What is diverticular disease?


Nearly 1 in 10 people over 45 have diverticulosis, pocketing in the large bowel. This may increase to around 8 in 10 people by the age of 85. Around 2 in 10 people with diverticulosis will go on to develop symptoms of diverticular disease at some point. (BUPA)

Diverticular disease and diverticulitis are related digestive conditions that affect the large intestine (bowel). Diverticula are small pockets that can develop in the lining of the intestine. Some people with diverticula don’t get any symptoms and only know they have them after having a scan for another reason. When diverticula cause symptoms, such as pain in the lower tummy, it’s called diverticular disease. If the diverticula become inflamed or infected, causing more severe symptoms, it’s called diverticulitis. The most common complication is developing abscesses and sepsis.

Symptoms of diverticular disease include:

  • tummy pain, usually in your lower left side, that tends to come and go and gets worse during or shortly after eating (emptying your bowels or passing wind eases it)
  • feeling bloated
  • constipation, diarrhoea, or both
  • occasionally, mucous in your stool

If your diverticula pockets become infected and inflamed (diverticulitis), you may suddenly:

  • get constant, more severe tummy pain
  • have a high temperature of 38C or above
  • feel sick or vomit
  • feel generally tired and unwell
  • get blood in your stool or bleeding from your bottom
  • if you suspect that you’re having a ‘flare-up’, make an appointment to see your GP immediately

Tests that GPs and Hospitals undertake to rule out ‘red flags’

  • Tests to rule out coeliac disease, IBS or bowel cancer. This may include blood tests, colonoscopy or CT scans.
  • Stool sample to check for infections, occult (hidden) blood and inflammation which may indicate inflammatory bowel disease (IBD)

They also check for:

  • A persistent change of bowel habit for 4 weeks or longer, especially if you are over the age of 40
  • Passing blood from the back passage
  • Unintentional weight loss of more than 2kg (4 pounds) over a short period of time.
  • Diarrhoea waking you from sleep
  • Fever

Risk factors and causes

  • Age
  • A diet lacking in fibre
  • Use of antibiotics which disrupts the natural gut flora
  • Long-term use of painkillers
  • Long-term use of proton pump inhibitors
  • An inflammatory diet (see foods that help below)
  • Underlying deficiencies (particularly magnesium that can increase risk of developing constipation)
  • Stress
  • Chronic long-standing constipation
  • Lack of digestive enzymes or low stomach acid that can increase risk of constipation

Tips to help reduce the risk

  • Eat enough fibre – aim for 30g per day. Make sure it is the right kind of fibre, avoiding gluten sources
  • Take probiotics after a course of antibiotics. One twice daily before meals: https://justfortummies.co.uk/product/live-bacteria-capsules/
  • Prevent dehydration, try to drink 2 litres of water/ herbal teas per day
  • Avoid caffeine which dehydrates the bowel
  • Increase your fruit and vegetable intake – 2 fruit + 5 veg
  • Ensure adequate magnesium intake to keep bowels regular
  • Ensure food is properly digested by taking a digestive enzyme tablet before meals: https://justfortummies.co.uk/product/digestive-enzyme-tablets/
  • Essential fatty acids, preferably from oily fish, are crucial to help reduce inflammation in the intestines.  If you’re not eating oily fish at least twice weekly, take a high-strength Omega 3 fish oil capsule daily: https://justfortummies.co.uk/product/omega-3-capsules/
  • Learn to manage your stress
  • Chew your food thoroughly; aim for 20 chews per bite to take the strain off your digestive system

Foods to avoid

  • Gluten – gluten containing grains (wheat, rye, barley, spelt) are abrasive and can aggravate the GI tract
  • Dairy – is mucous forming and may slow down bowel movements, leading to constipation, a risk factor for the development of diverticular disease
  • Excess red meat (if you do eat it try to find grass fed which is less inflammatory, and always take a digestive enzyme tablet before eating a meal containing red meat)
  • An acidic diet – acidic foods include; red meat, dairy, gluten, nightshade family vegetables, processed foods, artificial sweeteners and refined sugars
  • Coffee and tea
  • Carbonated drinks
  • Alcohol – is pro-inflammatory
  • Artificial sweeteners
  • Seeds – it is best to consume them milled so they do not get lodged in diverticula pockets and create irritation

Foods that help

  • An alkaline diet – this type of diet contains plenty of fresh fruits and vegetables, gluten free grains, essential fats from nuts, seeds, coconut, avocado etc *see link below
  • Fruit and vegetables – eat in abundance to increase fibre and antioxidants
  • Fermented foods: Kimchi, kombucha, sauerkraut and kefir as they contain beneficial lactobacilli bacteria
  • Apple cider vinegar to increase digestive juices
  • Crushed garlic – Garlic is one of the most potent antibiotics to kill harmful bacteria in the gut, helping to fight infections
  • Water – make sure you keep hydrated and flush your system out by drinking plenty of filtered water
  • Psyllium husk and slippery elm
  • Calming herbal teas – chamomile, lemon balm
  • Ginger – chop on to salads, stir-fry’s or have in hot water
  • Soluble fibre to provide bulk to the stool
  • Anti-inflammatory foods: Oily fish, walnuts, flaxseeds, chia seeds, turmeric, ginger.

Supplements that may help

You can download a large selection of free gut friendly, gluten-free, dairy-free and refined sugar-free recipes from my website using the link below. In particular I would recommend the following for Diverticular Disease as they are all high in fibre, high in antioxidants, high in good fats and gut healing nutrients:

  • Pear and Walnut Oatmeal bowl
  • Green coconut smoothie
  • Gut-healing spiced celery soup
  • Bone Broth
  • Salmon with miso vegetables
  • Rice, Bean and Kale Bowl with Lemon-Dill Tahini
  • Salmon, coconut and turmeric curry
  • Hemp and Tahini Bliss Balls
  • Anti-inflammatory turmeric energy balls

Useful Resources

Find my 7-day gut friendly recipe planner here: https://justfortummies.co.uk/recipes/

Guts UK https://gutscharity.org.uk/advice-and-information/conditions/diverticular-disease/