority of cases occur in patients age 50 or younger.

Chronic diverticulosis symptoms and signs
Common symptoms include bloating, discomfort in the lower abdomen, particularly on the lower left side. The pain comes and goes but it may gradually increase if the condition worsens. Other patients notice constipation, low fever, chills, nausea, vomiting and changes in bowel habits.

Diverticulitis treatment
In patients with asymptomatic diverticulosis, a fiber-rich diet is used to reduce intraluminal pressure and slow down the worsening of the disease. Fiber supplementation is also indicated in symptomatic diverticulosis in order to get symptom relief and prevent acute diverticulitis. A combination of soluble fiber, like glucomannan, and poorly absorbed antibiotics, like rifaximin, given 7-10 days every month is a good treatment choice. For uncomplicated diverticulitis the standard therapy is liquid diet and oral antimicrobials, usually ciprofloxacin and metronidazole. Hospitalization, bowel rest, and intravenous antibacterial agents are mandatory for complicated diverticulitis. Once in remission, continuous fiber intake and intermittent course of rifaximin may improve symptoms and reduce diverticulitis recurrence.

Ned Tijdschr Geneeskd. 2013. Conservative treatment of acute diverticulitis. Scientific evidence concerning the treatment of acute diverticulitis is scarce. We describe 2 patients with this condition in this article. The first, a 64-year-old man, came to the emergency room because he had experienced persistent abdominal pain for the previous 4 days. He was diagnosed with uncomplicated diverticulitis. The second patient, a 58-year-old woman, had had pain in her left lower abdomen for 4 weeks; the pain appeared to have been caused by complicated diverticulitis. Both patients were treated conservatively. Only the patient with complicated diverticulitis was administered antibiotics; she underwent surgery at a later date because of persistent pain. Several guidelines recommend the administration of antibiotics; however, a number of recent studies have revealed no benefit to the clinical course from the use of antibiotics. The Dutch guideline, therefore, recommends withholding antibiotics in the acute phase. Conclusive evidence on the best treatment for patients with frequent recurrences or chronic symptoms after an episode of acute diverticulitis is not available. Guidelines advise a personalised treatment strategy for each patient.

Progression, concerns
Previous research had concluded that up to one-quarter of people with diverticulosis will develop this painful and sometimes serious infection. But a15-year study shows that the risk is actually only about 1 percent over seven years,  University of California, Los Angeles, news release, Dec. 3, 2013.