Diverticulosis is a condition in which small pouches, known as diverticula, develop in the weakened wall of the digestive tract. Although diverticulosis is asymptomatic, the pouches can become infected and inflamed, leading to abdominal symptoms. This complication is called diverticulitis, or diverticular disease.
Symptoms of Diverticulitis:
- Pain in the lower left abdomen
- Rectal bleeding
- Fever and/or chills
- Nausea or vomiting
- Constipation or diarrhea
- Swelling or bloating of the abdomen
- Increased urgency, frequency, or discomfort when urinating
Complications of Diverticulitis:
- Fistula formation
- Abscess formation and peritonitis
- Colonic stricture
- A higher risk of colon cancer
How to Manage Diverticulitis Naturally?
Diverticulitis is usually treated with antibiotics, fiber, fasting with a clear liquid diet for bowel rest, and, in some cases, a sigmoidectomy.
Researchers now believe that diverticula pockets may encourage microbe communities that drive inflammation. The altered intestinal microbiota and resulting low-grade inflammation then contribute to the symptoms of diverticulitis. For this reason, researchers are now investigating natural solutions to target inflammation and improve altered intestinal microbiota.
Here’s your evidence-based guide to managing diverticulitis, the natural way.
Probiotics for Diverticulitis
Although clinical data is somewhat scarce, probiotics may potentially lead to symptom improvement by restoring the intestinal microbiota that was altered in the progression of diverticular disease.
Of the many probiotic strains, Lactobacillus reuteri is the most widely studied for gastrointestinal conditions due to its apparent anti-inflammatory effects in the intestine. A 2019 RCT found that L. reuteri combined with standard antibiotic treatment resulted in a reduction of abdominal pain and inflammatory markers compared to placebo.
A 2022 RCT then tested L. reuteri with bowel rest and fluids but without antibiotics. L. reuteri significantly reduced blood and fecal inflammatory markers compared to the placebo group, leading the researchers to conclude that the probiotic strain may potentially be used to improve the course of diverticular disease and prevent complications.
Berberine for Diverticulitis
Berberine is an alkaloid found in plants such as barberry, Oregon grape, and Chinese goldthread, otherwise known as Coptis, which researchers are currently investigating to further improve the benefits of berberine for diverticulitis.
The compound is a natural anti-inflammatory and anti-microbial agent with the ability to help fortify the intestinal walls. It does so by increasing the production of butyrate, a short-chain fatty acid that improves the expression of tight junctions.
A tight junction is a seal between two cells in the membrane tissue. They form a filtering system, preventing leakage from the inside of the digestive tube while regulating nutrient absorption into the surface of the gut wall. Disrupted tight junctions lead to gut barrier permeability, which allows microbes to escape from the intestinal tunnel and circulate, triggering inflammation and disease.
As the expression of tight junctions plays an important role in the development of symptomatic uncomplicated diverticular disease, berberine may prove to be a highly beneficial natural solution for symptom management and prevention. Butyrate additionally regulates the intestinal environment, keeps mucosal inflammation at bay, and has been found in human trials to lower the recurrence of diverticulitis.
Curcumin (Turmeric) for Diverticulitis
Curcumin is a potent anti-inflammatory compound extracted from turmeric that is currently used to manage a range of inflammatory and gastrointestinal conditions.
Much like berberine, curcumin may benefit patients with diverticulitis as it has been found to alleviate mucosal inflammation – especially by inhibiting tumor necrosis factor-alpha, an inflammatory chemical messenger associated with acute diverticulitis. Curcumin has also been found to promote healthy gut bacteria balance, enriching beneficial bacteria such as Bifidobacteria and Lactobacilli and reducing pathogenic bacteria.
Finally, curcumin can improve impaired intestinal permeability by preventing tight junction protein disruption. One of the ways curcumin strengthens the gut wall is by neutralizing the decrease of butyric acid-producing bacteria.
