1. University of Georgia Cooperative Extension Service
Diverticular Disease
University of Georgia
Cooperative Extension Service
Handout: Get The Fiber You Need, FDNS-E-
Today we are going to talk about Diverticular Disease.
ASK: What is diverticular disease? (wait for responses) That’s right. Diverticular disease is a disease of the colon where outpouchings or hernias form in the wall of the colon. In some people, these outpouchings can become inflamed and cause pain.
ASK: Raise your hand if you have, or know someone, with diverticular disease. It is estimated that one-third of people ages 40-50, and half of people over the age of 50 have diverticular disease. Today, we are going to discuss diverticular disease, how it occurs, the symptoms, and whether or not the foods you eat can play a role in this disease.

2. Diverticular Disease Diverticulosis Diverticulitis
Diverticular disease is a disease of the colon and includes two conditions: diverticulosis and diverticulitis. Diverticulosis is a condition that can lead to a more severe condition, diverticulitis. Ten to 25% of people that suffer from diverticulosis will have an attack of diverticulitis at some point in their lives.

3. Diverticulosis Common disease with age Cause unknown Potential causes:
Constipation
Pressure caused by moving dry, hard bowel movements
Diverticula
pouch-like projections
Diverticulosis is a common disease that occurs with age. The exact cause is not known for certain. But, it is believed that constipation and the pressure caused by moving dry, hard bowel movements can create pouch-like projections in the outer wall of the colon called diverticula.

4. Diverticulitis Inflammation of the diverticula
Material caught in pocket causes inflammation, infection
and bleeding.
Diverticulitis is when the diverticula develop inflammation. It occurs when material that is moving through the intestines gets caught in the diverticula. This can cause inflammation, and may lead to infection and bleeding. This disease causes more pain and is more severe than diverticulosis.

5. Signs and Symptoms Diverticulosis Most people have no pain or symptoms
Diarrhea
Constipation
Flatulence
Heartburn
It is actually possible to have diverticulosis and not know, because most people do not have pain or symptoms associated with it. The majority of cases do not show any symptoms. Some people may experience diarrhea, mild bleeding, constipation, flatulence, and heartburn. Many do not learn they have diverticulosis until they have a bout with diverticulitis.

6. Signs and Symptoms Diverticulitis Tenderness Cramps Abdominal pain
Infection
Fever
Nausea, vomiting
Blood in the stool
On the other hand, signs and symptoms of diverticulitis can be very painful and are likely to get the sufferers attention. Food caught in diverticula can cause tenderness of the abdominal region, cramps, and abdominal pain. It could also become infected this could lead to fever, nausea, and vomiting. There is often internal bleeding which could cause blood in the stool.

7. How do you know if you have Diverticular Disease?
Ask your doctor
Knowing could prevent
Pain
Hospital stays
Get tested by your doctor
If you think you are displaying signs and symptoms of diverticular disease it is a good idea to talk to your doctor. Knowing you have it can prevent future pain and possibly hospital stays, because you can make changes to help prevent complications in the future. There are tests your doctor can run to see if you have it.

8. What causes Diverticular Disease?
Lack of fiber in diet
weak areas form pouches
Lack of exercise
While the cause of diverticular disease is unknown, it is believed to be caused by a lack of fiber in the diet. Fiber makes stools soft and bulky making them easier for your intestines to move. When there is a lack of fiber to move it through, the stool may be hard and small, which causes stress the intestine. As a result of the pressure and stress, the weaker parts of the intestine may bulge out and form the pockets.
Also, a lack of exercise may also lead to diverticular disease. Exercise plays a role in maintaining a healthy colon. It helps move bowel movements through more easily and causes less stress on the intestine.

9. Controlling Diverticulosis
Diverticulosis is different than diverticulitis
High fiber diet
Adds bulk and softens stools
Exercise or physical activity
Although the exact cause of diverticulosis is unknown, it can be controlled. Diverticulosis is controlled differently than diverticulitis. Adopting healthy lifestyle habits is an effective first step in controlling diverticulosis and preventing diverticulitis from occurring. A high fiber diet is recommended with diverticulosis. An increase in the amount of dietary fiber will bulk up stool and the colon will not have to work so hard. Also, exercise or physical activity helps bowel movement and may be recommended. Be sure and consult your doctor before you begin any new exercise program.

