By John Messmer, MD

The term "diverticulosis" means that diverticuli have developed in the intestine. Most often they are found incidentally when a screening colonoscopy is performed when someone turns 50 or if a lower GI X-ray is done to investigate some symptom. During a colonoscopy procedure, the doctor can see the openings into the pockets; and on a lower GI study, liquid contrast material which is passed into the colon fills the pockets so they can be seen on X-ray.

The diverticuli can cause mild cramping after meals, during a bowel movement, or at other times. Since many things can cause these symptoms, it takes an examination to determine if the problem is due to diverticulosis.

Moderate to severe cases of diverticulitis

Diverticulitis refers to inflamed diverticuli. This is more serious and can lead to hospitalization because the diverticuli are infected and may rupture or bleed. Physicians can often diagnose mild cases by examining a person's abdomen and finding the swollen and tender colon in the left lower abdomen. It is a mild case if there are no signs of infection outside the intestine, if there is minimal to no fever, and if the person is able to drink fluids.

Treatment of moderate to severe cases of diverticulitis

Mild cases can be treated at home by putting the intestines to rest on a clear liquid diet and taking the proper antibiotics. Many times acute diverticulitis requires hospitalization on intravenous antibiotics and bowel rest for days or weeks. Surgery may be needed to clean out the infection and remove the affected bowel. Sometimes a person is given a colostomy to divert the intestinal contents out to a bag so the infected part of the bowel is isolated until it heals. Then it is removed and the intestine is reattached to eliminate the colostomy.

Diverticulitis, diverticulosis, and diet

For years a common recommendation for people with diverticulosis has been to avoid nuts, seeds, and vegetables with husks like corn. People with diverticulosis were also encouraged to eat a low-fiber diet. That is no longer the case. Physicians recommend avoiding only those foods that cause symptoms. As long as there is fiber from a variety of sources in the diet, the diverticuli should be less a problem. We need both gum fiber from fruits and vegetables and bran fiber from grains and seeds to make the contents of the colon the proper consistency. Eating a large bag of popcorn because it has fiber without balancing it with vegetables, fruits, and fluids could provoke trouble.

For more information on a recommended diet to prevent diverticulosis see the following article from TheDietChannel: Diverticulosis, Diverticulitis & Diet.

Diverticulitis, diverticulosis, and activities

Most diverticulitis or diverticulosis is located in the sigmoid colon, which is in the lower left abdomen. As long as it is not inflamed, the abdomen should not be more sensitive to pressure. The colon is far enough away from the other pelvic organs that a woman should not have any difficulty with intercourse unless she has an enlarged uterus that also presses on the colon.

There should be no reason to restrict activity. Most times, exercise may continue as usual. Occasionally, bouncing could cause some discomfort, so some people may find running a problem. However, cycling, rowing, walking, and most other exercises should be well tolerated. If any activity consistently causes pain, a doctor should be consulted rather than just assuming it is the diverticulosis causing the problem. Pain from the uterus and ovaries, prostate, bladder, aorta, kidneys, and pancreas can mimic diverticular pain so it is important to get an accurate diagnosis.

You can prevent diverticulitis and diverticulosis!

As with most health conditions, prevention is better than treatment. A rule of thumb for food fiber is that plants are the source. A variety of plant sources is best so different types of vegetables and fruits should be included throughout the week in amounts appropriate for the number of calories needed. Fruits, nuts, and seeds should be added here and there. Beans, lentils, and other legumes are highly nutritious in addition to providing significant amounts of fiber. Whole grains can also fit into the weekly diet to round it out. For those who do not eat that much food, such as the elderly or those who cannot be as active, a fiber supplement is a reasonable addition.

A healthy body and properly functioning intestine means proper food choices. It is relatively easy and is much more interesting than the same bland, low-fiber stuff that too many Americans call a diet.

For more information see Foods to Avoid if you have Diverticulosis.