FAQ : Frequently Asked Questions

 With aging, the intestinal walls tend to weaken. The pressure inside the colon increases, when the stool passes through the weakened bowels. It results in the formation of small, bulging pouches, called as diverticula. This condition is referred to as diverticulosis. Large intestine or colon is the most common site to develop diverticula. When diverticula get infected or inflamed, it is known as diverticulitis, which causes painful symptoms. Let’s understand more about diverticulitis through frequently asked questions.

1.      What is diverticulitis?

–          Diverticulitis can be described as infection or inflammation of diverticula that are developed along the intestinal wall. Aging, intake of foods less in fiber, obesity, inactive lifestyle, lack of exercise and unhealthy habits like smoking and alcoholism are the major contributing factors for diverticulitis.

2.      What are the symptoms of diverticulitis?

–          Diverticulosis is usually asymptomatic. But, diverticulitis may cause painful and severe symptoms. Abdominal pain is the most prominent symptom of diverticulitis. Pain is usually located in the lower left side of the abdomen. The patient may also experience tenderness in the abdomen, nausea, vomiting, flatulence, bloating, altered bowel movements like constipation or diarrhea as well as high fever and malaise. Abdominal pain may reduce after bowel movements.

3.      Diverticulitis flare up: what to do?

–          Diverticulitis flare up is the stage, in which active symptoms of the disease are experienced. Diverticulitis is characterized by infection or inflammation of diverticula. When the symptoms of inflammation and infection are evident, the sufferer is considered to have a flare up. The most common symptoms found in flare up include pain and tenderness in abdominal region, difficulty in urination, changes in bowel habits like constipation or diarrhea, stomach upset and fever. A diverticulitis flare up may be accompanied by bleeding in the digestive tract in some cases.

The best treatment to manage diverticulitis flare up symptoms is to bring out certain changes in your diet. During diverticulitis flare up, it is advised to consume a liquid diet, which includes water, plain soda, plain gelatin, ice chips and fruit juices without pulp. The purpose is to rest the bowels and flushing of the colon. It helps to prevent blockage or obstruction in the bowels. Remaining on liquid diet accelerates the healing process. When the symptoms are reduced, you can gradually take low-fiber diet. Additionally, you can take aloe vera juice, oregano oil and probiotics to eliminate the infection and heal inflammation. If the symptoms are severe, you may be prescribed antispasmodics to control spasms and stomach pain as well as antibiotics to eliminate infection and relieve the symptoms like abdominal pain and fever.

4.      Is diverticulitis hereditary?

–          Diverticulitis is not hereditary. In fact, it is an acquired disease. It is more prevalent in those who eat foods less in fiber and more of processed, high-fat foods. The possibility of developing diverticulitis increases with advanced age. However, if genetic factors are considered, it is observed that people with collagen disorders are more prone to developing diverticulitis.

5.      Is diarrhea a symptom of diverticulitis?

–          In diverticulitis, the sufferer experiences the symptoms related to gastrointestinal disturbance. There may be changes in bowel movements such as diarrhea or constipation. The person experiences diarrhea, either alone or alternating with bouts of constipation.

6.      Diverticulitis and constipation: what to do?

–          Chronic constipation can be one of the major contributory factors for diverticulitis. Intake of low-fiber foods and more of processed foods can increase the risk of developing this condition. In order to prevent the disease and its recurrent attacks, you need to include more of fiber in your daily diet. Your daily fiber requirement is minimum 25-35 grams. Fiber makes the stool soft and bulky, allowing it to pass easily through the bowels and thus, prevents constipation. The foods that contain high amount of fiber are whole grain breads, cereals, pastas, fresh fruits like pears, apples and prunes, vegetables like broccoli, peas, squash and spinach as well as beans like kidney beans and black beans. When taking high-fiber foods, drink plenty of water and fluid to prevent constipation.

7.      Eating popcorn and diverticulitis

–          Previously, it was assumed that the foods like nuts, seeds, corn and popcorn, which are hard to digest, should be avoided by the people with diverticulitis. It was considered that these foods can get stuck in the diverticula, causing inflammation. However, according to the recent research studies, there is no scientific evidence to support this recommendation. On the contrary, nuts and seeds contain rich amount of fiber, which can be proved to be beneficial for those with diverticulitis. In fact, according to the evidence from a huge cohort of health professions, popcorn may give a protective effect against the complications of diverticulosis.

8.      Effects of alcohol and diverticulitis

–          Drinking alcohol can affect the condition and can aggravate the symptoms. Alcohol can increase the intensity and duration of diverticulitis attacks. Since alcohol may aggravate the inflammation in the gastric system, it results in increased pain and further complications. Additionally, alcohol can interfere with the action of medications and antibiotics. If you taking alcohol with medications, you may experience the symptoms like drowsiness, dizziness, stomach upset, vomiting and diarrhea. So patients with active flare ups should strictly avoid alcohol.

9.      Stress and diverticulitis flare up: Truth

–          It is seen that stress and emotional problems can worsen the diverticulitis flare up. Stress may cause increased contraction in the intestine, which may lead to the formation of diverticula. Also, stress may activate inflammation in the intestine. Therefore, stress management is an important aspect of diverticulitis treatment. Stress can be reduced with the help of yoga, meditation, tai chi etc.

10.  What to do on diverticulitis attack?

–          If diverticulitis attack is mild, it can be managed with dietary changes and home remedies. You can apply heating pad to the abdomen, which would help reduce pain and cramps. You may also try relaxation techniques like meditation to relieve pain. Take enough rest and keep your bowels relaxed. Initially, for 2-3 days, you are recommended to stay on liquid diet that includes plain water, clear broth, plain soda, ice chips, ice pops and pulpless fruit juices. When the symptoms are reduced, you can start with low-fiber diet, which includes canned or cooked fruits without seeds or skin, canned or cooked vegetables like potatoes, peas and green beans as well as eggs, poultry, fish, milk, cheese, low-fat yogurt, low-fiber cereals and white rice. Once you start feeling better, you can gradually switch to regular high-fiber diet. Always increase your fiber intake gradually; otherwise, you may trouble from bloating and flatulence. Also, drink plenty of water and fluids to prevent constipation. If the symptoms are severe, the doctor prescribes medications like anti-spasmodic drugs like dicyclomine, chlordiazepoxide, hyoscyamine and scopolamine as well as antibiotics like ciprofloxacin, cephalexin, metronidazole and doxycycline.

11.  Diverticulitis Recovery Time after Surgery

–          The most common procedure for diverticulitis surgery is colon resection, which involves removing of affected part of the colon and reattaching the ends. Recovery time after surgery depends upon various factors such as type of surgery and patient’s overall health. Recovery time and possibility of developing complications is more in case of conventional surgical method as compared to the laparoscopic colectomy. Generally, the single-step open partial colectomy may require 4-7 days of hospitalization, if no complications are developed. If partial colectomy is done in two stages, hospital stay can be longer. Two surgeries are done between 6-12 weeks. If laparoscopic surgery is done, 4-5 days hospitalization is needed. It can take about 6-8 weeks for complete recovery after one-stage open partial colectomy, or after the second surgery of two-stage surgery. When undergone a laparoscopic surgery, you may require about 3 weeks for the complete recovery.