Healthy digestion: Keeping diverticulosis at bay

November 23, 2010 By Mark Versland, M.D.

Chances are if you have diverticulosis, you don't know it. Diverticulosis occurs when small pouches in your colon, called diverticula, bulge outward through weak spots, but it usually causes no discomfort or symptoms. If those pouches become infected or inflamed, however, you're likely to develop severe pain in the lower left side of your abdomen accompanied by fever, nausea and a change in bowel habits. That's called diverticulitis, which requires a doctor's care.

One in 10 Americans over age 40 has diverticulosis, including about half of Americans over age 60. Your risk increases as you age and the outer wall of your colon thickens. As the colon's passageway narrows, waste moves less easily and produces extra pressure that causes pouches to develop.

A low-fiber diet may contribute to the prevalence of diverticulosis. Without adequate fiber, stools become hard and difficult to pass, increasing pressure in the colon.

What to do
If you have diverticulosis, your doctor may recommend a high-fiber diet. But if you have mild diverticulitis, with its accompanying inflammation and stomach pain, your doctor may prescribe antibiotics and suggest you rest and consume a liquid or low-fiber diet until the inflammation resolves.
One in two people with diverticulitis develops severe symptoms and requires hospitalization. You may need surgery if the disorder doesn't respond to antibiotics or if you develop bleeding, abscesses (infected areas with pus), tears, blockages or fistulas (abnormal tissue connections).

Dietary changes
In the past, it was felt that avoiding nuts and seeds might be helpful in avoiding complications from diverticulosis. This in fact is not true. It has not been shown that avoiding nuts and seeds is of any benefit and, in the absence of diverticulitis, the individual doesn't have to avoid these things.
There are other diet and lifestyle changes you can make to help improve your digestive health (and your health in general):

• Eat 25 to 35 grams of fiber a day.
• Drink at least eight 8-ounce glasses of water or non-caffeinated beverages a day.
• Aim for at least 30 minutes of exercise on most days.
• Empty your bowels promptly when you feel the urge.

Mark Versland, M.D., is director of Gastroenterology at The Hospital of Central Connecticut. For information on Hospital of Central Connecticut physicians, please contact our free Need-A-Physician referral service by phone 800.321.6244.