Diverticulitis: Causes, Myths, Diet Tips, and Exciting New Treatments.

As we age, certain health conditions seem to pop up more often, and one of the names I’ve been hearing more frequently is diverticulitis. I’m amazed by how many people I know who suffer from it! That got me thinking—what exactly is diverticulitis, and can we better manage it through diet and lifestyle? After some research and internet chasings, I’ve compiled this article to explore the topic further.

Just a quick reminder: I’m not a doctor—always follow your healthcare provider’s advice!

Introduction

Diverticulitis is a condition that many people encounter as they age, it can be managed effectively through diet, lifestyle changes, and, when necessary, medical treatment.

This article explores what diverticulitis is, its common causes, myths, and facts, and provides guidance on managing flare-ups and long-term care. It also looks into new treatments and offers a mock diet plan to help those managing the condition. If you’re looking for specific information, feel free to skip ahead to the relevant section below.

Skip to a Section:

What Is Diverticulitis?
How Common Is It?
What Causes Diverticulitis?
Myths & Facts About Diverticulitis
Managing a Flare-Up and Short-Term Diet
Long-Term Management and Diet
Supplements and Compounds That May Help
New Treatments
A Two-Week Mock Diet Plan
Could Herbal Remedies Help?
Conclusion and Support Groups

What Is Diverticulitis?

Diverticulitis is a condition that occurs when small, bulging pouches (called diverticula) in the digestive tract become inflamed or infected. These pouches often develop in the lower part of the large intestine (the colon) and are particularly common as people age, especially after 40. This condition exists on a spectrum: Diverticulosis refers to the presence of pouches without any symptoms, while diverticulitis occurs when these pouches become inflamed or infected.

How Common Is It?

Diverticular disease, which includes both diverticulosis and diverticulitis, is more common than many people realise.

Diverticulosis refers to the presence of small, bulging pouches (called diverticula) in the walls of the colon. These pouches form over time, often as a result of ageing and increased pressure inside the colon. Diverticulosis by itself usually doesn’t cause symptoms, and many people may not even know they have it.
Diverticulitis, on the other hand, occurs when these pouches become inflamed or infected, leading to more severe symptoms like pain, fever, and digestive upset.

To my surprise, diverticulosis is extremely common. More than 30% of people aged 50 to 59 have diverticulosis, and this number increases with age.

By the time people reach 80, over 70% will have developed diverticulosis. However, only about 5% of people with diverticulosis go on to develop diverticulitis, the more painful and inflammatory condition.

What Causes Diverticulitis?

The exact cause remains unclear, but several factors can increase your risk of developing diverticulitis. Here are some of the most common contributors:

Low-Fibre Diet: A diet lacking in fibre may lead to constipation and straining during bowel movements, which puts pressure on the walls of your colon, contributing to the formation of diverticula.
Ageing: Diverticulitis is far more common in older adults. As we age, the walls of our colon can weaken, increasing the likelihood of developing diverticular disease.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Long-term use of medications like ibuprofen or aspirin has been linked to a higher risk of developing diverticulitis.
Obesity and Sedentary Lifestyle: Being overweight or inactive can also raise your risk.
Smoking: Smoking is another known factor that increases the likelihood of developing diverticulitis.

While diverticulitis can’t be completely “cured,” it is manageable with the right approach.

What Can I Do?

Diverticulitis is something many people live with their entire lives without ever experiencing a flare-up. But when flare-ups do happen, managing the condition becomes essential.

One concerning thought whilst looking into this is whether this condition will become even more widespread, especially in the Western world with its high-fat, low-fibre diets. Fast food, processed meals, and the general convenience of unhealthy eating habits might be fuelling an epidemic of digestive health issues.

Unfortunately, these high-fat, low-fibre foods can increase the likelihood of developing diverticulitis or experiencing painful flare-ups.

