Definitions
Diverticular disease is the term that encompasses diverticulosis and diverticulitis.
Diverticulosis is the presence of one or more diverticula (small pouches) in the colon (large intestine). It can be asymptomatic or symptomatic. Diverticular disease is defined by symptomatic diverticulosis.
Diverticulitis is the inflammation and/or infection of the diverticula. It can be acute or chronic. It characterizes the acute phase of diverticular disease.
Symptoms
Symptoms of diverticular disease may include abdominal distension, abdominal pain, bloating, nausea, diarrhea, constipation, and tenesmus (the urgent need to defecate). Symptoms may be worsened by food intake and relieved by passing stool or gas.
Nutritional treatment
There is no nutritional treatment for asymptomatic diverticulosis. In the case of diverticular disease, the goal of nutritional treatment is to increase the weight and volume of stools to reduce pressure on the colon walls and to optimize the intestinal flora. Generally, recommendations include adopting a high-fiber diet (25–35 g/day), maintaining adequate hydration (1.5–2 L of water/day), engaging in physical activity, and consuming probiotics (L. Casei).
Acute phase
During the acute phase (diverticulitis), the individual may have a liquid diet or NPO (nil per os or nothing by mouth) to reduce pressure on the colon walls. If necessary, treatment may also involve the use of parenteral (intravenous) therapy to maintain fluid and electrolyte balance. Then, the diet progresses to a restricted-fiber diet, then moderate, and finally normal, according to each individual's tolerance.
Long term
In the long term, the nutritional treatment of diverticular disease is adopting a high-fiber diet. It is adopted when acute symptoms disappear and progressively. Indeed, the amount of fiber consumed should be increased gradually to avoid potential digestive discomfort. At the beginning of treatment, it may also be recommended to favor soluble fibers, which are gentler than insoluble fibers. Soluble fibers are found in certain fruits, vegetables, grains, and legumes. A high-fiber diet notably helps optimize bowel function and contributes to reducing recurrences. Finally, it is important to note that consuming fruits and vegetables with seeds, seeds, nuts, corn, and popcorn would not increase the risk of diverticulosis or diverticular complications. It is therefore no longer recommended to avoid these foods in cases of diverticular disease.
References
- Bouthillier, Lise. January 2019. “Digestive Tract Diseases.” NUT 2047 – Clinical Nutrition 2. Montreal: University of Montreal.
- Schwartz, L., and C. E. Semrad. “Diverticular Disease and Diet.” Modern Nutrition in Health and Disease, by A. Catharine Ross, Wolters Kluwer/Lippincott Williams & Wilkins, 2014, pp. 1099–1101.
- https://www.merckmanuals.com/fr-ca/professional/troubles-gastro-intestinaux/maladie-diverticulaire/d%C3%A9finition-de-la-maladie-diverticulaire
- https://www.merckmanuals.com/fr-ca/professional/troubles-gastro-intestinaux/maladie-diverticulaire/diverticulose-colique
- https://www.merckmanuals.com/fr-ca/professional/troubles-gastro-intestinaux/maladie-diverticulaire/diverticulite-colique
- https://www.unlockfood.ca/fr/Articles/Digestion/Digestive-health/Ce-que-vous-devez-savoir-au-sujet-de-la-maladie-di.aspx#:~:text=Si%20vous%20souffrez%20de%20diverticulose,ou%20infect%C3%A9es%20par%20des%20bact%C3%A9ries