DIVERTICULOSIS AND DIVERTICULITIS
by Konstantin Monastyrsky
A high fiber diet is broadly recommended for the prevention of diverticular disease based on unconfirmed, unproven, untested, and speculative "theories" that a low fiber diet causes this pathology. In fact, it's the complete opposite — a high fiber diet is the primary cause of diverticular disease and related complications.
Diverticular disease has two distinct phases —
diverticulosis and diverticulitis. The first phase simply means that
you‘ve already acquired one diverticulum (singular) or several
diverticula (plural) inside your large intestine. Because it has no
symptoms, diverticulosis is usually discovered during a routine
colonoscopy or radiography exam.
The moment diverticulosis
turns into diverticulitis — inflammation of one or more diverticula, and
the second phase, — the conventionally-recommended treatment causes even
more harm because it is based on a combination of antibiotics and fiber.
It subjects patients to the unnecessary risks of abdominal surgery to
remove the affected colon, impaired immunity, uncontrollable bleeding,
ulcers, and strokes. This guide describes how to prevent diverticulitis
without resorting to fiber and antibiotics.
Well-known Facts About Diverticulosis
Diverticular disease isn‘t caused by genes or aging — two popular and widely believed misconceptions or intentionally told
If one of your parents had diverticular disease, and you get one too, it
has nothing to do with your genes, but with sharing the same table with
them for a good third of your life, and, thereafter, bringing up the
same eating habits into your adulthood.
● Aging. If
you get diverticular disease by the age 50 or 60, a good half of other
people in the same age group is still spared. Thus, it isn't like
getting age-related gray hair, wrinkles or the menopause, but some other
These “other causes” are hard stools (either large or
small), constipation, and straining:
“Constipation makes the muscles strain to move
stool that is too hard. It is the main cause of increased
pressure in the colon. This excess pressure might cause the weak
spots in the colon to bulge out and become diverticula.”
Diverticulosis and Diverticulitis;
National Institutes of Health; Publication No. 07?1163;
— But I've never
been constipated! My doctor diagnosed diverticular disease anyway. Why?
— Hard stools, that's why.
People who have hard stools
(either small or large), and strain to move the bowels, however
slightly, never consider themselves constipated.
The classical definition of constipation is “hard,
large stools,” not frequency or regularity of stools. Alas, most
people nowadays, including medical professionals, confuse constipation
with frequency of stools. In this erroneous worldview, only a
person who hasn‘t had a complete bowel movement for more than three days
is considered constipated, everyone else is just normal or "irregular."
A few generations ago the term “costivity” was broadly
used to describe large, hard stools and straining, while the term
“constipation” was used to describe irregularity. Unfortunately, both
terms have blended into one, and the distinction is no longer made.
For these reasons I reclassified constipation (see Fiber Menace, p.p. 97-128) into three distinct stages: functional (still reversible), latent (hidden), and organic (irreversible):
Functional constipation. This condition commonly follows surgery, colonoscopy, diarrhea,
temporary incapacity, food poisoning, treatment with antibiotics — the
circumstances that commonly damage intestinal flora and interfere with
intestinal peristalsis. A person becomes irregular, stools enlarged, and
may need to strain to complete moving the bowels. The person resorts to
fiber or laxatives for help.
If the intestinal flora, stools, and peristalsis aren't properly
restored following the adverse event, functional constipation
turns into the latent form (i.e. hidden), because fiber‘s or the laxative's
effects on stools creates the impression of normality. The stools become
larger, heavier, and harder, straining more intense, but there is an
impression of regularity.
Organic constipation. As time goes by, large and hard stools along with straining
enlarge internal hemorrhoids. This, in turn, reduces the diameter of the
anal canal, and causes anorectal nerve damage. At this juncture, the
person no longer senses a defecation urge, and becomes dependent on
laxatives to complete a bowel movement.
All through these three transformative stages, the
degree of straining increases, while the frequency of stools may remain
regular “thanks” to the laxative effect of dietary fiber. That‘s why you
can develop diverticular disease without any apparent “constipation.” In
reality, your constipation was already latent or organic, but rendered
invisible by laxatives or a laxogenic diet (i.e. high-fiber).
So it all boils down to English-language definitions.
