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Your 8-Step Plan for Living With Diverticular Disease

Your 8-Step Plan for Living With Diverticular Disease

If you have diverticular disease, it’s important that you eat more fiber, exercise regularly and take other steps to prevent attacks.

Once you have been diagnosed with diverticular disease, the goal of your treatment will be to keep your symptoms in check and prevent complications. There are some steps you can take to avoid repeat attacks and manage your condition.

Prevention starts with understanding the nature of diverticular disease and the factors that may aggravate it. Diverticular disease occurs when small pockets or outpouchings develop in the wall of the colon. This is known as diverticulosis and rarely causes pain or any other symptoms. Diverticulitis occurs when and if these pouches become inflamed or infected by bacteria in your stool. It is characterized by pain typically on the left side of your colon, nausea, fever and sometimes bleeding.

Exactly how or why diverticulosis turns into diverticulitis or diverticular bleeding is not fully understood, but many theories exist, and taken together, these theories help form the basis of your prevention plan, explains Akiva Marcus, MD, PhD, a gastroenterologist practicing at the Digestive Disease Center of the Palm Beaches and affiliated with Palms West Hospital, JFK Medical Center, and JFK Medical Center, North Campus in West Palm Beach, Florida.

“Diverticulitis is a lifestyle disease,” he says. “You are not eating right, not exercising enough, smoking cigarettes, drinking too much alcohol and not enough water, are overweight—and all of this adds up to diverticular disease.”

The good news: You don’t have to suffer excessively from diverticular disease. Learn how to manage your condition and maintain an active lifestyle with the following eight-step plan.

Watch what you eat
For years, it was thought that low-fiber diets play a role in aggravating diverticular disease. “The Western diet is low in fiber and high in animal fats, both which are linked to harder stools that are more difficult to pass," explains Dr. Marcus.

Fiber is not the whole story though, he says. It is more likely that the straining to pass stool causes pressure within the colon that leads to diverticular disease. Once the pouches form, bacteria from stool can get caught inside, where it can cause the pouch to tear or become inflamed or infected. For some people, increasing fiber intake could possibly help prevent diverticulitis attacks, new pockets from forming or diverticular bleeding, but there is no guarantee.

If you are living with diverticular disease, your doctor may recommend that you eat a fiber-rich diet. The Dietary Guidelines for Americans recommends adults get 14 grams of dietary fiber per 1,000 calories consumed. Keep in mind that 1/3 to 3/4 cup of high-fiber bran cereal contains 9.1 to 14.3 grams of fiber, one medium apple with skin has 4.4 grams and a medium-sized sweet potato with skin has 3.8 grams. Other high-fiber foods include beans, legumes, brown rice and whole wheat pasta. Ask your doctor if you should take a fiber supplement and which one might be appropriate for you.

In the past, doctors advised people with diverticular disease to avoid eating seeds and nuts for fear that these tiny kernels could get lodged in the pouches and cause an attack, but this is no longer the case. “Many nuts are healthy sources of protein and good fats and there is no reason to avoid eating them if you have diverticular disease,” Marcus advises.

Drink more water
Water helps fiber—and stools—move through your system more easily. Aim to drink 8 ounces of water eight times daily.

Maintain a healthy weight
Being overweight or obese is associated with a higher risk for diverticular disease, possibly due to inflammation and changes to the balance of good and bad bacteria in the gut.

Stop smoking
People who smoke cigarettes are more likely than nonsmokers to experience diverticulitis and more likely to have a complicated course, Marcus says. If you smoke, ask your doctor for advice on the best way to quit.

Move more
Lack of exercise sets the stage for diverticular disease. Follow the exercise guidelines set for healthy Americans. Try to get at least 150 to 300 minutes of moderate-intensity exercise or 75 to 150 minutes of vigorous exercise each week.

Vigorous exercise, in particular, may lower your risk of diverticulitis, but make sure you get clearance from your doctor before making any radical changes to your physical activity regimen, Marcus cautions.

Curb alcohol intake
If you have diverticulosis and you drink too much alcohol, your risk of diverticulitis may be two to three times greater than that in the general population. Be mindful of how much alcohol you consume and drink in moderation, or no more than one drink per day for women or two daily drinks for men.

Stay regular
Having regular bowel movements each day with no straining will keep your colon healthy and diverticulitis attacks at bay. In addition to eating more fiber, drinking more water and getting regular exercise could help. Some people may also benefit from using a “toilet stool” that provides a platform for your feet. This helps ensure they’re in a natural squatting position, which could help ease the passage of stools.

Know when to seek help
“If you have a history of diverticular disease, call your doctor the minute you feel an attack coming on,” Marcus says. “Your doctor can prescribe antibiotics and try to get ahead of any severe complications that could require surgery.”

Bonus: Marcus points out that the lifestyle adjustments that may help prevent diverticulitis could also help prevent colon cancer.

Medically reviewed in August 2019.

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