Diverticulosis (Diverticular Disease)

Diverticulosis is a condition in which small pouches, or diverticula, protrude from a weakened segment of the colon wall. Many people have no symptoms. Others experience occasional mild pain or diarrhea or blood in the stools. But if waste material clogs one or more of the pouches, diverticulitis, an inflammation characterized diverticula by fever, bleeding, intense pain, and general malaise, may develop. If diverticulitis goes untreated, serious complications can arise, such as perforation of the intestine, which may lead to peritonitis, a life-threatening inflammation of the membrane that lines the abdominal cavity.

Diagnostic Studies and Procedures

When a doctor suspects diverticulitis, he may order a colonoscopy, inspection of the lining of the colon with a flexible tube that has special viewing devices. He may also have a stool sample tested for hidden, or occult, blood.

Medical Treatments

Uncomplicated diverticulosis is usually treated conservatively. A high-fiber diet is generally recommended, as well as laxatives if constipation is part of the problem. Antibiotics will be prescribed to treat any infection. When the infection is severe or heavy bleeding occurs, surgery may be necessary to remove the diseased part of the colon. In especially severe cases, the entire colon may have to be removed, but this can usually be done in such a way that normal bowel function will be retained.

Alternative Therapies

Alternative therapies should be used only as adjunctive treatments.

Ayurveda. A series of cleansing enemas may be given to clear the colon. The diet is then adjusted to prevent constipation, which promotes diverticulitis.

Herbal Medicine. Chamomile, papaya, and red clover -- consumed either as teas or extract capsules -- are among the herbs recommended for diverticulitis. Some herbalists advocate two cups of pau darco tea daily to alleviate intestinal inflammation and abdominal cramps. Psyllium seeds, included in many stool softeners, may also be prescribed, but a doctor should be consulted before taking these.

Nutrition Therapy. Diet plays an important role in prevention and treatment of diverticular disease. A low-fiber, high-fat diet increases the risk of diverticulitis, and research indicates that increased fiber intake helps prevent its symptoms in those who have diverticulosis. Spicy or seedy foods should be avoided. Supplements of vitamins A, E, and C, as well as garlic capsules, are sometimes suggested.

A flare-up of diverticulitis calls for a bland, pureed diet devoid of raw fruits and vegetables, alcohol, and caffeine. A psyllium seed laxative may be recommended to prevent constipation. A high-fiber diet can be resumed a month after all symptoms subside.

Self-Treatment

Once diverticula form, they cannot be eliminated, but diligent self-care can prevent acute diverticulitis. In addition to following dietary recommendations, drink at least eight glasses of fluids a day to keep stools soft. Allow yourself a minimum of 10 minutes for a bowel movement at about the same lime each day, but do not strain. (See a doctor if your stool is black, or if you have fever or severe pain.) Exercise helps prevent constipation; make it part of your dairy routine There also appears to be a relationship between diverticulitis, a sedentary lifestyle, and obesity.

Other Causes of Abdominal Pain

Appendicitis causes acute abdominal pain and cramping. Colon polyps, colon or rectal cancer, and inflammatory bowel disorders can bring about bloody stools and altered bowel habits.