If constipation was defined as “having large stools regularly that
may require a certain degree of straining” or “a condition
requiring a high-fiber diet and laxatives,” rather than “not
having stools for three days in a row,” you wouldn‘t have asked that
question, and wouldn't have developed diverticular disease in the first
Thus, with the correct definitions of constipation, you
and your doctors would logically concentrate on
reducing stool size and preventing straining — the essence of my
recommendations, — instead of attaining stools at least once every three
days. Those who have small stools and never strain to move their bowels
never develop diverticular disease, regardless of their age or gender.
It‘s apparent, then, that the life-long avoidance of
large stools and straining is key to the prevention and treatment of
diverticular disease, and it‘s particularly paramount for aging adults.
The alternatives to not treating the underlying causes
of large stools, constipation, and straining are more fiber in the diet,
more laxatives, more antibiotics, more pain and suffering, invasive
surgeries, substantial expense, and simply more of the same time and
again — where there is one diverticulum, there is often another lurking
nearby, and the only way to get rid of them all is to surgically remove
the entire colon, which is not exactly a safe or desirable option.
Diverticular disease gains in “popularity” with age:
10% are affected by the age of 40, over 50% by age 60, and almost 90%
beyond 80 years of age. No surprise here: constipation and straining are
particularly widespread among aging adults. Also, more women than men
are affected by diverticular disease because constipation affects
significantly more women than men.
It‘s sad, but true: unless you eliminate large stools
or straining and restore the natural functioning of the large intestine,
diverticular disease ALWAYS gets worse. This guide explains why it gets
worse and how to avoid it. Read on.
Prognosis: Most Often From Bad
Diverticulosis is irreversible, meaning that once
you‘ve developed even a single diverticulum it‘s yours for life, because
the body can‘t stretch back a protruded intestinal wall any more than it
can grow back new teeth.
Fortunately, if you restore the normality — intestinal
flora and small stools — inside the affected colon, and no longer need
to strain to move your bowels, diverticulosis most likely will remain
dormant for the rest of your life, and is no more harmful than the
crevices on an aging face — not necessarily a desirable outcome, but
If, on the other hand, you don‘t restore intestinal
flora and small stool size, and continue straining, the diverticula may
get filled by stagnant stools, become infected, and turn into
diverticulitis — an inflammation or ulceration of one or more
When diverticula get infected, you may experience
high fever, sense pain in the lower abdomen, observe blood in the
stools, or begin suffering from paradoxical diarrhea — a symptom of
When that happens, anything is possible: from an
abscess obstructing the colon to perforation of the intestinal wall;
from deadly peritonitis to an even deadlier sepsis. And that‘s what you
really want to avoid, because a large share of people don't survive this
experience, even when surgeons and hospitals are nearby and first class.
This applies particularly to the uninsured,
underinsured, or people far away from a major metropolitan area, who are
commonly relegated to overloaded, understaffed, under-equipped, and
low-rated community hospitals, where the experience of general surgeons
may not be as high as in the major teaching or specialized, gastric
In these cases, an emergency operation to treat
peritonitis by a general surgeon instead of an experienced gastric
surgeon with a similarly top-notch surgical team, usually has an outcome
similar to asking a professional cabbie to substitute a Formula One
So even if you are Mr. Buffet or Mr. Gates, and you
happen to be somewhere in the ?boondocks‘ (even with a fuelled jet
standing by to whisk you out, which is too late in this case), your
chances of surviving a perforation of an infected diverticula aren't
very high, considering that even in the best hospitals mortality rates
are sky-high — upwards of 25%.
I don't write this to convince you that diverticulitis
is dangerous (it is), but to tell you — don't be an idiot hoping that
your good insurance, good doctors, or loads of money may help you to get
away with this deadly ailment.
Pay and Pray vs. Think and Act
There are two diametrically opposed approaches to
remedy lifestyle diseases, and diverticular disease is no exception:
Pay and Pray. It means attack the disease directly, and hope it goes away. The
standard treatment protocol for diverticular disease relies on dietary
fiber, laxatives, antibiotics, systemic muscular relaxants,
immunodepressants, and finally, surgery to remove the affected portion
of the large intestine. Patients experience pain and suffering, and
incur hefty expenses in the process. After one diverticulum is patched
up, another one may flare up again at any time. “Pay and pray” is
clearly not effective, not safe, and not cheap.
Think and Act. It means eliminate the causes of diverticular disease. First — to
prevent diverticulosis from ever happening to you. Second — since
diverticulosis itself is irreversible, it may remain dormant as long as
the causes of infection (large, stagnant stools) are kept at bay. It‘s
also possible to recover from mild symptoms of diverticulitis, and, most
importantly, never again develop new diverticula.
