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by John R. DeBanto, M.D.

Diverticulosis is a disease of the colon experienced mostly by those who live in westernized societies. It is characterized by “outpouchings” or “potholes” in the colon. The main complications include bleeding, infection and pain. Diverticulosis is a tremendous problem which accounted for over 2.7 billion dollars in health care costs in the United States annually, according to the American Gastroenterological Association.

The Cause
Diverticulosis is probably caused by increased intraluminal (inside the colon) pressure and abnormal motility (the movement of the colon). Those individuals who consume more fat and less fiber – typical of a meat-based diet – tend to be predisposed to diverticulosis. Meat has essentially no fiber and those who consume it without a proper amount of fiber may be at risk of developing diverticulosis and its potential complications. A study at Oxford in England showed that vegetarians were less likely to have diverticulosis than nonvegetarians, 12% to 33%, respectively. A study in Greece has also found a correlation between the lack of fiber and the increased risk of diverticulosis.

The Risks
Diverticulosis alone can have associated spasm with resultant crampy abdominal pain. However, there is also the possibility of diverticular hemorrhage which occurs in 15% to 40% of those with diverticulosis and can be life threatening, especially in those of advanced age. The bleeding usually requires the patient to be hospitalized, and surgery may even be required if the bleeding is severe or persistent. Luckily, the bleeding does not recur in most cases and preventative measures can be taken that include a high fiber diet. Diverticulitis occurs in 10% to 25% of those with diverticulosis. It is characterized by inflammation and infection of the little “outpouchings” which can be very painful and cause a high fever. Diverticulitis can lead to serious consequences such as peritonitis (severe inflammation of the area around the intestinal tract characterized by severe pain with movement), which is a surgical emergency. Diverticulitis may require hospitalization.

Diverticulosis, with its potential complications and high health care costs, may be prevented by a diet high in fiber – including fruits, legumes, whole grains and vegetables – and an avoidance of a diet higher in animal fats such as meat and dairy products. Theoretically, those with a strictly vegetarian or vegan diet should be able to ingest the proper amounts of fiber per day and avoid the costly and potentially serious consequences of diverticulosis. However, it takes 20-30g of bran to achieve a therapeutic effect for those already suffering from diverticulosis. In that case, most physicians recommend a supplemental fiber such as psyllium, one to two tablespoons a day with plenty of water.

Dr. DeBanto is a specialist in the field of gastroenterology.

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