Boswellia Serrata for Diverticulitis
Boswellia is a curative herbal extract widely used in Ayurveda and Traditional Chinese Medicine (TCM). Boswellia is a promising treatment for diverticulitis due to its anti-inflammatory and anti-oxidative properties on the intestinal barrier.
Boswellia contains two active compounds, incensole acetate and incesole. The two compounds inhibit NF-κB activity which is implicated in the immune and inflammatory response to microbial infection in symptomatic diverticulitis. Boswellia has also been shown in studies to suppress TNF-α – a pro-inflammatory cytokine that is overexpressed in patients with Symptomatic Uncomplicated Diverticular Disease (SUDD) and decreases during remission.
A 2020 pilot study tested a food-grade formulation of curcumin and Boswellia serrata on patients with symptomatic uncomplicated diverticulitis disease (SUDD). After 30 days of treatment, 77% of the participants reported lower pain intensity, and 88% of patients reported symptom relief within the first 10 days. The study suggests that Boswellia and curcumin may be useful for abdominal pain relief in SUDD patients.
Managing Diverticulitis with Diet
Mild cases of diverticulitis are often treated with a low-fiber diet or a period of bowel rest with fasting and then a clear liquid diet of broth, fruit juices without pulp (except for orange juice), ice chips, ice-pops, and jello.
As the condition improves, low-fiber foods are introduced, such as canned or cooked fruits and vegetables, eggs, fish, poultry, low-fiber cereals, white bread, rice, pasta, and noodles.
For those in remission or not suffering acute symptoms, a high-fiber diet is recommended to soften the stool and prevent constipation. A 2019 study found that fiber from fruit and cereal is more likely to reduce the risk of diverticulitis, whereas fiber from vegetables didn’t appear to make a difference.
When increasing your fiber intake, it’s important to drink at least 8 cups of water or fluid a day. This will help soften your stool and ease its passage through the colon. Green tea and ginger tea may be especially helpful as they they are anti-inflammatory.
What Not to Eat with Diverticulitis
A few wide-scale studies have investigated the long-term effect of diet on the development of diverticulitis. A 2017 study followed over 46,000 men from 1986 to 2012 to find a correlation between diet patterns and any incidence of diverticulitis, diverticulosis or diverticular bleeding.
They found that a “Western” dietary pattern was associated with an increased risk of diverticulitis. A Western pattern includes a high intake of red and processed meat, sweets, fried foods, high-fat dairy products, and refined grains. A “Prudent” pattern was found to decrease the risk of diverticulitis, meaning a diet rich in fruit, vegetables, whole grains, poultry, fish, and legumes.
Red meat is a well-known culprit when it comes to gastrointestinal conditions. A survey from the same cohort as above confirmed a strong association between red, processed meat and the risk of developing diverticulitis.
Managing Diverticulitis with Exercise
Regular exercise and movement are recommended for those managing diverticulitis, as exercise helps promote bowel movement and prevents constipation.
Studies show that those who live a sedentary lifestyle are particularly at risk of diverticular complications, with physical activity lowering the risk. Running, specifically, resulted in a significantly lower risk of disease development.
Stress Management
Stress relief is an important part of managing diverticulitis. When we experience long-term stress, we release excessive cortisol which can lead to impaired digestive function. This in turn increases inflammation and can irritate the diverticula, leading to a flare-up. Stress may also make it harder for your body to fight infections, as it can weaken the immune system response.
Taking up yoga, meditation, breathwork or tai chi can greatly help reduce stress. Meditation may be especially helpful, as researchers recently found that the practice can directly promote more beneficial gut bacteria – especially Bacteroides.
A Comprehensive Approach to Diverticulitis
Diverticulitis is a somewhat overlooked condition, and although more research on treatments is definitely needed, there are many natural solutions that may help prevent or manage flare-ups.
It’s best to take a comprehensive approach that includes dietary adjustments with the advice of your doctor, regular exercise, stress management, and natural supplements such as probiotics and/or herbal agents with anti-inflammatory and anti-microbial properties.
Evinature