Myths & Facts About Diverticulitis

Myths & Facts About Diverticulitis

Myth: Eating nuts, seeds, and popcorn will cause flare-ups.
- Fact: Recent studies have debunked this myth. There’s no evidence that these foods get stuck in diverticula or cause inflammation. In fact, nuts and seeds are a great source of fibre! –
- (Recent studies, including a prominent one published in The American Journal of Clinical Nutrition, have debunked the myth that nuts, seeds, and popcorn cause diverticulitis flare-ups, showing no increased risk of complications from these foods)
Myth: Diverticulitis only affects older people.
- Fact: While it’s more common in people over 50, younger individuals can develop diverticulitis, especially if they have risk factors like smoking, obesity, or a family history of the condition.
Myth: Diverticulitis will always require surgery.
- Fact: Most cases of diverticulitis can be managed with diet, medication, and lifestyle changes. Surgery is typically reserved for severe cases involving complications like abscesses, perforations, or recurrent flare-ups.

Managing a Flare-Up and Short-Term Diet

If you experience a flare-up, the immediate goal is to rest your digestive system. A clear liquid diet for a few days might be recommended to give your colon time to recover. Once symptoms improve, you can gradually introduce low-fibre foods.

Clear Liquid Diet:
- Broth (vegetable, chicken, or beef)
- Fruit juices without pulp
- Gelatine and ice pops (without fruit pieces)
- Water, tea, and coffee (without cream)
Low-Fibre Foods:
- Canned or cooked fruits (without skins or seeds)
- Cooked vegetables (without skins)
- White rice, pasta, and refined grains
- Eggs, fish, and poultry

If symptoms persist or worsen, it’s essential to consult your doctor. In some cases, they may prescribe antibiotics, or, in severe cases, recommend hospitalisation.

Long-Term Management and Diet

For long-term management, preventing future flare-ups becomes the main focus. A high-fibre diet is the key to keeping your colon functioning properly, as it encourages smooth and regular bowel movements, reducing the pressure that can lead to diverticula formation or inflammation.

Spicy Foods and Diverticulitis

During a flare-up, spicy foods like chilli, cayenne, and black pepper can irritate the digestive tract. Long-term, your tolerance to spices may vary. Some people can handle small amounts of spice, while others may find it aggravates their symptoms. Pay attention to how your body reacts and adjust accordingly.

Low-FODMAP Diet for Diverticulitis

Another approach worth considering is the low-FODMAP diet. This diet, often recommended for those with IBS, may help manage diverticulitis symptoms during flare-ups by reducing fermentable carbohydrates that can cause gas, bloating, and discomfort.

What is a Low-FODMAP Diet? The low-FODMAP diet limits fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—types of carbohydrates that are poorly absorbed in the small intestine and ferment in the colon, causing gas and bloating.
How It Helps Diverticulitis: During or after diverticulitis flare-ups, a low-FODMAP diet may reduce gas and digestive strain, helping alleviate symptoms like bloating and discomfort.
Low-FODMAP Foods to Include:
- Lean proteins (chicken, fish)
- Gluten-free grains (quinoa, rice)
- Low-FODMAP fruits (bananas, berries)
- Certain vegetables (carrots, courgette, spinach)
High-FODMAP Foods to Avoid:
- Garlic, onions
- Wheat, rye
- Dairy (unless lactose-free)
- High-FODMAP fruits (apples, pears)

A low-FODMAP diet is usually done as a short-term elimination diet, where foods are gradually reintroduced to identify triggers. It may be especially helpful during periods of digestive sensitivity following a diverticulitis flare-up.

What to Eat for Long-Term Management

Whole grains: Brown rice, whole wheat bread, quinoa, oats, and barley are all excellent sources of fibre, which helps regulate digestion.
Fruits and vegetables: Aim for at least five portions a day. Fresh, frozen, or canned options (without added sugar) provide essential vitamins and antioxidants.
Legumes: Beans, lentils, chickpeas, and peas are great sources of fibre and protein.
Nuts and seeds: Despite old myths, these foods are safe to eat and provide valuable fibre, healthy fats, and nutrients.
Water: Staying hydrated is essential to help fibre work effectively. Without enough water, fibre can actually lead to constipation.

What to Avoid

Processed foods: These are often high in refined sugars and unhealthy fats, making them difficult to digest and potentially irritating to the gut.
Red and processed meats: Research suggests that high consumption of red or processed meats may increase the risk of diverticulitis complications.
Alcohol and caffeine: Both substances can irritate the digestive tract. Monitoring your intake can help prevent flare-ups.

