Digestive Health and Complications of a Low-Fiber Diet: What is Diverticulosis?

Patient Expert

Recently I learned something new about myself.   Not anything extraordinary or shocking, but it does involve my health.   Following a colonoscopy on Friday morning, a doctor discovered that I have diverticulosis.

What is diverticulosis?

In the lining of the colon or lower portion of the large intestine, small pouches or sacs which bulge outward can develop in weak spots of the colon wall.   Each pouch is called a diverticulum.   When a person has several pouches, they have the condition called diverticulosis.   Uncommon in younger adults, about 10 percent of Americans older than 40 have the condition.   Diverticulosis becomes more common as people age and an estimated 50 percent of Americans over the age of 60 have the condition.

Diverticulosis usually causes no symptoms.   However, some people may experience mild symptoms, including bloating, gas, nausea, and constipation, alternating with diarrhea, and tenderness or pain, most often in the lower left portion of the abdomen.   These symptoms can also be associated with other conditions such as irritable bowel syndrome.   Certainly discuss with your doctor if you are experiencing any of these symptoms.

What causes diverticulosis?

Diverticulosis is usually caused by chronically increased pressure and strain on the colon wall.   A common contributing factor to the development of diverticulosis is constipation, something which we all have experienced at some point in our lives I imagine.   Constipation may cause people to strain when passing stool during a bowel movement.   The straining may cause increased pressure in the colon which contributes to the small herniations of the colon wall.   Hereditary factors and lack of exercise may also be associated with diverticulosis.

I've learned that diverticulosis is rare in rural Asia and Africa where people regularly eat high-fiber diets.   It is believed that a diet low in fiber is the primary contributing factor to the development of the condition.   In Western industrialized countries, especially the United States, England, and Australia, we commonly do not eat enough foods rich in fiber.

Is diverticulosis dangerous?

According to an 2006 article in the Journal of Clinical Gastroenterology, ten to 25 percent of people with diverticulosis develop diverticulitis, an inflammation or perforation of the pouches.   Severe abdominal cramping with pain and tenderness, usually on the lower left side, is the most common symptom.     The pain is often sudden and severe, but may starting gradually and increase of several days.   Other symptoms may include nausea, vomiting, fever, chills, or a change in bowel habits.

Possible complications from diverticulitis include bleeding, infections, abscess, small tears (perforations), peritonitis (inflammation of the lining of the abdominal cavity, which may be fatal unless treated immediately), fistula, or blockages in the colon.   These always require treatment to prevent them from progressing.   For more information on diverticulitis and its treatments, please refer to the sources listed below.

Fortunately, I haven't experienced diverticulitis but a close relative has.   He was very sick and in a great deal of pain.

How is diverticulosis treated?

In most cases of diverticulosis, a high-fiber diet and pain medications help to relieve symptoms.   Mild diverticulitis may be treated with rest, oral antibiotics and a liquid diet for a recommended period of time.   Sometimes a very serious attack of diverticulitis may require a hospital stay, IV antibiotics, and possible surgery.

My doctor pointed out that existing diverticula (the pouches) cannot be healed.   However, it is possible to prevent the formation of new pouches.   A high-fiber, low-fat diet will help prevent constipation by making stools soft and easy to pass, while decreasing pressure in the colon.   Drinking plenty of fluids will also help to soften stools.   Regular exercise will help to keep you "regular."

Getting Enough Fiber

The American Dietetic Association recommends that adults should eat 20-35 grams of fiber each day, an amount much greater than the typical American diet.   To get more fiber, we should eat whole-grain breads and cereals; fruits such as apples, pears, blackberries, and figs; vegetables such as broccoli, corn, peas, spinach, and squash; and starchy vegetables such as kidney beans, black beans, lentils, and chickpeas.

For an extensive list of foods and their fiber content, consult the Fiber Content Chart found on New York's Continuum Health Partners website.   I was pleased to learn that my favorite fruit, dried figs, has 3.5 grams of fiber each.   Yum!

So, not only should I be getting more fiber to help with losing weight, or to help with eliminating constipation, I should be eating more fiber to prevent the development of more pouches in my colon.   This new information (diagnosis) has made the necessity of the matter even more important.

SOURCES: National Digestive Diseases Information Clearinghouse by NIDDK (NIH) - Diverticulosis and Diverticulitis

Johns Hopkins Health Alert - Diverticulosis and Diverticulitis

Bowel Function - Dietary Fiber by Warren Enker, MD, Beth Israel Medical Center

December 5, 2010
Weight: 229.3 lbs
Blood Pressure: