Also indexed as: Diverticulitis, Diverticulosis
Adhering to a high-fiber diet is one key to keeping diverticular
disease at bay. According to research or other evidence, the following self-care steps may
help you manage this digestion disorder:
- Recognize the warning signs
- Seek immediate medical attention if you develop symptoms such as
painful abdominal cramping, fever, and nausea
- Diet right
- Help prevent the disease by eating a high-vegetable, high-fiber,
and low-meat diet
- Get moving
- Start a regular program of physical activity, such as jogging, to
help prevent symptomatic diverticular disease
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full diverticular disease
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About diverticular disease
Diverticular disease is a condition of abnormal pouches in portions of the colon.
High pressure inside the intestine may cause these outpouchings (called diverticula) to
develop in areas of weakness within the wall of the colon.1 The development of
these pouches is called diverticulosis. Rarely, diverticula may also occur in the stomach or
small intestine. When the pouches become inflamed (often as a result of bacterial infection), symptoms such as cramping pains, fever,
and nausea can result.2 Such an infection (called diverticulitis) is potentially
life-threatening and requires immediate medical intervention. Diverticular disease becomes
increasingly common as people age and is a malady of 20th-century western society, primarily
due to the consumption of a low-fiber diet.3
Product ratings for
diverticular disease
What are the symptoms?
People with diverticular disease may or may not have abdominal cramps, bloating, constipation, and tenderness or pain, especially along
the lower left side of the abdomen. When there is an active infection, there may also be
fever, chills, nausea, and vomiting.
Medical options
Over-the-counter fiber supplements such as
methylcellulose (Citrucel), polycarbophil calcium (FiberCon), and psyllium (Metamucil) are often recommended.
Serious cases may be treated with prescription drugs, including intravenous antibiotics such as cefazolin (Ancef), cefamandole (Mandol), amikacin (Amikin); pain medication in combination with
acetaminophen, such as codeine (Tylenol with Codeine), hydrocodone (Vicodin, Lortab), oxycodone (Percocet); and intestinal antispasmotics
such as hyoscyamine (Levsin, Levbid).
Injections of vasopressin may be used to control bleeding diverticula.
For mild conditions, healthcare practitioners typically recommend adequate fluid intake and
a high-fiber diet. Some severe cases might require a liquid diet or surgical removal of the
affected portion of the colon. Giant diverticula always require surgery.
Dietary changes that may be helpful
Dietary factors influence the frequency and severity of diverticular disease recurrences. A
diet high in fiber has been shown to be
protective against diverticular disease.4 One study of food intake revealed a 50%
increase in incidence of diverticular disease in people eating a diet high in meat and low in vegetables relative to those eating a high-vegetable
and low-meat diet.5 In addition to helping prevent the disease, a high-fiber diet may also be useful as a treatment for
diverticular disease.6
Lifestyle changes that may be helpful
Obesity may be associated with increased
severity of diverticular disease.7 Studies have yet to be conducted to determine if
weight loss decreases signs and symptoms of diverticular disease in patients who are
overweight.
Physical activity, specifically jogging or running, has been reported to protect against
symptomatic diverticular disease.8 While the reason for its positive effect is not
known, exercise is associated with reduced symptoms of a variety of other diseases of the
colon.
Vitamins that may be helpful
In people with diverticular disease, a
fiber supplement may improve constipation.
The results of double-blind of fiber supplementation for diverticular disease have been mixed.
One study9 demonstrated a beneficial effect of fiber supplementation in people who
suffered from abdominal pain and pain with bowel movements; whereas a second
study10 indicated no improvement in these symptoms following fiber supplementation.
Nevertheless, long-term fiber supplementation may protect against the complications of
diverticular disease.11
Glucomannan is a water-soluble dietary
fiber that is derived from konjac root (Amorphophallus konjac). A preliminary
clinical trial found that approximately one-third to one half of people with diverticular
disease had reduced symptoms of diverticular disease after taking glucommanan.12
The amount of glucomannan shown to be effective as a laxative is 3–4 grams per day.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
A preliminary trial of the herb psyllium
supports the use of this type of fiber in relieving the symptoms associated with diverticular
disease and constipation.13
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References:1. Halphen M, Blain A. Natural history of diverticulosis. Rev
Prat 1995;45:952–8 [in French].
2. Thompson WG, Patel DG. Clinical picture of diverticular disease of the
colon. Clin Gastroenterol 1986;15:903–16.
3. Ozick LA, Salazar CO, Donelson SS. Pathogenesis, diagnosis, and
treatment of diverticular disease of the colon. Gastroenterologist 1995;6:55–63
[review].
4. Handler S. Dietary fiber: Can it prevent certain colonic diseases?
Postgrad Med 1983;73:301–7.
5. Manousos O, Day NE, Tzonou A, et al. Diet and other factors in the
aetiology of diverticulosis: an epidemiological study in Greece. Gut
1985;26:544–9.
6. Elfrink RJ, Miedema BW. Colonic diverticula. When complications
require surgery and when they don’t. Postgrad Med 1992;92:97–8,
101–2, 105, 108.
7. Ozick LA, Salazar CO, Donelson SS. Pathogenesis, diagnosis, and
treatment of diverticular disease of the colon. Gastroenterologist 1995;6:55–63
[review].
8. Aldoori WH, Giovannucci EL, Rimm EB, et al. Prospective study of
physical activity and the risk of symptomatic diverticular disease in men. Gut
1995;36:276–82.
9. Smits BJ, Whitehead AM, Prescott P. Lactulose in the treatment of
symptomatic diverticular disease: a comparative study with high-fibre diet. Br J Clin
Pract 1990;44:314–8.
10. Ornstein MH, Littlewood ER, Baird IM, et al. Are fibre supplements
really necessary in diverticular disease of the colon? A controlled clinical trial. Br Med
J (Clin Res Ed) 1981;25:1353–6.
11. Leahy AL, Ellis RM, Quill DS, Peel AL. High fibre diet in symptomatic
diverticular disease of the colon. Ann R Coll Surg Engl 1985;67:173–4.
12. Papi C, Ciaco A, Koch M, Capurso L. Efficacy of rifaximin in the
treatment of symptomatic diverticular disease of the colon. A multicentre double-blind
placebo-controlled trial. Aliment Pharmacol Ther 1995;9:33–9.
13. Ewerth S, Ahlberg J, Holmstrom B, et al. Influence on symptoms and
transit-time of Vi-SiblinR in diverticular disease. Acta Chir Scand Suppl
1980;500:49–50.