Diverticulitis may be on the rise: Diet can decrease risk

September 12, 2018 Providence Health Team

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.

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. The disabling colon problem can cause cramps, diarrhea, constipation, obstruction, fever and rectal bleeding.

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.

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 increases 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 breads, 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.

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.

Expert resources

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. Check out healthy recipes and tips from our nutrition specialists.

Need a primary care doctor? Find a PSJH physician near you:

For same-day appointments, extended hours and trusted providers, visit Providence Express Care Clinics, Express Care Virtual, and Urgent Care.

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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