My approach to eliminating the causes of diverticular
disease is simple and inexpensive. Just follow these three logical
Step #1. Eliminate dietary fiber
Considering everything you‘ve previously read, heard,
or known about diverticular disease, you must first eliminate dietary
fiber and fiber laxatives from your diet! There are three key properties
of fiber — bulk, acidity, and gases (the last two from fermentation) —
that make it such a disastrous choice for the prevention of diverticular
stools create pressure inside the colon, congest and obstruct the
infected diverticula, and require straining to expel them. The issue of
congestion and obstruction is an important one — how can one heal
inflammation or an ulcer inside the diverticulum, when the inner surface
of its mucosal membrane is “encrusted” by fibrous, acidified, gaseous,
decaying stools and pathogens that have no way of getting out?
colon‘s environment is mildly alkaline. The continuous acidity from
fiber‘s fermentation causes mucosal inflammation, decimates desirable
bacteria, and provides a good breeding ground for infectious bacteria
inside the colon.
who experiences flatulence knows how painful gases can be, especially
when you can‘t let them out in social settings. The gases create
permanent pressure inside the colon, and contribute to pain and
suffering. When these gases become trapped inside the infected
diverticulum, the pain is often unbearable.
Nonetheless, fiber is still recommended because it's
the only “soft” laxative considered suitable for long-term (years
instead of just days or weeks) use. In essence, fiber is a lesser kind
of evil vis-?vis other types of “hard” laxatives.
Not that medical
professionals or even patients aren't well-aware of fiber's significant
side effects — patient notes (which describe them) are inserted into
every single package of fiber laxatives:
“Side Effects: Bloating, gas, and a feeling
of fullness may occur. If these effects continue or become
bothersome, inform your doctor. Notify your doctor if you
experience: stomach cramps, nausea, vomiting, rectal bleeding,
Metamucil Powder; Rite Advice,
Patient Counseling at www.RiteAid.com
And it makes no
difference whether the fiber comes from a capsule, powder,
shake, wafer, or one‘s diet — once inside your gut, fiber is
still fiber regardless of how it was processed and packaged.
Even if none of these side effects bother you, once
you're hooked on fiber, straining becomes inescapable for the following
properties. Doctors and nutritionists refer to indigestible
fiber as a 'bulking laxative' or 'roughage' because it makes stools?
rough and bulky.
'Bulky' means that the stool's weight increases from a normal 75-150 g
to 300-500 g per day.
'Rough' means that the stool's size (diameter) increases from a normal
15-20 mm to 30-35 mm or more. The fiber itself isn‘t necessarily
“rough,” but the large stools are definitely rough on the delicate
tissues of the colon, rectum, and anal canal.
And that‘s how the problems commence. Because the
maximum opening (aperture) of an adult anus is tiny — 3.5 cm (1.4”) —
large stools can‘t easily pass. If you already have enlarged internal
hemorrhoids — and about two thirds of people over fifty do — the anal
opening is even smaller. Straining becomes the only way to expel large
stools through the narrow pathway.
Next comes the possibility of inflammation inside the
diverticula, because soluble fiber (mucilage, hydrophilic
mucilloid) is a potent inflammatory and diarrhea-causing agent.
Inflammatory bowel disease (IBD) directly contributes to the development
of alternating patterns of diarrhea and constipation, straining,
formation of new diverticula, and diverticulitis.
But here comes the Catch 22: once you‘ve
eliminated all kinds of fiber, constipation may grow even worse because
now stools are starting to become small, hard, and dry, and you need to
strain even harder to expel them. This phenomenon is well familiar to
anyone who tried and failed the Atkins Diet, which is fiber-free by
To break this vicious cycle of strain if you do,
strain if you don‘t, follow my recommendations in Overcoming Fiber Dependence guide.
Step #2. Restore intestinal flora
Healthy bacteria reside and procreate inside the
protective layer of the mucosal membrane, and derive their nutrients
from mucus. To give them a good home and head start, your mucosal
membrane must be healthy, well-nourished, and populated with beneficial
bacteria. To accomplish this goal, follow my recommendations in the Restoring Intestinal Flora guide.
Step #3. Eliminate straining
Straining is a “side effect” of large stools, hard
stools, irritable bowel syndrome, anorectal nerve damage, impaired
peristalsis, and constipation.
