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“I was told I have diverticulosis! What do I need to know?”

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Q

My colonoscopy didn’t find any polyps—which is good. But it did find diverticulosis. Should I be concerned? Anything I should do?

A

Diverticulosis is very common in the US, largely because so many Americans do not eat enough fiber. About half of adults in the US have diverticulosis by age 60—and nearly everyone over 80 has it.

Diverticulosis is a condition in which small pouches, called diverticula, form in the inner wall of the colon and bulge outward. Most diverticula cause no problems and are only found during a colonoscopy, barium enema or other such test for an unrelated condition.

Sometimes, though, diverticula can cause mild symptoms such as cramps, bloating and constipation. Increasing the amount of fiber in your diet can help ease symptoms and can help keep new pouches from forming.

Doctors used to advise patients with diverticulosis to avoid popcorn, nuts, seeds and certain other foods because they thought that small pieces of these foods might get trapped in the pouches and cause infection. The latest research has found that such foods do not get stuck in diverticula—and are not only safe to eat but are healthy sources of fiber.

If bacteria leak through a diverticulum wall, however, the pouch can become infected or inflamed—and when it does, the condition is called diverticulitis. Let your doctor know if you have symptoms that include abdominal pain (most often, but not always, on the left side), fever, nausea, severe cramping and/or a change in bowel movements. Diverticulitis is usually treated with antibiotics and a liquid diet for a few days to give the colon a rest. You may also need to stick to a low-fiber diet during flare-ups of symptoms because fiber may be too irritating to the inflamed tissue. That means eating only foods such as chicken and potatoes without skins.

Occasionally, a tear of a blood vessel in a diverticular pouch can cause gastrointestinal bleeding—a serious, potentially life-threatening condition. The bleeding may stop by itself or may necessitate diagnosis and treatment of the bleeding blood vessel via colonoscopy and radiological or surgical repair. A perforated pouch can also form an abscess and need to be drained, a hospital procedure.

The best way to keep your diverticulosis from causing problems is to be sure to consume enough fiber. Aim for 25 grams (g) to 30 g daily. Good sources of fiber include beans, whole grains, fruits and vegetables. Discuss with your doctor whether taking fiber supplements is a good idea for you. Exercising—moderate to brisk walking is a good choice—for at least 30 minutes a day, five days a week helps keep bowel movements regular, which reduces risk for diverticular problems. Keeping your gut healthy with probiotic foods such as yogurt or with a probiotic supplement can help. Look for yogurt that contains live cultures and a supplement that contains at least five billion colony forming units (CFUs) of bifidus and five billion CFUs of acidophilus.

Source: Anil Minocha, MD, professor of medicine and chief of gastroenterology, Overton Brooks VA Medical Center, Shreveport, Louisiana. Dr. Minocha is author of Dr. M’s Seven-X Plan for Digestive Health. Date: July 21, 2018 Publication: Bottom Line Health
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