Natural treatments for diverticular disease

Definition: Treatment of infected or inflamed pouches in the large intestine.

Principal proposed treatments: None

Other proposed treatments: Fiber supplements psyllium, glucomannan, methylcellulose

Introduction

Almost one-half of all Americans older than age sixty years develop diverticulosis: small, bulging pouches (diverticula) in the colon. In most cases, these diverticula do not cause any discomfort. However, in perhaps 15 percent of people with diverticulosis, diverticula may become inflamed or infected. The result is a condition called diverticulitis. Symptoms of diverticulitis include pain, nausea, and sometimes fever.

It is thought that the main cause of diverticulosis is the relatively low-fiber diet consumed in developed countries. Fiber is critical to digestion because it softens stools and makes them pass through the bowel more easily. Factors that cause diverticulitis include increased pressure in the bowel from straining to pass a hard stool, defects in the colon wall, and chronic constipation. The conventional treatment of diverticulitis includes dietary changes and antibiotics, and sometimes surgery.

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Proposed Natural Treatments

Fiber supplements have shown promise for both preventing and treating diverticulosis and diverticulitis. Studies suggest (but do not prove) that diets high in fiber and low in total fat and red meat may help prevent diverticular disease. Furthermore, high fiber consumption may help prevent diverticulitis from developing in people with diverticulosis. However, this has not been proven, and the results of the scant published controlled trials on the topic have been inconsistent.

Common fiber supplements used to treat the condition include psyllium, glucomannan, and methylcellulose. However, the use of fiber supplements during an active bout of diverticulitis is not advisable, because the colon needs to rest.

Contrary to some reports, there is no evidence that obesity or consumption of caffeine or alcohol increases the risk of diverticular disease. However, high levels of physical activity may reduce the risk of developing the condition.

Bibliography

Aldoori, W., and M. Ryan-Harshman. “Preventing Diverticular Disease: Review of Recent Evidence on High-Fibre Diets.” Canadian Family Physician 48 (2002): 1632-1637.

Feldman, Mark, Lawrence S. Friedman, and Lawrence J. Brandt, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. New ed. 2 vols. Philadelphia: Saunders/Elsevier, 2010.

Murray, C. D., and A. V. Emmanuel. “Medical Management of Diverticular Disease.” Best Practice and Research: Clinical Gastroenterology 16 (2002): 611-620.

Ornstein, M. H., et al. “Are Fibre Supplements Really Necessary in Diverticular Disease of the Colon?” British Medical Journal (Clinical Research Edition) 25 (1981): 1353-1356.

Pogacnik, Dr. Javier Salgado. "Living with Diverticulitis: Get the Full Scope of Symptoms, Treatment, and Prevention." UT Southwestern Medical Center, 6 Oct. 2021, utswmed.org/medblog/diverticulitis-symptoms-treatment/. Accessed 14 Dec. 2022.

Smits, B. J., A. M. Whitehead, and P. Prescott. “Lactulose in the Treatment of Symptomatic Diverticular Disease: A Comparative Study with High-Fibre Diet.” British Journal of Clinical Practice 44 (1990): 314-318.