Whatever you happen to have, all of these conditions
are addressed in depth in the Restoring Normal Bowel Movements and Restoring Anorectal Sensitivity guides. If you are affected by IBS, please also study the Irritable Bowel Syndrome guide.
It goes without saying, that all of these guides are
interrelated, and all three steps are usually executed in parallel.
That‘s all there is to my method: stay clear of fiber,
normalize your stools to prevent straining, eliminate disbacteriosis,
restore the biological function of your large intestine, and help the
bacteria to take hold inside your gut. Simple, safe, inexpensive,
efficient, and good for your health.
Finally, let me warn you in the least ambiguous terms:
when you are experiencing diverticulitis — an acute form of diverticular
disease — DO NOT FOLLOW ANY OF THESE RECOMMENDATIONS. At this point
you'll need professional medical help. Only once you are stable — no
bleeding and no sharp pain — you can start relying on the above guides
to prevent a relapse.
Also, I recommend informing your doctors as forcefully
as possible about this site and Fiber Menace. Don't be
embarrassed — it's your health and life on the line, not your
self-esteem. Dead patients don't blush. The doctors aren't shrinking
violets either — they'll take your advice in stride because they too
don't want to get embarrassed by prescribing you a wrong and harmful
And if they ignore your pleas to review this
information, and continue to insist that you keep using fiber and
antibiotics to prevent and treat diverticular disease, they will, at the
very least, violate the code of medical ethics (Hippocratic
Oath) which says:
— I will prescribe regimens for the good of
my patients according to my ability and my judgment and never do harm to
— To please no one will I prescribe a
deadly drug nor give advice which may cause his [patient] death.
analytical essay was published back in 2005. As expected, it was
universally ignored, dismissed, and ridiculed by patients and doctors
alike. Six-and-a-half years and millions of harmed lives later, I was
finally proven right. Judge for yourself:
Fiber Not Protective Against Diverticulosis
Contrary to popular medical wisdom, following a high-fiber diet has no
protective effect against developing asymptomatic diverticulosis,
according to a colonoscopy-based study presented at the 2011 Digestive
Disease Week (DDW) meeting (abstract 275).
In fact, the study showed that
patients who ate more fiber actually had higher prevalence of the
and Endoscopy News, July 2011, Volume: 62:07]
Fiber May Not Prevent Diverticular Disease
decades, doctors have recommended high-fiber diets to patients at risk
for developing the intestinal pouches, known as diverticula. The
thinking has been that by keeping patients regular, a high-fiber diet
can keep diverticula from forming.
But the new study suggests the
opposite may be true. [WebMD,
January 23, 2012]
A High-Fiber Diet Does Not Protect Against Asymptomatic Diverticulosis
A high-fiber diet and increased
frequency of bowel movements are associated with greater, rather than
lower, prevalence of diverticulosis. Hypotheses regarding risk
factors for asymptomatic diverticulosis should be reconsidered. [Gastroenterology;
Volume 142, Issue 2, Pages 266-272.e1, Feb. 2012]
Frequently Asked Questions
Q. Why aren‘t doctors using your method to treat and
prevent diverticular disease?
Because it isn‘t based on the kind of interventional
therapy doctors traditionally perform, but on basic preventive
principles available to anyone. Just as you don‘t need a prescription
for a bar of soap to keep your hands germs-free, you don‘t need a doctor
to prevent diverticular disease.
The sole objective of my method is to keep a person
with a case of preexisting diverticulosis from turning into
diverticulitis. Once that happens, it‘s too late for prevention, and
you‘ll need a doctor. In an ideal world, after patching you up, doctors
would suggest using this method to prevent a relapse. And as doctors
learn more about it, some of them certainly will.
Q. Why does fiber seem to help some people with
It doesn‘t. At best, fiber is a placebo. At worse, it‘s
the main cause of diverticular disease. In between, it creates a false
sense of security and postpones proper treatment, because fiber may
temporarily reduce the symptoms of irregularity by increasing the size
and weight of stools, and create the illusion that you‘re no longer
constipated. It may also cause diarrhea or semi-soft stools, which, for
a while, may clear out the content of an infected diverticulum.
When a person experiences mild diverticulitis, doctors
invariably prescribe antibiotics, pain relievers, and anti-inflammatory
drugs. The resulting remission results from medication therapy, and not
Furthermore, patients with acute diverticulitis aren‘t
placed on high-fiber diets to “relieve” it, but on a zero-fiber liquid
diet, because gastric surgeons, who are called in to manage the
treatment at this stage, are well aware of fiber‘s danger, and prohibit
patients from taking it.