Supplements and Compounds That May Help

In addition to dietary changes, the following supplements and natural compounds may support gut health and help prevent future diverticulitis flare-ups, but listen to your body:

Slippery Elm: Known for its soothing properties, slippery elm can help reduce inflammation and irritation in the digestive tract.
Psyllium Husk: A natural fibre supplement derived from the seeds of the Plantago ovata plant. It can help regulate bowel movements and prevent constipation, which is a common trigger for diverticulitis flare-ups. You can try and incorporate into foods or start with half a teaspoon of psyllium in a glass of water or juice, and gradually increase the dosage.
Probiotics: Some studies suggest that probiotics can help maintain a healthy gut microbiome. They can be found in fermented foods like yoghurt, kefir, sauerkraut, and kimchi, or taken as a supplement.
Omega-3 Fatty Acids: Found in fatty fish like salmon, flaxseeds, and walnuts, these have anti-inflammatory properties and may help reduce gut inflammation.
Aloe Vera Juice: Aloe vera is known for its soothing properties and may help reduce irritation in the digestive tract. Some people with diverticulitis find that small amounts of aloe vera juice help manage symptoms.

A Two-Week Mock Diet Plan for Diverticulitis Flare Up and basic Management

This mock diet plan is an idea of foods designed to help manage symptoms and prevent future flare-ups by focusing on high-fibre, gut-friendly foods, and avoiding known irritants like spicy foods, caffeine, and alcohol.

Week 1: Gradual Introduction of Fibre
- Day 1-3 (Clear Liquid Diet):
  - Breakfast: Herbal tea (like chamomile or peppermint) and apple juice (without pulp)
  - Lunch: Clear vegetable broth with no solid particles
  - Dinner: Clear chicken broth
  - Snacks: Ice chips or ice lollies (without fruit pieces)
- Day 4-7 (Low-Fibre Diet):
  - Breakfast: Scrambled eggs with white toast (no butter)
  - Lunch: Grilled chicken breast and mashed potatoes (without skins)
  - Dinner: White rice with steamed carrots or green beans (peeled and softened)
Week 2: Reintroducing Fibre for Long-Term Management
- Day 8-10 (Soft, Fibre-Rich Foods):
  - Breakfast: Porridge made with water, topped with a small portion of mashed banana
  - Lunch: Quinoa and soft-cooked vegetables like courgette and carrots
  - Dinner: Baked salmon with brown rice and steamed spinach (softened)
- Day 11-14 (High-Fibre Diet):
  - Breakfast: High-fibre cereal (such as bran flakes) with almond milk and blueberries (softened)
  - Lunch: Lentil soup with whole wheat bread
  - Dinner: Grilled chicken breast with roasted sweet potatoes (skins on) and quinoa

Could Herbal Remedies Help?

In my previous article, Eat Myself Happy, I explored natural remedies like saffron to improve mental well-being. For digestive health, herbs like chamomile and slippery elm can soothe the digestive system and reduce inflammation.

Some traditional remedies that may help with diverticulitis include:

Aloe Vera (Egypt & India): Used for its anti-inflammatory properties to calm the digestive tract.
Turmeric (India): The active compound, curcumin, helps reduce inflammation in the gut.
Liquorice Root (Traditional Chinese Medicine & Middle East): Often used to reduce inflammation and promote gut healing.
Ginger (Asia & Africa): Helps reduce nausea and bloating.
Slippery Elm (Native American Traditional Medicine): Forms a soothing gel when mixed with water to reduce irritation in the digestive tract.
Chamomile (Europe & Middle East): Traditionally used to soothe cramps and inflammation in the digestive system.

Is there any New Treatments on the horizon?

There have been a few promising developments in treating diverticulitis in recent years, However traditional management with diet, antibiotics, and sometimes surgery remains the cornerstone of treatment.

