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Have severe diverticulosis. Suffering from digestive issues. Suggest diet and also medication/treatment?

May 2014
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Practicing since : 2002
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Hello, have just had CT scan due to trip and fall (showing pelvic fracture); getting around is slow of course on crutches. The CT scan also is the first time I've heard that I have "severe diverticulosis", which my GP said is largely undetected in the majority of people who have it, and also I was advised I may not ever even get diverticulitis. However, I have been suffering from digestive issues for last five days which causes me to rush to the loo which is both painful trying to rush anywhere on crutches, as well as emotionally scary in case there's not enough time. I understand high fiber foods/lots of raw fruits & vegetables are in part the preventative eating treatment for diverticulosis; however that is not so good with existing digestive problems which Immodium hasn't stopped (unless I stop eating for 24 hours, at which point it seems to work. But then as soon as I have even a rice-only meal, the problem returns). Long-term, I face additional reparative surgery from a rupture I suffered when giving birth to my first child 25 years watery stools are not helpful whether short term or long-term, except that they are not terrible if one has diverticulosis. Do you have either diet/nutrition advice or medical/Rx advice I might consider or review with my GP? Thank you.
Posted Thu, 18 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Vivek Chail 1 hour later
Hello XXXXX,
Thanks for writing in.

This is Dr Vivek, specialist in CT scan with 10 years experience answering your question.

I have gone through your details and substantiate that presently you have 3 problem areas:
1. Pelvic fracture due to osteoporosis.
2. Diverticular disease (described as severe by you as per your doctor).
3. Reparative surgery for a rupture that's 25 years old.

Right now you seek guidance regarding medical and surgical treatment and nutrition.
As you must be informed, diverticuli are small mucosal outpouchings from bowel wall.
Let me tell you that diverticulitis has a lower incidence in elderly patients. In those symptomatic, there is an acute form and a low grade chronic form.

I would like a colonoscopy to confirm CT scan findings first. Please do share your CT report findings if possible.
You should be aware of following symptoms which herald diverticulitis:
1. Altered bowel habits.
2. Nausea with vomiting.
3. Pain lower abdomen left side.
4. Bloating and flatulence
5. Watery stools and constipation

Elderly patients are less symptomatic.

Medical treatment:
1. Liquids in diet.
2. Antibiotics for a week.
3. Slow improvement in diet after stabilising patient's bowel.
4. Pain management.

Surgical treatment:
This can be done as
1. Single stage surgery (elective approach)
2. Two stage surgery (commonly practised)
3. Three stage surgery (classical approach and rarely done nowadays)

Nutritional information:
A high fiber low fat diet.
In symptomatic patients, role of high fiber diet is less than in symptomatic ones.

Hope I have answered your question.
Please do send in more questions if you require more information.

If you don't have questions, I request you to please close this thread and post feedback.

Dr Vivek.

Above answer was peer-reviewed by
Follow-up: Have severe diverticulosis. Suffering from digestive issues. Suggest diet and also medication/treatment? 25 hours later
Dear Dr. XXXXXXX thank you for your time and patience in responding. The problem of a high-fiber diet, I believe, is that it is going to encourage more bowel movement and while I've not yet conquered the current diahhreal condition, am concerned doing the right thing for diverticulosis may not be doing the right thing for my current condition of diahhrea, exacerbated by having to move about by crutches and also the current condition is risky due to the lessened effectiveness of 25-year-old surgery on the rectal wall/sphincter muscle...

Do I manage my diet and medication therefore for the acute diahhreal situation and be sure I am essentially not risking any watery stool condition, at least until either a) I'm off crutches or b) until I've had some reparative surgery/treatment for the muscles that seem to not be holding as well as they used to do? Or is the 'severe' diverticulosis the much greater problem and I should eat high fiber and just live next to a loo since I may not otherwise be able to manage appropriate controls? Thank you.
Answered by Dr. Vivek Chail 8 hours later
Hello XXXXX,
Thanks for your question and I am pleased to help you out with your problem.

As you have written, it is true that a high fiber diet is given to soften the stool and prevent constipation. It will also reduce intraluminal pressure in the during colonic transit and decrease chances of acute diverticulitis.

Right now we have two situations in our minds concerning your dietary modifications.
A.     Your current diarrhea which you have been tolerating for the last week, along with crutches and reparative surgery problem.
B.     Your severe diverticulosis which has been diagnosed on CT scan.

First I will consider your present acute diarrhea and suggest a low fiber diet and once you are comfortable, you can slowly change that to a high fiber one. Details of both are given as follows.

A.     For the current acute diarrhea:

I suggest you go in for a low fiber diet right now and slowly increase fiber content as your diarrhea improves.

Components of a low fiber diet include:

1.     White bread and white rice
2.     Canned or well cooked vegetables (after removing seeds and pealing off skin)
3.     Canned or cooked fruit (after removing seeds and pealing off skin)
4.     Dairy products such as cheese, milk and yogurt
5.     Eggs
6.     Low-fiber cereals
7.     Meat that is finely ground or tender and well cooked
8.     Pasta

When your situation improves, you can switch over to a normal high fiber diet by slowly increasing the fiber amount over a week.

It is true that a clear liquid diet is more suitable in acute diarrhea, but this is not what would suit you with crutches and your 25 year old surgical history. However, for your information (you could follow this when you are off crutches/ post surgical repair and if the need arises) a clear liquid diet would surely help.

Component of clear liquid diet is generally juices without pulps, broth, tender coconut water.

B.     Diet to continue keeping your severe diverticulosis in mind:

A high fiber diet that we have been talking about earlier can be taken as per your suitability with following components.

1.     Multi grain and whole wheat bread and cookies
2. XXXXXXX whole grain cereals such as oatmeal porridge
3.     Beans and legumes
4.     Vegetables such as broccoli, carrots, corn
5. Fruits with high fiber such as apples, bananas and pears
6.     Brown rice
7.     Whole wheat pasta

Please have adequate amounts of fluids and water to avoid dehydration.

I hope that your question has been answered.
Further questions are always welcome. If you don’t have any more questions, I request you to please close this thread and post a feedback.

Hope you come off your crutches soon,
Wishing you good health

Dr Vivek
Above answer was peer-reviewed by
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