Diverticulosis is a common gastrointestinal issue that is often found on screening colonoscopy. It appears that diverticulosis increases with age and while premenopausal women seem to be at lower risk, the incidence of this condition increases in women during menopause. Diet, sedentary lifestyle and likely hormones seem to have an effect on the progression of diverticulosis.
Diverticulosis, typically asymptomatic, seems to form when the colonic mucosa and submucosa herniate through the vascular portals in the intestinal lining. The most common complications of colonic diverticulosis is acute diverticulitis which is characterized by inflammation localized to the diverticulum and the surrounding mucosa. Typically acute diverticulitis is self limiting, meaning in 20% of cases, the episode will resolve itself. However antibiotics are generally prescribed to manage the condition. Chronic gastrointestinal symptoms are common after an episode of diverticulitis.
Hypothesis of Fiber Deficiency
In the 1970s, it was theorized that low fiber diets contributed to diverticulosis. It appeared that diverticulosis was rare in countries with high fiber diets. However more recent studies showed that neither constipation or fiber intake were associated with an increased risk of colonic diverticulosis.
What May Causing the Issue
Diverticula, which are outpouchings of colonic mucosal tissue into the connective tissue, seem to be at the root of the issue. As such inherited connective tissue disorders such as Marfan syndrome can be associated with diverticulosis.
Hormones can also be at play with diverticulosis risk. Premenopausal women as compared to older women had a higher incidence of diverticulosis. This may mean that hormones are seen to protect women from intestinal lining issues. Obesity was also a factor in diverticulosis due to decreasing circulating estrogen and increasing free testosterone.
Compelling Evidence that Diet and lifestyle Contribute to Risk
What seems to be contributing to the incidence of diverticulitis is age, female sex, diet and lifestyle more than anthing else. With increasing age comes the risk of diverticulosis. Women over 60 years of age for example are at higher risk than younger women.
Another factor appears to be a Western diet (including low dietary fiber and high red meat intake). When coupled with low physical activity, a diet that is not rich in phytonutrients and good quality fats can increase the incidence of diverticulosis. The underlying issue tends to be dysbiosis or disordered gut flora. Antibiotics use can also leads to an unbalanced microbial community precipitating the progression of the disease.
An Approach to Managing Diverticulosis
While only useful under the guidance of a healthcare professional, here are some considerations for diverticulosis:
- Avoid non steroidal anti-inflammatory drugs such as Advil, Motrin or Aleve, which can be damaging to the gastrointestinal tract
- Avoid alcohol
- Keep a Diet diary for 7 days as IgG mediated food sensitivities may be part of the issue
For acute episodes:
- Rest is recommended
- Water, tea or clear broths only
- Avoid cooking in oil for a period of time
- Turmeric or curcumin can also be useful
- Homeopathic remedies
- Slippery elm gruel to sooth and help heal tissues: 1.5 tsp to 1-2 cups of hot water; let cool and take 3 times per day
Other considerations can be:
- Mixed gut soothing formulas such as L-glutamine, N-acetylglucosamine, citrus pectin, deglycyrrhizinated licorice and other soothing herbs
- FIsh oil
- Castor oil packs
Long term treatment:
Another consideration can be The Metabolic Balance ® Program is a unique nutritional system. The program, which is based on the patient’s blood markers, allows the gut to heal during a 2 week detoxification process in which no oils are recommended. This period of detoxification is healing for the gut while not depriving the patient of any major food group.
For more information please contact Dr. Gupta, ND