Diverticulitis
Updated May. 31st, 2023
The intestine is essentially a tube with an absorptive layer on the inside and muscles wrapping the outside that squeezes rhythmically to move food along. If the muscle layer is weakened, the inner tissue can push through it and form small outpouchings called diverticula. This condition is called diverticulosis. If these pouches become filled with fecal matter and bacteria they can become infected and inflamed, causing the condition called diverticulitis.
Cause of Diverticulitis
Many things can cause the outside muscle layer of the colon to weaken and allow the inner layer to form diverticula. Diverticulosis (the formation of the pouches) is most commonly caused by age, and low dietary fibre. Insufficient fibre in the stool makes the colon have to work harder to push it along, which can cause increased pressure and eventual weakening of the muscle. For more information, please see our Fiber article. Straining when passing stool, and prolonged constipation can both contribute to the problem. Abusing laxatives for long periods of time can eventually cause a weakening of the muscles of the colon as well. Once the diverticula have formed, the infection that causes diverticulitis is usually the result of low dietary fibre, high dietary sugar, chronic constipation and/or intestinal infections.
Signs and Symptoms
Although diverticulosis may not have any overt symptoms, it can present with mild cramps, bloating, and constipation. The symptoms of diverticulitis are abdominal pain and tenderness, usually in the lower left quadrant. The infection can cause fever, alternating constipation, and diarrhea, as well as painful intestinal spasms and even bleeding. It can also occasionally cause bloating and gas, nausea and vomiting, and lack of appetite.
All of the above symptoms can be seen in cases of inflammatory bowel disease (IBD) as well so further testing is required. For more information, please see our IBD article. Diagnosis is commonly found by contrast CT scan allowing medical doctors to see any diverticula in the colon and even inflammatory changes there as well.
Lifestyle Changes
The most effective ways to alter your lifestyle for improvement of diverticulitis include reducing stress, quitting smoking and regular exercise. It’s very important to never suppress a bowel movement. If you are regularly straining to defecate you can increase your chances of forming diverticula so it’s important to minimize straining. When you are sitting on the toilet, ensure that your thighs are parallel to the floor or that your knees are above your hips. This position helps to ease the release of stool by opening up the passageway. If you need to, you can even use a footstool to keep your knees at a desirable height. Regulating bowel movements will be beneficial and can be assisted through abdominal massage and hydrotherapy. Also, intestinal cleansing will rid the colon of build-up and optimize its functioning.
Diet During a Flare
Assess your diet for irritating substances that may contribute to diverticulitis. These are foods that can clog the diverticula and create a pocket of infection. Some examples are: nuts, seeds, non-leafy raw vegetables, millet, oatmeal, legumes, fruits and berries with skins or seeds, coconut, corn, and popcorn. High sugar in the diet can also promote infection by providing a rich food source for the bacteria. Drink 8-10, 8oz glasses of water each day to help soften the stool and promote proper colon function. Start your day with a bowel stimulating glass of warm water with lemon juice. Some practitioners will even recommend water or juice fasting to help give your colon a rest and a chance to repair itself.
Diet to Prevent Flares
Consume a low fat and high fibre (at least 30g a day) diet. Include fresh fruits (with skin) and vegetables, prunes, figs, garlic and well cooked brown rice in your diet. Avoid grains, seeds, nuts, dairy products, sugar products, spicy food, fats, and processed foods. Use water-soluble fibres like chicory root, oat bran or apple pectin. Broil or bake fish and meats instead of frying. Steam vegetables lightly. Be sure to continue to continue drinking sufficient water
Supplements
There are a wide variety of supplements that can benefit diverticulosis and diverticulitis. As mentioned above, fibre is a great way to treat diverticulosis and prevent diverticulitis. Once an infection has occurred, anti-microbial and immune-boosting herbs and nutrients can help it to resolve more quickly. Some examples are: Echinacea, Astragalus, Garlic, and Zinc. Probiotics can also provide a protective layer of good bacteria to prevent the growth of bad bacteria in the diverticula. For more information, please see our Probiotics article. Please see the list below for further suggestions.