Diver, tickle, what?
Diverticulitis is one of the conditions under the umbrella term of ‘diverticular disease’. Diverticulitis is a progression of diverticulosis. A person who has diverticulosis may not even know that they have it; diverticulosis occurs when the lining of the large intestine herniates, ballooning out, and forms little out pouches or ‘pockets’. This condition on its own may not be a concern for a person.
Problems can arise however, when faecal matter gets trapped and compacted in these little intestinal lining pockets. As the name diverticulitis suggests, remembering that “-itis” suggests infection or inflammation, there is an infection and inflammation of the diverticula. If left unmanaged, diverticulitis can cause perforation of the bowel, making someone very sick.
What to look for – Diverticulitis signs and symptoms.
As mentioned above, diverticulosis can be asymptomatic for most individuals; it’s only once the condition progressed that signs and symptoms start to occur. Since diverticulitis is an infection and inflammation, we’re looking at some usual indicators: fever and lack of appetite may be experienced. Other signs or symptoms include: excess farting, seeing blood or mucous in your stools, and noticing changes in your bowl habits – could be diarrhoea or constipation. You might experience nausea, vomiting or abdominal pain.
The thing to remember is some of these signs and symptoms can be pretty vague, and could be almost anything. What I ask in clinic is – “ Is this symptom new for YOU?”, “is this a CHANGE to your normal habits?”. By asking this we can start to see if this is a chronic picture, or an acute change. A change in your usual bowel habits warrants further consideration.
Getting a diagnosis.
So now that we’ve noticed some new or changed signs and symptoms, how do we get to a diagnosis? A GP might do a standard blood test and see that the White Blood Cells (WBC) are suggesting there is an infection in your body. A blood test for Red Blood Cells (RBC) and Iron studies will show if there is perhaps some internal bleeding, creating low iron. Finally, a blood test for inflammation might come back positive, in this case we are looking at CRP and ESR. Whilst this blood tests will help confirm that there is a problem, they can’t pinpoint exactly what is causing it.
To confirm diverticulitis, visual laboratory investigations need to take place. These test may include a barium enema, ultrasound, CT scan, or a colonoscopy. These tests will be looking for the diverticula (out pouches), as well as showing if there is anything stuck in them. The visual tests are also looking for any abscesses, fistulas, or overt bowel obstructions. Usually the findings from one or more of these tests is enough to rule out, or confirm, diverticulitis.
Nutrition goals for Diverticulitis.
Using food as medicine in diverticulitis is aimed at preventing infection and inflammation. The main treatment aim is to improve gut motility and transit time, as constipation is a major risk factor for this disease. A more efficient transit time also reduces the rate of faecal matter collecting and compacting in the out pouches.
If you’ve read my previous blog on constipation, you might be familiar with the following three nutritional goals:
- High fibre diet – aim for 28-34 grams per day.
- Increase hydration – in diverticulitis, aim for 2.5L per day.
- Reduce saturated fats and red meat – staples for the Modern Western World diet.
Do you have diverticulitis, or other diverticular disease? Would you like to work one on one with me to get things moving again? Make yourself a booking for a complementary 15 minute phone call, to see if we’re a good fit.