Diverticulitis is a condition of the digestive tract or intestine, arising from the presence of diverticula. These are small pouches in the lining of the intestine, caused by layers of tissue protruding through the muscular wall. They can be present in any part of the intestine, but most often in the lower part, or sigmoid.
The presence of these pouches or diverticula is called diverticulosis, and it is very common in the western world, especially among older people. It is thought to be caused mainly by insufficient fiber in the diet. In most cases, it causes no symptoms, and people are not aware of its existence unless they have a colonoscopy. The problem arises when these pouches become infected or inflamed, which is what usually leads to diverticulitis.
Diverticulitis can be a very painful condition, and its most recognizable symptoms are severe cramps in the lower left side of the abdomen. Other symptoms include alternating constipation and diarrhea, nausea and vomiting, and fever. There may also be rectal bleeding. It is necessary to seek immediate medical help in order to obtain an accurate diagnosis, as these symptoms can be confused with those of other conditions.
When diverticulitis has been diagnosed, sufferers in the acute phase are usually put on a liquid or very soft diet, including soups, Jell-o, puréed vegetables, and mashed bananas. This is to give the bowel a chance to rest, so that the healing process can take place. The doctor may also prescribe antibiotics.
Once the infection has cleared up, it is necessary to concentrate on preventing recurrent diverticulitis. More than half of those who have the disease do not have recurring attacks, but in cases where they recur more than once, the doctor may recommend surgery, to remove the section of the bowel which is worst affected. It is very desirable to avoid this if at all possible.
The most important factor in preventing a recurrence of diverticulitis is to eat a diet that is high in fiber – the fiber content recommended by the American Dietetic Association is 20-35 grams a day. Foods high in fiber are fruit, green vegetables such as spinach and broccoli, and wholegrain foods such as brown bread and brown rice. The top priority is to avoid constipation, as this would put more pressure on the colon and increase the likelihood of the diverticulitis recurring. For this reason it is also necessary to drink plenty of fluids, especially water, in order to replace the liquid absorbed by the fiber. Without this, the fiber itself can cause constipation.
Until recently, doctors advised patients to avoid nuts and seeds, as well as fruits and vegetables containing seeds, such as raspberries, strawberries or tomatoes, warning that seeds could lodge in the pouches and cause recurrence of the inflammation. However, recent research suggests that there is no evidence for this. In fact, nuts and seeds are not only high-fiber foods, but also contain EFAs (essential fatty acids such as Omega 3 and 6), which are highly beneficial.
Diverticular disease in general, and diverticulitis in particular, are often thought of as being diseases of advanced civilizations, with their sedentary lifestyles and diets full of processed, sugary and fatty foods. If you have had the disease and want to prevent a recurrence, or if you want to avoid having it in the first place, a diet of healthy unprocessed wholefoods, with plenty of liquids, is the way to go. Include regular daily exercise, and you will ensure a healthy digestive system, and avoid further problems.