10. Controlling Diverticulitis
Check with doctor first!
Low fiber (residue) diet initially
Gradually increase fiber
Low fat diet
In severe cases only
liquid diet or tube feeding may be necessary.
If you think you are showing signs and symptoms of diverticulitis, you should consult your physician first. Changes to your diet should not be made unless your doctor makes the suggestion. A doctor may choose to treat it by having you not eat foods or beverages that are not completely digested, such as fiber, this is often called a low residue diet. Then gradually return to a high fiber diet. Foods that are high in fat cause muscle contractions in the colon and may add to discomfort, so a low fat diet may also be recommended. In severe cases a liquid diet or tube feeding (to rest the colon) may be necessary.

11. Follow a High Fiber Eating Plan
Eat more fruits, vegetables, whole grains and beans
Increase fiber gradually
Drink plenty of water
Increasing the fiber in your diet is a pretty easy task and is important for your health even if you do not have diverticulosis. Foods that are high in fiber provide more than just fiber, they contain important vitamins and minerals. To increase fiber, eat more fruits and vegetables, whole grains, and beans. Fiber should be added gradually into your diet. If fiber is increase too quickly, it may cause uncomfortable bloating and gas. Also, drink plenty of water when you increase the amount of fiber that you eat to prevent constipation.

12. Should You Avoid Certain Foods?
Unknown at this time
Husks
Sunflower seeds
Peanuts
Popcorn
Fruit and vegetables with seeds
The question of whether eating foods with husks or fibrous material to prevent complications with diverticular disease is not known at this time. Some people believe husks can cause problems, so nut and seeds that have husks, such as sunflower seeds, peanuts, popcorn, and tough skinned vegetables are sometimes avoided.
If you have a reoccurring problem with diverticulitis it is a good idea to discuss these foods with your doctor. If your doctor recommends that you avoid them, then pay attention to his/her advice.

13. Be Physically Active Important for colon health
30 minutes most days of the week.
Divide into 5 to 10 minute sessions
Moderate intensity
Brisk walking, swimming, dancing, yard work, vacuuming, sweeping.
Being physically active is an important step you can take towards colon health. Experts recommend that you get at least 30 minutes of moderately-intense physical activity most days of the week. If you have been inactive, be sure to start slowly. Include periods of rest interspersed within your activity until you can more easily perform the activity continuously for at least 30 minutes. You can divide it into several sessions of 5-10 minutes. Examples of activities done with moderate intensity include brisk walking, swimming, dancing, yard work, vacuuming and sweeping the floor.

14. Points to Remember
Diverticular disease is a common disease that can develop with aging.
Lifestyle changes may help control diverticulosis and prevent diverticulitis.
Healthy eating – emphasizing a high fiber diet
Increase physical activity
If you experience signs and symptoms of diverticulitis consult your doctor.
There are several important points that you should take away from this lesson. Be aware that diverticular disease is a disease that can develop with aging. Making changes in your lifestyle may help control diverticulosis. These changes include healthy eating, emphasizing a high fiber diet from fruits, vegetables, whole grains, and beans; and increased physical activity. These lifestyle changes may help prevent problems with diverticulosis. If you do develop symptoms of diverticulitis, be sure to consult your doctor.

15. Review
Which is the more severe form of diverticular disease, Diverticulosis or Diverticulitis?
Why is it important to eat a diet high in fiber to help control Diverticulosis?
What should you do first if you experience symptoms of Diverticulitis?
Which is the more severe form of diverticular disease, Diverticulosis or Diverticulitis? Answer: Diverticulitis is the more severe form when the diverticula develop inflammation. Diverticulosis is a condition that can lead to a more severe condition, diverticulitis.
2) Why is it important to eat a diet high in fiber to help control Diverticulosis? Answer: A high fiber diet is recommended with diverticulosis. An increase in the amount of dietary fiber will bulk up stool and the colon will not have to work so hard.
3) What should you do first if you experience symptoms of Diverticulitis? Answer: If you think you are showing signs and symptoms of diverticulitis, you should consult your physician first. Changes to your diet should not be made unless your doctor makes the suggestion.