Here are some of the newer treatment approaches I’ve read about being explored or implemented:

Targeted Antibiotic Use
In the past, antibiotics were prescribed for nearly all cases of diverticulitis, even mild ones. However, recent studies suggest that antibiotics may not always be necessary, especially in uncomplicated cases. Some doctors now recommend watchful waiting or limited antibiotic use for mild diverticulitis, focusing on managing symptoms rather than immediately resorting to medication. This approach reduces unnecessary antibiotic exposure and is in an effort to help in reducing antibiotic resistance.
Probiotics and Gut Microbiome Therapy
Probiotics, which help restore a healthy balance of bacteria in the gut, are being increasingly studied for their potential role in preventing diverticulitis flare-ups. A healthy gut microbiome may lower inflammation and reduce the risk of future attacks. While more research is needed, some studies suggest that taking probiotics regularly, particularly strains like Lactobacillus and Bifidobacterium, might reduce the recurrence of diverticulitis.
Mesalamine
Mesalamine is an anti-inflammatory drug traditionally used for conditions like Crohn’s disease and ulcerative colitis. Some studies have explored its use in preventing diverticulitis flare-ups by reducing inflammation in the colon. However, the results are mixed, and while it’s not widely adopted for diverticulitis, it’s an area of ongoing research.
Dietary Fibre Supplements
Increasing fibre intake has long been a standard recommendation for preventing diverticulitis, but new studies suggest that specific fibre supplements, like psyllium husk, may be more effective than just relying on dietary fibre alone. Psyllium husk supplements can bulk up stool and ease passage through the intestines, reducing pressure in the colon. This approach is especially beneficial for people who find it challenging to consume enough fibre through diet alone.
Minimally Invasive Surgery
For people with recurrent or complicated diverticulitis, surgery may be needed. The good news is that minimally invasive surgical techniques, such as laparoscopic surgery, have become more advanced, leading to faster recovery times, smaller scars, and less post-operative pain compared to traditional open surgery. This technique can be especially useful for removing damaged sections of the colon while preserving as much healthy tissue as possible.
Stem Cell Therapy
I do find this area of medicine fascinating! Although still in the early stages of research, stem cell therapy has been explored for treating various inflammatory conditions, including diverticulitis. The idea is that stem cells could help repair damaged tissue in the colon and reduce inflammation, but this approach is still largely experimental and not yet a mainstream treatment.
Fecal Microbiota Transplantation (FMT)
Fecal microbiota transplantation is an emerging treatment that involves transplanting healthy stool (and the beneficial bacteria it contains) from a donor into a patient’s digestive system. This therapy has shown promise for conditions like Clostridium difficile infections and inflammatory bowel disease (IBD), and research is ongoing to see if FMT could help manage chronic diverticulitis by improving gut flora balance and reducing inflammation. It is still experimental for diverticulitis but is a field to watch for future developments.
Anti-TNF Agents
Anti-TNF (tumour necrosis factor) agents, which are used to treat inflammatory conditions like Crohn’s disease, have been studied in severe cases of diverticulitis to reduce inflammation. Though not widely used yet, they might be considered for patients with chronic, recurrent diverticulitis that doesn’t respond to conventional treatments.
Dietary Modification Using Specific Carbohydrates
Some researchers are exploring the potential role of low-FODMAP diets (a diet low in certain fermentable carbohydrates) for diverticulitis management. This diet has been shown to help with other gastrointestinal disorders like IBS, and reducing certain types of carbohydrates might help lessen symptoms during flare-ups. However, more research is needed to confirm its benefits for diverticulitis specifically.

Conclusion and Support Groups

Diverticulitis can be managed effectively through diet, lifestyle changes, and, when necessary, medications or natural supplements. The way to manage it long-term is to focus on a balanced, high fibre diet, plenty of hydration, and avoiding known irritants like alcohol and spicy foods.

Support Groups can be valuable resources for those managing diverticulitis and offer further more in depth advice:

In the UK:
- Guts UK: gutscharity.org.uk
- NHS Support: NHS Diverticulitis Resources
In the USA:
- Gastrointestinal Society: badgut.org
- Cleveland Clinic Diverticulitis Resources: Cleveland Clinic

By following these dietary and lifestyle guidelines, you can better manage diverticulitis and reduce the risk of future flare-ups. For more information on using natural remedies to support digestive health, check out my article Can I Eat Myself Happy?

Explore More on Life Without Limits

If you found this article helpful, be sure to explore more on Life Without Limits. Discover my journey through IPH, Celiac Disease, GERD, and more. Check out my other insightful posts on Managing GERD, Celiac Disease Tips, and Health & Wellness Resources. Join me as we navigate the challenges of chronic illness together.