I have a very close friend who has suffered from diverticular disease for many years. The cramping, diarrhoea, constipation and excruciating pain are just some of his symptoms. He’s overweight, doesn’t exercise and is hitting the big five-o. He’s a carer for his elderly mother who has dementia and can never find the time to cook. They rely on frozen prepared meals that are bought online and delivered to their house every few weeks.
He tries hard to supplement this with fresh fruit – bananas, apples and pears, but more often than not, it’s the cakes, biscuits and sweets/candies that win. It’s an awful cycle that only serves to make his diverticular disease worse.
If you know someone in a similar situation, or perhaps you have diverticular disease, then this weeks blog post: How to Help your Diverticular Disease may help.
A little bit of history on diverticular disease – our most common gut disorder
Diverticulosis is a new disease; it didn’t appear until the 1800s. The actual term ‘diverticulosis’ first appeared in 1914, but it took until 1971 for surgeons Painter and Burkitt to suggest that diverticulosis was a deficiency disease, a disease caused by a deficiency of fibre.
But why was that?
As Dr Greger says: ‘In the late 1800s roller milling was introduced – further removing fibre from grain, and we started to fill up on fibre deficient foods like meat and sugar. A few decades of this and diverticulosis was rampant.’
The United States and Europe now have the highest rates of diverticular disease in the world. Whereas under developed populations in Africa and Africa have relatively low rates of the disease, but with urbanization in these areas, rates of diverticulitis are also rising.
What is diverticular disease?
Imagine a balloon, one of those long skinny balloons that you use to make balloon animals. If you blow it up and then squeeze it, a bulge appears in the balloon. That’s exactly what happens in your colon. A ‘bubble’ appears in the wall of your intestine, this is diverticula. Diverticulosis is when there is one, or many of these diverticula.
Diverticulitis is when one of these diverticula becomes acutely inflamed and causes you pain, sometimes fever and sometimes infection.
What causes diverticular disease?
It’ll come as no surprise to you to learn that it all comes down to what you eat, or what you don’t eat.
If you don’t eat enough fibre every day, for instance if you survive on the typical Western diet of red meat, processed meat, sugary snacks, high-fat foods and refined grains with dairy and high-sugar drinks such as fried chicken, pizza, hot dogs, sausages, burgers and fries, then you will not be softening and bulking up your poo. As a result you may have to strain when you go the toilet.
If you’ve been straining for many years, then as Dr Greger says: “…it can literally blow out pockets from your colon.” It’s pretty similar to when you squeeze the air in that long skinny balloon and bubble occurs.
As Dr Greger goes on to say: ‘it’s easy to move large soft, moist intestinal contents through the gut. In contrast, try squeezing through a lump of tar. When we eat fibre deficient diets, our faeces can be become small and firm, and so our intestines have to really squeeze hard to move them along, and this build-up of pressure may force out those bulges. And eventually, a low-fibre diet can sometimes lead to the colon literally ‘rupturing’ itself.’
What can you do to alleviate/ treat / prevent diverticular disease?
Eat fibre! It’s as simple as that.
Research has shown that ‘a diet high in fibre mainly from fruits and vegetables and low in total fat and red meat decreases risk of diverticular disease. Evidence indicates that the insoluble component of fibre is strongly associated with lower risk of diverticular disease; this association was particularly strong for cellulose. Caffeine and alcohol do not substantially increase risk of diverticular disease, nor does obesity, but higher levels of physical activity seem to reduce risk of diverticular disease’. 
Like most diseases, prevention is always better than cure, so try not to get it in the first place. If you do, then concentrate on eating a whole food, plant-based diet. Plant foods are bursting with fibre, whereas animal foods such as meat, fish, chicken, dairy, eggs have no fibre, and processed foods such as white rice, white bread etc have little or no fibre.
Remember the balloon, if you exert a huge force trying to pass your stool, then you may cause a bubble or diverticular. Eating fibre will keep your poo / stools soft and moist and will make them easier to pass so you won’t be straining or exerting a huge pressure.
If you already have diverticula, then eating a plant-based diet will help to keep them from becoming inflamed and infected.
Dr. John McDougall says that a starch-based, high-fibre diet has relieved symptoms in 90% of cases of severe colon disease, including diverticular problems. “Patients with diverticular disease have much less trouble after they change to a healthy, high fibre, plant-based diet. A high fibre diet will also reduce the risk of future bleeding and infection and decrease the likelihood of developing new diverticuli.” However, “the diverticuli that have already formed are permanent herniations of the colon, and will not disappear except by surgical removal, which is rarely indicated.”
Should I avoid nuts and seeds?
As Dr Greger says: “Sometimes on autopsy, you can find nuts, seeds, or pieces of corn or popcorn stuck in those pockets, which led to this theory that they be what triggered the inflammation. So the conventional wisdom has been to tell elderly folks to stay away from these foods.”
However, he goes on to say: “But at the same time, the lack of plant foods caused the whole problem in the first place, so do we really want to tell people to cut down?”
The clear answer is no.
Research in the Journal of the American Medical Association clearly states: ‘nut, corn, and popcorn consumption did not increase the risk of diverticulosis or diverticular complications.’
It appears in fact that a higher intake of nuts and corn could help to avoid diverticulitis in adult males. A 2009 article in Clinics in Colon and Rectal Surgery states, “Without any good evidence, certain foodstuffs such as nuts, seeds, popcorn, and corn have long been implicated in the development of diverticulitis and are often advised against by physicians. They were thought to provoke diverticulitis or diverticular bleeding by causing luminal trauma. In a large prospective study of men without known diverticular disease, State et al found that nuts, corn, and popcorn consumption did not increase the risk of diverticulosis, diverticulitis, or diverticular bleeding.”
So if you, or if you know someone with diverticulitis try to eat lots more fibre, aim for 40 grams a day and reduce or stop eating animal foods (meat, dairy, and eggs) that contain no fibre at all and processed foods that contain very little.
If you’re just starting out on your plant-based journey then read my post How to get started on your plant-based journey and to learn about the power plate. It was developed by Physicians Committee for Responsible Medicine and provides optimal health for you and your family and is brilliantly flexible so you can eat in a way that suits your taste and lifestyle whilst getting all the nutrients you need.
If you’re struggling to eat more whole grains everyday, check out my five tips to help you here: How to easily eat more whole grains everyday
A typical food plan for the day may look like this:
Oatmeal/porridge for breakfast made with water or plant-based milks such as rice milk. Topped with fresh fruit such as sliced banana. Two slices of wholemeal toast, spread with 100% fruit jams. Read about my 7 of the best ever plant-based breakfasts
Water and/or tea or coffee, black or made with plant-based milks.
Mid morning snack of fruit, or read my post on 11 simple plant based snacks to enjoy at work
For an afternoon snack remember to check out my suggestions here: 11 simple plant based snacks to enjoy at work
Now it comes to dinner. What’s quick to make, nourishing and doesn’t cost the earth? Try some of my delicious dinner recipes.
Wishing you lots of health and happiness.