If you’ve yet to make fibre your friend, or have experienced chronic constipation for years, you may be at an increased risk of diverticular disease, where abnormal pockets, or pouches, form in the wall of the large intestine or colon. These are known as diverticula.
Some people have pockets that never become inflamed or cause problems, says Caroline Tuck, a nutritionist and postdoctoral research fellow at Queen’s University in Kingston, Ont., who focuses on gastrointestinal diseases. In such cases diverticular disease is only discovered by accident, during a screening for colon cancer, for example. “It’s only about 20 percent of the time that they flare up and become an issue.”
But when they do become inflamed or infected, you will almost certainly know it, as they can cause debilitating pain.
Experts aren’t sure what causes diverticular disease, but there is some speculation that a low-fibre diet may be a factor. Without enough bulk in the stool, the colon has to work harder to push waste through and this pressure may cause the weak spots where pouches (or diverticula) form. “It’s also thought to be associated with people who’ve had constipation throughout their lifetime,” says Tuck.
Whatever the exact cause, if you end up with inflammation or infection due to diverticulitis, you’ll know something’s wrong. The typical symptoms include gas and bloating, diarrhea or constipation, nausea, loss of appetite and often pain in the abdominal region, particularly on the lower left side.
In acute conditions, you might experience a few severe attacks that clear up with treatment, but in chronic cases, the inflammation and infection seem to subside but never really clear up. To reach a diagnosis of diverticulitis, your doctor may do blood tests, an X-ray or CT scan to see if you have an infection. (These are the 10 things doctors secretly wish they could tell you.) If left untreated, diverticulitis can lead to serious complications, including abscesses, bleeding and scarring, which, in rare cases, may require surgery to repair. Read on for the best tips to help improve your condition.
Monitor your symptoms.
If you know you have diverticular disease, pay attention to your symptoms, especially as you age because you’re more likely to experience diverticulitis as you get older. It’s estimated that diverticulitis affects about five percent of 40-year-olds and at least 50 percent of people over age 80.
Take your medication.
When you have a flare-up, and it’s determined that you have diverticulitis, your doctor will likely prescribe antibiotics to clear out the infection. Ensure you take the entire round of meds prescribed, even if your symptoms subside and you start to feel better. You may also be put on a low-fibre liquid diet for a few days to allow your bowels time to heal.
Get in lots of liquids.
Whether you love tea, juice or water, staying hydrated is important in the prevention of constipation, which can make the condition worse. (Here’s how to tell if you’re dehydrated.)
Do practice healthy bowel habits.
That means not using enemas (unless prescribed by your doctor) or laxatives (which you can become dependent on if used too often) and avoiding straining during bowel movements.
Find time for exercise.
Go for a walk, sign up for a yoga class or schedule some time in your calendar to do laps in the pool. “Physical activity of any kind will help,” says Tuck.
Embrace high-fibre foods.
Think whole-grain breads and cereals, brown rice, quinoa, bulgur, beans and plenty of fresh vegetables and fruits (with the skin on, when possible). If you’re new to high-fibre eating, start slowly to allow your stomach to adjust to the change. Most people need about 18 to 30 grams of fibre a day, so check the nutrition facts label on packaged foods to make sure what you’re buying really is fibre-rich. Check out this Apple and Walnut Muesli for a last-minute brekkie.
Ask a dietitian to evaluate your diet.
Talk to a dietitian for advice on healthy eating for your condition to make sure you’re eating a balanced diet focused on whole foods and not unwittingly missing out on something that could help. Some people with diverticulitis avoid seeds, nuts and berries, for example, due to a belief that the hulls could get stuck in the diverticula, contributing to infection, but there’s no evidence that these foods make the condition worse. “That’s the most common misconception about diverticulitis, and it can actually be counterproductive,” says Tuck. Nuts and seeds are great sources of fibre, making them an excellent option for people with diverticular disease.
Try probiotics and vitamin D.
Adding a few supplements to your healthy gut regimen may reduce your risk. According to a 2015 study published in JAMA, people who live in areas with less sun exposure (hello, Canada!) and low vitamin D levels, are more likely to develop diverticulitis. Ramp up your levels of D with a daily supplement of no more than 5,000 IU.
Improving the balance of bacteria in your gut could also help to reduce your symptoms of pain and bloating and even prevent a recurrence of diverticulitis. Begin by slowly incorporating more fermented foods, like kefir and kombucha, into your diet. A probiotic supplement might also do the trick, but Tuck warns that their efficacy remains unproven: “While use of probiotics is thought to be safe, systematic reviews of trials have not been able to draw clear conclusions regarding the role of probiotics for diverticular disease,” she says.
Read up on your condition.
As with every disease, condition and ailment, the more you know, the better. Read up on the latest research and thinking about diverticulitis and get inspired with some delicious whole food recipes for total gut health. Check out Your Nutrition Solution to a Healthy Gut by Kimberly Tessmer, Reverse Gut Diseases Naturally by Michelle Honda, and The Healthy Gut Workbook: Whole-Body Healing for Heartburn, Ulcers, Constipation, IBS, Diverticulosis & More by Victor Sierpina.