Q. Why does
the conventional treatment of diverticulitis may cause more harm than
The conventional treatment may certainly save you from
lethal infection, but not from inevitable relapse and surgery. As odd as
it may sound, the standard treatment protocol recommends a high fiber
diet for patients who have just recovered from acute diverticulitis
“For the patient who is not very ill, treatment at
home is reasonable, with rest, a liquid diet, and oral antibiotics (cephalexin
250 mg qid [four times daily]). Symptoms usually subside rapidly. The
patient gradually advances to a soft low-roughage diet and a daily
psyllium seed preparation. A barium enema 2 wk later can confirm the
diagnosis. After 1 mo [month], a high-roughage diet is resumed.”
THE MERCK MANUAL, Sec. 3,
Ch. 33, Diverticular Disease
The key reason behind this oddball strategy is the
simple fact that after this intense treatment with antibiotics, the
patients‘ intestinal bacteria are wiped out, and they become
constipated. A “high-roughage” diet creates the illusion that there is
normality, but, alas, this treatment (antibiotics + fiber) is bound to
cause diverticulitis again (and not just diverticulitis).
The 17th edition of The Merck Manual finally
acknowledged antibiotics-associated colitis: an “acute inflammation of
the colon caused by Clostridium difficile [pathogenic bacteria] and
associated with antibiotic use.” (3:33:29).
After a certain amount of time this condition may turn
into chronic ulcerative colitis, which increases the risk of colon
cancer up to thirty-two times, and, according to The Merck Manual,
“nearly 1/3 of patients with extensive ulcerative colitis require
surgery” (3:33:31), which usually means colectomy (the complete removal
of the colon).
Nonetheless, doctors follow this absurd treatment
protocol because that‘s the protocol they were taught while in medical
schools, and any other approach may trigger a malpractice lawsuit..
This practice is even stranger when you consider that
patients are initially (and properly) advised to adopt a fiber-free
liquid diet to heal their acute diverticular inflammation. But once the
acute stage has passed, their health and recovery is put in jeopardy
again by exactly the same fiber that caused their diverticulitis in the
This is a systemic error that snuck its way into
medical textbooks and still rules. My work on the adverse role of fiber
in human nutrition and disease is the first substantial revision of this
destructive doctrine and unhealthy practice.
Q. What are the most common misconceptions about
fiber‘s role in diverticular disease?
The therapeutic and preventative role of fiber in diverticular
disease is steeped in its own mythology. Let‘s review these
myths, as detailed in the article entitled Diverticular Disease by the National Institutes of Health.
For starters, even the opening statement reveals that the
beneficial role of fiber in the prevention and treatment of
diverticular disease is just conjecture (a theory) without any
“Although not proven, the dominant theory is that a low-fiber
diet is the main cause of diverticular disease.” [link]
Here are the other “dominant” falsehoods from the same source:
[diverticular] disease was first noticed in the United States in
the early 1900s. At about the same time, processed foods were
introduced into the American diet. Many processed foods contain
refined, low-fiber flour. Unlike whole-wheat flour, refined
flour has no wheat bran.”
Not true. The “disease was first
noticed” in the early 1900s not because of dietary changes in
the American diet, but because in 1895 Wilhelm Conrad R?tgen
accidentally discovered X-rays. Before X-rays became
commonplace, people were dying from undiagnosed and unknown
internal diseases because there were no non-invasive diagnostic
tools, no exploratory surgeries, and autopsies were extremely
rare. Secondly, since diverticular disease affects primarily
people over 50, dietary changes in the early 1900s wouldn‘t even
show up in people until the late 1930s or early 1940s.
disease is common in developed or industrialized countries —
particularly the United States, England, and Australia — where
low-fiber diets are common.”
Not true. Also common in these
countries is watching television, drinking beer, and driving a
car. But just like any other conjecture, it doesn‘t mean these
activities cause diverticular disease. Diverticular disease is
more common in developed Western countries not because the
traditional Western diet is low in fiber, but because of
excessive consumption of fiber and fiber laxatives. If
Westerners consumed even more fiber, the incidence of
diverticular disease would be even higher, as described in the
[diverticular] disease is rare in countries such as Asia and
Africa, where people eat high-fiber vegetable diets.”
