Diverticulitis vs. Diverticulosis

There is still a good deal of confusion about diverticulosis (the condition) and diverticulitis (the inflammation).

Diverticuli are tiny "pockets" of weakness in the wall of the large intestine. This condition is called diverticulosis, and a third of the people over age 50 in the United States have it. Some have just a few diverticuli, while others may have 20 or more. Most people have no symptoms and only find out that they have diverticulosis when they have a colonoscopy.

Diverticulitis is infection/inflammation of the diverticuli. In other words, a person with diverticulosis may get diverticulitis when stool gets caught in one or more of these “pockets,” and they become inflamed or infected. This typically causes fever, pain and tenderness in the abdomen. The two major signs of diverticular disease are bleeding and infection.

Diverticulitis usually clears up within a week with antibiotics and a liquid or soft diet. (A soft diet includes anything that does not require a lot of chewing: soup, mashed potatoes, cooked or pureed vegetables, bananas, Jell-O and pudding fit this category.) After the acute infection clears up, patients should eat a high-fiber diet including nuts, seeds, whole grains, fruits and vegetables. They should drink plenty of fluids and avoid constipation at all costs, even if that requires taking Metamucil (psyllium seed) or other fiber products daily. Hard stools or straining will cause more diverticuli to appear or the existing ones to enlarge.

The National Digestive Diseases Information Clearinghouse clearly states: "Until recently, many doctors suggested avoiding foods with small seeds such as tomatoes or strawberries because they believed that particles could lodge in the diverticula and cause inflammation. However, this now a controversial point and no evidence supports this recommendation."

Benson T. Massey, MD, Associate Professor of Medicine in the Division of Gastroenterology and Hepatology at the Medical College of Wisconsin, specializes in gastroenterology. According to him there is NO evidence to suggest that such foods worsen diverticulosis. To the contrary, eating high fiber foods is the ONLY treatment for diverticulosis. He says that how diverticulitis develops is a mystery. It could be from hard stool or bacteria alone, but it is probably not from a nut getting lodged in a pocket.

Everyone should eat a diet high in fiber, but especially people with diverticulosis. Nuts are a good source of fiber and protein. Although nuts contain fat, it is mostly unsaturated, the "good kind." Several studies have shown that heart-healthy diets that contain various nuts lower cholesterol and coronary heart disease risk. With a strong family history for colon cancer, it's all the more reason to eat plenty of high fiber foods.

http://healthlink.mcw.edu/article/1013634026.html

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