D

1. Diverticulosis-  the development of the little pouches in the colon wall
2. Diverticulitis- acute and sometimes severe abdominal pain with fever, usually requiring medical attention, antibiotics, and sometimes even hospitalization
3. Diverticula– the name of these pockets in the bowel

The general belief is that Diverticulosis develops over a long term of years stemming from a lack of adequate fiber in the diet especially with a diet high in meat. Seeds like poppy seed or sesame seeds, etc often can result in abdominal pain because the seeds get into diverticula (pockets) and cause irritation and infection. If there is a fever, it may be necessary to take an antibiotic. If it is a bad enough flareup, hospitalization can even become necessary where a liquid diet will be initiated and gradually worked back to low residual foods, etc. As the bowel heals, fiber over time needs to be increased to a higher amount and consumed ongoing forward. Some people have used psyllium husk fiber supplement over a long period of time and may be able to prevent flare-ups. If an active flare-up is unresolved and ongoing, it can turn into complications which may include obstruction in the bowel, abscess, and perforation all resulting in hospitalization. Seek medical attention if it doesn’t resolve on its own.

General Instructions 

Initiate complete bowel rest with a clear liquids diet of broth, pulp-free juice, and water for 24 to 48 hours. Gradually reintroduce foods by eating ONLY LOW FIBER low residual foods like white rice, fully cooked soft vegetables, rolled oats, mashed potatoes, and eggs. Continue on this diet until symptoms improve. 

To prevent another flare-up- you future goal as you recover is to;

1. Drink liquids daily–  about 1/2 gallon. You can accomplish this easily by filling 2 quart mason jars with herb tea, tea, or water and consume one before noon and the other after lunch ending by 4PM
2. Exercise regularly 
3. Gradually increase foods higher in fiber and work towards a high fiber diet 
4. Avoid seeds in foods such as poppy seeds, sesame seeds, small types that can become lodged in the diverticula
5. Avoid juice with pulp early on
6. Avoid smoking and keep alcohol consumption low

STEPS TO RECOVERY–  PREVENTION IS ESTABLISHING A HIGH FIBER DIET

Step 1

Clear liquid diet, usually 24-48 hours, although in more extreme conditions, up to 9 days. Consume only these during this clear liquid diet phase

• All kinds of broth 
• Bone broth (filtered to clear without particles)
• Collagen Peptides shaken to fully dissolve in pulp-free juice, diluted juice, or water. Gelatin is also ok but mix in cold water first to avoid clumping then add hot if you wish to. 
• Miso broth
• Pulp-free juice- (not citrus)  apple, cranberry, grape, mango, etc
• Popsicles
• Herbal tea
• Green or black tea
• Liquid to equal about 1/2 gallon daily which includes these listed

Step 2

Low residual diet;  this is a low fiber diet. Continue on this menu until symptoms subside and you are improved. Easy-to-digest foods are best. Taking enzymes like a pancreatin 4x or papaya enzyme may be helpful as an optional supplement. Here is a basic list of low residual foods to select from;

• White bread, white sourdough bread
• White rice
• White pasta
• Yogurt, cottage cheese, kefir, and milk unless lactose intolerant or have casein issues. If casein is your issue, try goat milk. Goat milk is very low in casein and will generally be tolerated well. Also try A2 milk which is also lower in casein but from cows 
• Protein:  eggs, fish, poultry- both turkey and chicken, tofu
• Fruits & Vegetables:  canned or well cooked without skin or seeds, such as applesauce, peeled carrots and potatoes

Step 3   Recommended Daily Fiber is between 25 to 38 grams 

Convert to high fiber once fully recovered from the flare-up. This must be gradual and progressive. Start with a small amount of higher fiber foods and increase gradually as tolerated. 

• Beans (try for 1/2 cup each day)  & lentils
• Whole grain foods like pasta, breads, and cereals
• Fruits & vegetables with skins

Step 4

Supplements are optional but beneficial. Consider these

• Psyllium Husk- either capsule or loose husks. Do not use powder, it is harder to mix and loose husk is just better. Taking 1-2 capsules at each meal can be easy and helpful. Taking the loose husk is better for higher fiber amount compared to the capsules. ALWAYS consume enough water when taking fibers including psyllium husk. It needs water to work and is required to expand or puff-up the fiber in the bowel for its purpose. If using powder, start with 1 teaspoon and over the course of about a week, work up to 1 tablespoon 2 x daily. When taking this fiber shaken into water or juice, allow 45 minutes before eating or taking a supplement capsule or medication. Psyllium can absorb your supplements so you lose the benefit if you don’t wait for the 45 minutes
• Bone broth- make your own, it is much less expensive and better quality
• Collagen Peptides- supports the bowel wall and the protein is easily absorbed
• Fish oil 1000 to 3000 mg. per day
• Vitamin D3  2000 to 5000 mg per day 
• Probiotics– we recommend the 16 Probiotic capsules, taken at bedtime
• Zinc  20-50 mg in capsule form only. It needs to be taken without food for best results. Some may get nauseated from it, while others have no problems. You have to try it to determine this. Do not take tablets
• Teas;  chamomile, comfrey leaf, teas, ginger root, slippery elm, marshmallow root or leaf
• Aloe Vera Juice – 1 oz a couple of times per day. It can loosen the stool so if that is an issue, take it once per day. Inner filet is better for those with diarrhea issues and whole leaf can act as an aid for constipation.