I received an email inquiring about diverticulitis recently. My first reaction was “diverti- what?” I’ve never heard of the condition and neither do I know of anyone having it (which is a good thing!). But you know what? I discovered that diverticulitis, and a related disease called diverticulosis, are actually quite common in our modern cities, especially if you’ve reached the middle age and above. But yet when I asked around, not many people know much about it.

So I decided to dig further and put together some basic but essential facts on these two digestive ailments, as well as links where you can get more information about them. Hope you’ll find this guide useful.

At a Glance

• What is Diverticulosis?
• Symptoms of Diverticulosis
• What is Diverticulitis?
• Symptoms of Diverticulitis
• What Causes Diverticular Disease?
• Does Diverticulitis Diet Help?
• Books Related to Diverticulitis
• Useful Links

What is Diverticulosis?

First, let’s define some terms.

When a small bulge, or also known as a pouch, protrude out of the surface of the colon, it’s called a diverticulum. A diverticulum is not to be confused with a growth or a tumor. You can think of it like a fold but in the shape of a small berry or pouch that bulges from the colon. When there are more than one diverticulum, they are called diverticula.

Someone who is diagnosed with diverticula is said to have diverticulosis.

Diverticulosis is common among people who are 45 years of age and above. It’s estimated that about 30 percent of those above 45 and as much as 70 percent of people older than 85 years in the US alone have diverticulosis. However, an increasing number of younger people are also diagnosed with this condition, especially those who are obese.

Symptoms of Diverticulosis

Diverticulosis usually occurs in the lower, descending portion of the colon, which is on the left side of the abdomen, although it may also happen on the right side.

Many people with diverticulosis are totally unaware of it because they usually do not feel any discomfort, and therefore, may not require any treatment.

However, some individuals have also reported intermittent mild pain in the lower left abdomen, changes in their bowel habits or persistent bloating as a result of the condition. In some rare cases, diverticula may also bleed.

Since the symptoms of diverticulosis are common and are shared by other gastrointestinal diseases, a thorough medical examination (which may involve CT scan and/or ultrasound) is needed to diagnose the condition accurately.

What is Diverticulitis?

Diverticulitis describes the condition where the small bulges (diverticula) in the lining of the colon are inflamed and infected. Some ten to 25 percent of people with diverticulosis will develop diverticulitis.

Simple diverticulitis can usually be resolved with a course of antibiotics. But when the infection is left untreated and does not clear up by itself, a collection of pus called abscess in the colon may be created. An unresolved abscess would spread and infect surrounding healthy colon tissue, and even puncture a hole through the colon wall.

If the hole is large enough, pus and waste will leak out of the colon and contaminate the abdominal cavity, leading to an inflammation of the peritoneum (peritonitis) — a potentially fatal condition that requires immediate medical attention.

Another type of complication called fistula may also occur when infected diverticula spread outside the colon. In this case, a fistula, which describes an abnormal tract between two organs which shouldn’t be connected, is formed when the infected part of the colon sticks to a nearby organ, such as the small intestine, bladder or skin. This may cause chronic inflammation to the affected organs.

Lastly, diverticula inflammation may also lead to partial or total obstruction of the colon due to the swelling and narrowing of the bowel wall.

Collectively, diverticulosis and diverticulitis are known as colonic diverticular disease.

Symptoms of Diverticulitis

Symptoms of diverticulitis depend on the severity of the condition. They may include acute (sharp) abdominal pain and/or localized tenderness on the lower left abdomen. Some people may also experience fever, vomiting, nausea, constipation or diarrhea. Diverticulitis may also lead to bleeding in the colon.

What Causes Diverticular Disease?

Despite advances in medical research, we still know very little about the exact cause of diverticular disease. But scientists suspect that the following conditions may contribute to its occurrence:

• Insufficient fiber: When there is not enough dietary fiber, stool becomes less bulky and requires more contraction of the colon to move. This would lead to higher pressure, especially at the sigmoid colon (the ending part of the large intestine before the rectum and anus), and promotes the occurrence of diverticulosis in the gut.
• Constipation: When there is constipation, more force is required to move the bowel. The increased pressure, however, can cause some parts of the colon that are weaker to deform and bulge out.
• Sedentary lifestyle: Physical exercise may help to move stool quicker through the colon and hence, giving less chance for diverticula to form.
• Old age: Diverticular disease is more common among those above 45 years old, although the exact reason is unknown. The prevalence could be a result of multiple factors including weaken colonic wall, age-related wear and tear, and decreased mobility.
• Abdominal obesity: A high accumulation of fat around the waist is linked to acute diverticulitis in younger obese adults, according to a study conducted by the University of Maryland Medical Center.

Does Diverticulitis Diet Help?

If you’re diagnosed with diverticulitis, what should you eat to prevent another diverticulitis attack?

Previously, it was thought that tiny foodstuff like corn, seeds, nuts and popcorn would trigger a diverticulitis attack.

But research seems to suggest otherwise. In fact, based on a preliminary study published in the Journal of the American Medical Association in 2007, eating nuts and seeds twice a week may even help to prevent diverticulitis, though the reason is unclear.

Here’s one suggestion to consider: To prevent diverticulitis attacks, one way is to include fresh foods that are anti-inflammatory, nutrient-dense, minimally processed (read: high-fiber) and that you’re not allergic or sensitive to. These could include salmon (choose wild Alaskan salmon if possible), spinach, sweet potatoes, ginger, papaya and other bright color vegetables and fruits.

It’s also equally important to avoid foods that are inflammatory too to reduce the chances of diverticulitis flare-ups. These culprits are quite easy to spot: they are usually found in ready-to-cook packages, in a box, don’t look anything like real foods, and are often impregnated with hydrogenated vegetable oil and trans fats.

But what if you just had a diverticulitis attack? In this case, you may need to stick to a liquid diet and totally abstain from high-fiber foods for a period of time to prevent aggravating the inflammation in the colon. When your condition eases, fibrous foods may be re-introduced slowly before going back to your normal diet. Discuss with your physician on the exact foods that you should and should not take during the recovery period.

Books Related to Diverticulitis

Here are some books from Amazon that you may find useful in your fight against diverticulosis and diverticulitis. If you know of other great books that are not listed here, let me know in the comments. Thanks!

Coping with Diverticulitis
by Peter Cartwright

The Healthy Gut Workbook: Whole-Body Healing for Heartburn, Ulcers, Constipation, IBS, Diverticulosis & More
by Victor S. Sierpina

Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion (Fourth Edition)
by Elizabeth Lipski

Diverticular Disease: Emerging Evidence in a Common Condition (Falk Symposium)
Edited by W. Kruis, A. Forbes, K.-W. Jauch, M.E. Kreis and S.D. Wexner

Useful Links

Finally, if you’re interested to learn more about diverticulosis and diverticulitis, please check out these excellent online resources:

• Cleveland Clinic
• eMedicine
• MedLinePlus

Related products others have found useful:

7 Time-Saving Kitchen Tools You Should Have

The Anti-Inflammation Diet & Recipe Book

Anti-Inflammatory Multi-Herb Formula

Which Fish Oil Gives You More Anti-Inflammatory Nutrients?