Diverticulitis may be on the rise: Diet can decrease risk

September 12, 2018

Providence Health Team

[3 MIN READ]

Studies have shown that diverticulitis has increased significantly since 2000 and poor diet and obesity may be part of the problem.
Nearly every American over 80 has some diverticula - or pockets - in their colon.
Providence physicians say prevention via diet changes, like added fiber, and exercise is key.

For all the known information about diverticulitis, little conclusive evidence exists to establish the cause of the abdominal inflammation. But ask any clinician, and they are likely to say that they are seeing more people with diverticulitis.

How diverticulosis develops

Aging and heredity may be primary factors in its development. But nearly any adult should at least be aware of how the condition may develop, how it is treated, and, perhaps most importantly, how it possibly can be prevented.

Diverticulitis is inflammation or infection of small pouches called diverticula that develop along the intestinal walls. The formation of the pouches is known as diverticulosis. The more serious disease, diverticulitis, may involve anything from a small abscess in one or more of the pouches to a massive infection or perforation of the bowel. This disabling colon problem can cause cramps, diarrhea, constipation, obstruction, fever, and rectal bleeding.

What the experts say about the increase of diverticulosis

A study published in 2015 in The American Journal of Gastroenterology noted the apparent increase in the United States. While the study looked at diverticulitis rates in only one county in Minnesota, it found a 50 percent increase in the condition between 2000 and 2007. According to the American Society for Gastrointestinal Endoscopy, one in two Americans over age 60 and almost every American over age 80 has diverticula in their colon — the small pouches that can become inflamed. The authors of the 2015 study also found an increase in the presence of the disease in younger people.

While it’s not known with certainty what causes diverticula, which can lead to diverticulitis, physicians suspect some possible culprits. Chief among them: a person’s diet.

In 2017, Harvard researchers published a study in the journal Gut that said eating red meat is associated with an increased risk for developing diverticulitis. The study’s authors also found the risk for developing the disease was lower in people who substituted fish or poultry for unprocessed red meat.

How to decrease your risk of diverticulosis

Eating foods high in fiber, like whole grains and whole fruits and vegetables may decrease the risk of diverticulosis, says the Journal of the American Medical Association. A JAMA study published in 2008 debunked the notion that eating nuts, popcorn, and seeds increase the risk of diverticulitis or diverticular bleeding.

Why is fiber in the diet so important? Lack of fiber makes the bowels strain harder to pass stool through the colon. That causes increased local pressures that lead to the formation of pouches at weak points in the colon wall. The increased pressure along with undigested food caught in these pouches can erode the diverticular wall, causing inflammation and possible bacterial infection, which can result in diverticulitis.

In addition to eating more fiber — whole-grain bread, oatmeal, bran cereals, fibrous fresh fruits, and vegetables — nutritionists recommend avoiding refined foods, such as white flour, white rice, and other processed foods.

Chef Tse’s Mediterranean salad has 8g of fiber:

Finally, regular exercise may help avoid developing the condition that can lead to diverticulitis. Muscle toning may encourage regular bowel movements.

Treating diverticulosis

Treatment may be as simple as eating a diet high in fiber or taking a fiber supplement. Or, your primary care provider may suggest medication or a “probiotic,” a supplement with “good bacteria” found in a healthy intestine.

Mild diverticulitis can be treated at home with antibiotics and a few days of a liquid diet. More severe symptoms may require hospitalization for intravenous antibiotics, bowel rest (no eating or drinking), or surgery.

Find a doctor

Looking for diet and lifestyle recommendations to build healthy eating and drinking habits? Providence has trusted primary care doctors who can help, as well as providers in every medical specialty. Find the physician that's right for you in our provider directory. Through Providence Express Care Virtual, you can also access a full range of healthcare services.