Not true. (a) High-fiber diets
are prevalent only among the poor and very poor, usually in
rural areas; (b) poor people in these regions die well before
the age commonly associated with diverticular disease in the
West; (c) no reliable healthcare system exists in rural Africa
and Asia to provide reliable and relevant health statistic
regarding diverticular disease; (d) when Africans do have access
to hospitals, doctors have concluded: “The study shows that
the African colon has a number of pathological lesions contrary
to previous reported literature.” (Ogutu EO, at al;
Colonoscopic findings in Kenyan African patients; East Afr Med
J. 1998 Sep;75(9):540-3); and (e) affluent Africans and Asians
consume very little fiber — as is apparent to anyone who‘s ever
visited an authentic Asian (Japanese, Chinese, Thai, Korean,
Indian) or African (Moroccan, Ethiopian, Kenyan, South African)
restaurant, where the dominant dishes are meat, fish, and sea
food, and the side dishes are primarily white rice, whose fiber
content is a just 0.4%.
“Both kinds of
fiber help make stools soft and easy to pass,” which is good
for diverticular disease.
Not true. Insoluble fiber is a
bulking laxative. It makes stools large and hard to pass. That‘s
why fiber is called “roughage.” Soluble fiber is a
hyperosmolar laxative and diarrhea-causing agent. It does makes
stools watery, but it also causes bowel inflammation, bloating,
and flatulence, and isn‘t suitable for extended use.
prevents constipation,” which is essential for diverticular
Not true. Fiber DOES NOT prevent
constipation. Just like aspirin can relieve pain, natural and
medicinal fiber can relieve constipation in people because it is
a potent laxative. But fiber can‘t prevent constipation, just
like aspirin can‘t prevent migraines or arthritis. In fact, if
any aspirin manufacturer made such an outlandish claim, the FDA
would shut it down.
Also, note that fiber DOES NOT relieve chronic constipation,
only sporadic constipation in healthy people. When a few
legitimate attempts were made to prove fiber‘s effectiveness for
“chronic constipation,” according to the American College of
Gastroen?terology Functional Gastrointestinal Disorders Task
Force (2005), they didn‘t pan out as explained in Fiber
Specifically, there are 3 RCTs [randomized controlled
trials] of wheat bran in patients with chronic constipation,
but only 1 is placebo-controlled. This trial did not
demonstrate a significant improvement in stool frequency or
consistency when compared with placebo — neither did 2
trials that compared wheat bran with corn biscuit or corn
Schoenfeld, MD, MSEd, MSc;
Medscape Today from WebMD
Because people who are affected by chronic constipation are also
likely to be affected by hemorrhoidal disease and anorectal
nerve damage. In this case, large, rough stools are not only
undesirable, but are outright damaging. if you already have
diverticular disease, your goal is not “large stools more
often,” but small stools without straining, and fiber
is never going to help you accomplish this reasonable and easily
Q. What is the normal frequency of stools?
Ideally, you should move the bowels after each major
meal. Eating and/or drinking stimulate(s) a wave of intestinal
peristalsis (gastrocolic reflex) which always precedes defecation. The
breaking of this natural pattern of elimination necessitates straining
because withholding a bowel movement even once causes stools to enlarge
and dry out. This, incidentally, is why you should never encourage
children to withhold stools.
Also, stool withholding is the primary cause of
“traveler‘s constipation.” Fiber in this case becomes outright
dangerous. First, it takes two to three days for fiber to reach an
already congested colon. Second, by the time it does, fiber makes
matters only worse, because the situation becomes similar to a police
car trying to clear out gridlock by driving right into the middle of it.
That‘s how some people “earn” diverticulosis — elastic intestinal walls
can easily stretch, bulge, and prolapse to accommodate the arriving and
Q. I don‘t strain, I‘m not constipated, I don‘t
consume fiber, I have small stools, and I still have diverticulosis?
Even a single occurrence of intense straining years ago
may have created one or more diverticula. And the chances of that
happening grow as you get older because aging intestines aren't as
elastic and resilient as before.
Q. What if I still require surgery?
Surgery resects (cuts out)
the part of the large intestine affected by infected diverticula. If you
go back on a high-fiber diet after the surgery, in a few years or even
few months time you may develop another diverticulum, because all of the
conditions that were in your colon before the surgery will repeat
themselves again. Perhaps they‘ll get even worse, following the
compulsory treatment with antibiotics. Besides, even if you need
surgery, your stools and intestinal flora should be kept as normalized
as possible to prevent complications and to speed-up recovery.