Diverticulosis

Diverticulosis

Diverticulosis is a classic good-news–bad-news condition. On the one hand, it’s a disease with virtually no symptoms, and it may never cause problems. On the other, diverticulosis can progress and become a related, though more serious, problem known as diverticulitis. Together, the two ailments are known as diverticular disease.

No question, you’re at greater risk of getting diverticular disease as you get older. Diverticulosis, especially, is a common problem in America, reports Peter McNally, D.O, chief of gastroenterology at Evans Army Hospital in Colorado Springs, Colorado, and spokes person for the American College of Gasteroenterology.

After you cross the treacherous waters of middle age, there’s a very good chance that you’ll get diverticulosis. According to the National Digestive Disorders Clearinghouse, about half of all Americans between 60 and 80 have diverticulosis, and almost everyone over 80 does.

Some definitions: A diverticulum is a grape-size pouch or sac that protrudes from the wall of the colon (large intestine). Sacs occur in other places along the gastrointestinal tract as well, but rarely. The pouches are thought to arise from excess pressure buildup in the colon, usually due to a lack of fiber in the diet. Doctors often compare the condition to an inner tube poking through weak spots on a tire.

Typically with diverticulosis, diverticuli (small multiple pouches) appear. Once established on the colon, they’re permanent. Most people never know they have the condition, says Michael Epstein, M.D., founder of Digestive Disorders Associates in Annapolis, Maryland.

Diverticulitis occurs, though, when the diverticuli trap bits of stool or undigested food and become inflamed. This inflammation causes abdominal pain, usually around the left side of the lower abdomen. If the diverticuli become infected, the pain is accompanied by fever, nausea, vomiting, chills, and cramping. At this point, people often see their doctor, who diagnoses the disease. Because diverticulosis usually “flies below radar,” people can miss opportunities to stop its transformation, says Dr. Epstein.

Fortunately, that transition from diverticulosis to diverticulitis may not occur—the statistical likelihood is 10 to 25 percent—and you can do things to improve your odds of never developing either affliction.

Try This First

Viva variety. In countries where dietary fiber is high, such as Africa and China, diverticular disease is virtually nonexistent. Although there’s no conclusive evidence, that’s a strong case for increasing your intake of fiber as part of a regular healthy diet, says Dr. McNally. “Try to get from 25 to 40 grams of fiber in your diet a day,” he says. That’s combined soluble and insoluble fiber because both can help. Soluble fiber, which dissolves easily in water, takes on a soft texture in the intestines that helps prevent dry, hard stools. Insoluble fiber passes almost unchanged through the intestines and adds bulk to the stool. Dr. McNally recommends incorporating high-fiber foods such as beans, whole grains like buckwheat, bran cereals such as Kellogg’s All-Bran, fresh fruits like avocados, and vegetables such as artichokes into a daily regimen. Add fiber to your diet slowly. Too much, too soon may lead to gassiness, bloating, and diarrhea. Each week, increase your daily intake by no more than five grams, the amount of fiber in one cup of cooked carrots, says Dr. McNally.

Other Wise Ways

Raise your glass. Dr. Epstein says that increasing water and fiber at the same time is a good idea. Lacking sufficient fiber, the bowel has to work harder to push the stool out. He advises drinking plenty of fluids, six to eight glasses daily, which just means a tall glass every couple of hours. Not sure you’re getting enough water? Test yourself by examining your urine. “It should look light, not dark,” says Dr. Epstein.

Build a base at breakfast. Another good idea: Mix a tablespoon of powdered fiber with a glass of orange juice in the morning. “It’s a real simple, healthy way to start the day,” says Dr. McNally. Check your pharmacy shelves for powdered fiber that comes in different flavors, consistencies, and sizes, like Metamucil and Citrucel.

Investigate veggies. “In the best of all possible worlds,” says Joanne Curran-Celentano, Ph.D., R.D., associate professor of nutritional sciences at the University of New Hampshire in Durham, “you want to get a lot of fiber from vegetables” and not only because of their fiber content. Vegetables contain other desirable nutrients that are good for the body, such as cancer-fighting beta-carotene. Her favorites include kale and squash.

Subtract seeds. Doctors are currently debating the effects of seeds on diverticulosis. Some experts say that seeds of all types can aggravate the condition and lead to diverticulitis. Dr. Epstein, for instance, tells people to at least cut back on seeds as well as corn, nuts, and popcorn.

Stay active. As you age, physical activity falls off, notes Bryant Stamford, Ph.D., director of the Health Promotion and Wellness Center at the University of Louisville in Kentucky. Without the benefits of exercise, the gastrointestinal tract slows down, which can make diverticular disease worse. So try to get a little bit of exercise—even if it’s just a walk around the block—every day, he suggests.