Wednesday, May 18, 2005


diverticulosis food to avoid

DIVERTICULOSIS used to be a rare disease; even today, it's almost nonexistent in certain parts of the world. But in the United States over half of the people over 60 have it, and most of them don't even know it. Diverticulosis is really a "lifestyle" disease that's easily prevented by dietary modifications. Unfortunately, by the time most people realize they have it, it's too late and the disease is established. But the good news is that simple changes in the diet will prevent it from ever becoming a serious problem.

Diverticulosis occurs when tiny sacs or pockets, somewhat like little balloons, form overtime on the outer walls of the colon due to pressure from trying to pass stools that are, hard and dry. As you would imagine, people who suffer from chronic constipation often develop diverticulosis. The reason it is so common today is that our diet contains so many refined foods lacking in fiber. Our digestive systems were made to process more bulk than most of us consume, so they work overtime to produce small, hard stools that ultimately stress the colon beyond endurance.

Some people with diverticulosis have no symptoms; others have chronic constipation alternating with diarrhea, gas, and sometimes pain in the lower left side of the abdomen.

Occasionally a bit of fecal matter will become trapped in the little sacs or outpouchings and become infected. This is the more serious stage of diverticulosis called diverticulitis. If this happens, you may develop fever, cramps, and rectal bleeding and you must be treated with antibiotics by a physician.

Some people learn they have diverticulosis when an x-ray is taken for some unrelated complaint, but most people discover it only when they develop diverticulitis. After their bout is cured with the help of antibiotics, they realize that they have to try to prevent diverticulitis from developing again. By taking the proper steps, they can.

Diverticulosis has a simple treatment: fiber. In the old days, even when I was in medical school, it was believed that people with this problem should eat a soft, bland diet so as not to tax the colon. We now know that a bulky diet high in fiber is one that will help the colon do its job.

Many studies have shown that increasing the fiber in one's diet can prevent surgical treatment in roughly 90 percent of patients. Bran supplementation is highly effective. Bran tablets, available in health food stores, are handy. Alternatively, you can use coarse miller's bran. Make sure you don't overdo it; too much fiber all at once can upset your system. Increase your intake gradually over three or four weeks. You can expect some gas in the beginning and perhaps some bloating.

Many of my elderly patients find bran difficult to tolerate. If you have trouble with bran tablets, try psyllium powders, which are available over-the-counter in pharmacies as well as in health food stores. Be sure to take them with plenty of water and adjust the amounts gradually to suit your needs.

It's important to drink lots of fluids--six to eight glasses of water each day--not only in conjunction with the bulking agents like psyllium and bran, but also to fight constipation.

If you have diverticulosis and particularly if you've ever had an attack of diverticulitis, you should avoid eating foods that contain nuts, seeds, and other hard particles such as popcorn. That includes seeds used as toppings on baked goods like poppy seeds and sesame seeds as well as seeds and hard particles inside the food itself like the seeds in zucchini or cucumbers or the grain particles in cracked-wheat bread. These tiny particles could become lodged in the sacs of the colon and become infected, bringing on an attack of diverticulitis.


Adopt a high-fiber diet. This means lots of fruits and vegetables, whole grains, and cereals. Avoid eating processed food: substitute whole grain bread for white, a whole apple for apple Juice.
Add a fiber supplement to your diet. Take psyllium seed bulking agents. Follow the directions on the package and be sure to take with plenty of water.
Avoid constipation and, if you do become constipated, don't use laxatives, if you do experience some constipation, increase your psyllium and water Intake, and if this doesn't work add bran to your diet. You can take it in tablet form, available in health food stores. Take three tablets daily and increase by three tablets every few days until you achieve the desired result. You can also take bran In the form of coarse miller's bran -- a teaspoon a day, increased by a teaspoon every few days. You can also sprinkle it on foods and cereals or mix it into baked foods like muffins and meatloaf. Increase bran Intake gradually over the course of about a month. You can expect some gas and bloating when you first begin.
Drink plenty of fluids every day: from six to eight glasses of water or other fluid.
Avoid eating seeds, nuts, and foods with hard particles that could become lodged in the diverticular sacs, These include strawberries, figs, tomatoes, zucchini, cucumber, baked goods that have cracked wheat, poppy, sesame, or caraway seeds.


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