Dear Patients,

Hope everyone had a great holiday. This month’s newsletter is about diverticulosis, diverticulitis and the appropriate diet for each.

DEAR DR. GUY: After my last colonoscopy, I was told I have diverticulosis. Will this lead to diverticulitis? I currently have no symptoms but wonder if I should do anything to prevent it from progressing.

ANSWER: Although the two conditions are related, and diverticulosis is a risk factor for diverticulitis, many people who have diverticulosis never go on to have diverticulitis. In those who do eventually develop diverticulitis, it is not clear what causes the condition, so it’s difficult to know how to prevent it. A healthy diet and regular exercise may help.
Diverticulosis is a condition that affects the gastrointestinal tract. Small sacs, called diverticula, bulge out of the wall of your colon. The condition is very common as people age. Estimates are that about half of the U.S. population over 50 has diverticulosis. Most people have it by the time they reach 80. With those statistics in mind, a finding of diverticulosis during a colonoscopy isn’t unusual. Generally, it’s not a cause for concern.
Diverticulosis by itself typically doesn’t trigger any symptoms. Rarely, diverticula may bleed, causing blood in the stool. As in your case, diverticulosis is often found during a routine colonoscopy or on an imaging exam, such as a CT scan, that’s done for another reason. You can have diverticulosis for years without any complications or problems. If one or more of the diverticula become inflamed, however, that condition is diverticulitis.
While diverticulosis usually doesn’t lead to any discomfort, diverticulitis can be quite painful. Common symptoms include significant abdominal pain, as well as fever, constipation or diarrhea, nausea, and fatigue. A mild case of diverticulitis may go away on its own without any treatment. When treatment is necessary, antibiotics and a liquid or low-fiber diet may be all that is necessary to resolve symptoms.
However, in more severe cases, diverticulitis can lead to a tear in the colon that allows bowel contents to leak into the abdomen. In that situation, hospitalization usually is required for effective treatment. In some cases, emergency surgery may be necessary to repair a hole in the colon.
In contrast to diverticulosis, diverticulitis is uncommon. Only about 5 percent of people who have diverticulosis ever go on to develop diverticulitis. In general, diverticulitis is poorly understood. Unfortunately, little is known about what leads a person with diverticulosis to develop diverticulitis.
Although limited knowledge about what causes diverticulitis makes it difficult to offer solid prevention strategies, there are a few guidelines that may help. People who are overweight tend to develop diverticulitis more often that people who are at a healthy weight. So, exercising regularly and maintaining a healthy weight may provide some protective benefit against diverticulitis. Some research suggests diet also may play a role, with people who eat a low-fiber diet possibly at increased risk for diverticulitis.

DEAR DR. GUY: Are there trigger foods I should avoid to prevent diverticulitis attacks?

ANSWER: Actually, no specific foods are known to trigger diverticulitis attacks. And no special diet has been proved to prevent attacks.
In the past, people with small pouches (diverticula) in the lining of the colon were told to avoid nuts, seeds and popcorn. It was thought that these foods could lodge in diverticula and cause inflammation (diverticulitis). But there’s no evidence that these foods cause diverticulitis.

If you have diverticula, focus on eating a healthy diet that’s high in fiber. High-fiber foods, such as fruits, vegetables and whole grains, soften waste and help it pass more quickly through your colon. This reduces pressure within your digestive tract, which may help reduce the risk of diverticula forming and becoming inflamed.
If you think that you’re having a diverticulitis attack, call Dr. Guy immediately. I may suggest that you follow a clear liquid diet for a few days to let your digestive tract rest and heal.

If you have questions or concerns about diverticulosis, call and set up an appointment to speak with Dr. Guy.

Reminder – it is not too late to get your flu shot; call our office to get one now.

Hope this finds you well.

Dr. Guy
“A Care Beyond”