Diverticulitis

Diverticulitis

Back in 1972, during an administrative stint at the U.S. Department of Agriculture, I had a hard-working secretary who was plagued by diverticulitis. It manifested itself as abdominal pain and cramping, usually on the lower left side, plus occasional fever and bloody stool. I felt for her. My younger brother had also had diverticulitis.

At the time, dietary treatment for diverticulitis was quite controversial. Doctors had been recommending a low-fiber diet to treat it for about 50 years, and my secretary's doctors told her to avoid fruits and vegetables. But that didn't make much sense to the then-small group of natural medicine advocates, including yours truly, who were into high-fiber whole foods.

Even a cursory look at how people eat around the world showed that cultures with a high-fiber diet had little or no diverticulitis (and little or no constipation). Meanwhile, in the industrial West, with its processed foods and low-fiber diet, diverticulitis was common. (And incidentally, constipation was rampant.)

My secretary felt torn between the advice of those advocating high fiber and low fiber, and not knowing what to do added a good deal of stress to her already unpleasant situation. As luck would have it, that very year British researcher Neil Painter, M.D., of Manor House Hospital, London, published a study in the British Medical Journal that all but proved that diverticular disease was caused by a low-fiber diet. He recruited some 70 people with diverticulitis and placed them on a diet of whole-wheat bread, high-bran cereals and plenty of fruits and vegetables. That high-fiber diet cured or substantially relieved symptoms in 89 percent of the study participants.

I showed my secretary the study, and I hope she took it to heart. But alas, our careers took us in different directions, and I lost track of her, so I don't know how she fared.

Prevention with Fiber

Today, of course, doctors know that a high-fiber diet is the way to go. I've always eaten that way--lots of fruits, vegetables, breads and herbs--which is why, unlike my brother and secretary, I've never been bothered by either diverticulitis or constipation.

Our ancestors ate lots of fiber, and our colons evolved to handle it. Without enough fiber, we know, strange things begin to happen down there. Food moves more slowly through the colon, causing constipation, and little pockets known as diverticula develop in the colon wall. Sometimes diverticula become plugged with little bits of digested food and often little seeds. If diverticula become inflamed and swell, they cause pain and the other symptoms of diverticulitis.

More than half of those over 60 have noninflamed, painless diverticula, while an estimated 10 percent develop the inflammation of diverticulitis.

To reduce your risk of diverticulitis, the two most important factors are a high-fiber diet and exercise, according to Walid H. Aldoori, M.D., professor in the Department of Nutrition at the Harvard School of Public Health. But while you're eating more whole grains and fresh fruits and vegetables, you should watch some other dietary factors as well. Be sure to drink plenty of nonalcoholic fluids to keep things moving efficiently through your digestive tract. And if you've had diverticulitis, you should steer clear of some small, indigestible seeds--poppy, sesame, raspberry and strawberry--which can plug diverticula and aggravate the condition.

Finally, natural medicine expert and herb advocate Andrew Weil, M.D., professor at the University of Arizona College of Medicine in Tucson and author of Natural Health, Natural Medicine, suggests eliminating tobacco, which is good advice even if you don't have diverticulitis.

Green Pharmacy for Diverticulitis

There are many herbs that can help. Here are my favorites.

Flax (Linum usitatissimum). Commission E, the German expert panel that passes on the safety, effectiveness and dosage of medicinal herbs for the German government, approves using one to three tablespoons of crushed flaxseed two or three times a day (with lots of water) to treat diverticulitis.

Psyllium (Plantago ovata). Powdery, high-fiber psyllium seed is the major ingredient in Metamucil and a few other bulk-forming commercial laxatives. A few tablespoons a day (with plenty of water) provide a healthy amount of diverticulitis-preventing fiber. Watch how you react to this herb if you have allergies, however. If allergic symptoms develop after you take it once, don't use it again.

Wheat (Triticum aestivum). Dr. Painter, whose study found a high-fiber diet to be the cure for diverticulitis, estimated that wheat bran contains five times the fiber of whole-wheat bread, making it the fiber-lover's fiber. He's not alone in his endorsement of wheat bran.

"Bran is the safest, cheapest and most physiologically effective method of treating and preventing constipation," says gastroenterologist W. Grant Thompson, M.D., professor at the University of Ottawa. And, I might add, when you're avoiding constipation you're also avoiding diverticulitis.

Slippery elm (Ulmus rubra). Dr. Weil suggests using slippery elm bark powder to treat diverticulitis. The fibrous bark contains large quantities of a gentle laxative that soothes the digestive tract while keeping things moving.

The Food and Drug Administration has declared slippery elm to be a safe and effective digestive soother. Prepare it like oatmeal, adding hot milk or water to the powdered bark to make a cereal.

Camomile (Matricaria recutita). British herbalist David Hoffmann, author of The Herbal Handbook, suggests sipping on camomile tea throughout the day. This herb is particularly valuable in treating diverticulitis because its anti-inflammatory action soothes the entire digestive system, he says. I suggest making a tea with two teaspoons of dried camomile per cup of boiling water. Steep for five to ten minutes.

Prune (Prunus dulcis). Prunes combine lots of fiber with a sweet, delicious taste. They've been a folk remedy for constipation for ages. If I had diverticulitis, I'd eat plenty of prunes or drink prune juice.

Wild yam (Dioscorea villosa). According to California herbalist Kathi Keville, author of The Illustrated Herb Encyclopedia and Herbs for Health and Healing, whom I highly respect, wild yam helps relieve the pain and inflammation of diverticulitis. I like her formula: two parts wild yam, (anti-inflammatory and antispasmodic), one part valerian (relaxing digestive tract soother), one part black haw (antispasmodic) and one part peppermint (anti-inflammatory and antispasmodic).

If I had diverticulitis, I might use a couple of tablespoons of this herb mixture brewed in a quart or so of water.