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Diverticular Disease
 

Diverticular Disease Introduction

Diverticula are small, pea- or grape-sized pouches caused by the protrusion of the inner lining of the large intestine through weakened areas of the colon wall. The presence of diverticula in the colon wall is called diverticulosis. Colonic diverticula are often associated with a low-fiber diet. The lack of fiber has become commonplace in many Western diets, and often leads to conditions such as chronic constipation. Constipation causes straining during bowel movements, since the smaller and harder stools are more difficult to pass. Diverticula form when the pressure inside the intestine increases from straining during defecation or from lack of fecal bulk.

Diverticulosis usually has no symptoms. However, symptoms such as fever and lower abdominal pain can occur with a condition known as diverticulitis. This condition results when the diverticula become inflamed, perforated, or impacted. Diverticulitis can be caused by undigested food particles and bacteria that have become trapped in the diverticula. Diverticulosis and diverticulitis are also called diverticular disease.

Diverticular Disease Symptoms

Diverticular disease usually has no symptoms, but may include;

  • mild abdominal cramps
  • bloating
  • constipation

If diverticulitis is present, symptoms can include;

  • Episodes of lower abdominal pain and cramping
  • Tenderness in the abdomen
  • Changes in bowel habits (constipation or diarrhea)
  • Fever
  • Possible nausea and vomiting

Complications developing from diverticular disease are rare, but can include rupture of the inflamed diverticulum, spilling feces and bacteria into the abdominal cavity. This may lead to peritonitis, an inflammation of the abdominal cavity membrane, requiring hospitalization and possible surgery.

Diverticular Disease Statistics

According to the National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health (1):

  • About 10 percent of Americans over the age of 40 have diverticulosis.
  • Diverticulosis becomes more common as people age.
  • About half of all people over the age of 60 have diverticulosis.

Diverticular Disease Treatment

A high-fiber diet is the most important component in the prevention and standardized treatment of diverticular disease. When treating the condition and its associated complications, like bacterial infections, antibiotics are commonly prescribed. Diverticular rupture and peritonitis require hospitalization, intravenous antibiotics, and possible surgery.

Supplements helpful for Diverticular Disease

Psyllium and Pectin Fiber

A high-fiber diet including the use of natural plant fibers such as pectin (fruit fiber) and psyllium may be an effective prevention and treatment of diverticular disease. [2-4] Pectin and psyllium have been traditionally used as bulking agents to improve stool consistency, promote peristalsis, and reduce straining during defecation. [5]



Probiotics (Lactobacillus acidophilus and bifidobacteria)

Probiotics supplementation is shown to enhance intestinal tract immunity, improve digestive health, relieve food allergy symptoms, and insure healthy intestinal microflora. Since antibiotics are used to treat diverticulitis, and often destroy friendly bacteria in the intestinal tract, probiotic supplementation may be particularly helpful for persons suffering from this condition. [6-8]



Peppermint Oil

Enteric-coated peppermint oil supplements have been shown to reduce colonic spasm and abdominal pain. Peppermint oil supplementation also has antimicrobial effects on the intestines, which may be effective for diverticulitis. [9-12]



Olive leaf extract

Olive leaf extract contains a phenolic glucoside, known as oleuropein, which has been shown to have powerful antioxidant and antimicrobial properties. [13-14] Olive leaf extract supplementation can also help to maintain healthy intestinal microflora.



Oregano Oil

Oil of oregano has been used traditionally for various inflammatory conditions, infections, indigestion, dysentery, and jaundice for centuries. Oregano oil is a powerful antiseptic and potent antibacterial, and has been used as an alternative to antibiotics [15]. Oregano oil supplementation has been shown to eliminate bacterial microorganisms, including intestinal bacteria and parasites. [16-18]



Grapefruit seed extract

Grapefruit seed extract has been shown to exhibit certain antimicrobial and antifungal properties in the gastrointestinal system. [19-20] Grapefruit seed extract supplementation may assist in the restoration and maintanence of healthy intestinal microflora.



Cat’s Claw

Cat's Claw, a traditional South American medicine, has been shown to have antimicrobial and antifungal properties. Cat’s Claw extract supplementation may help eliminate intestinal pathogens and support healthy intestinal microflora. [21-23]

References

1. National Institute of Diabetes and Digestive and Kidney Diseases:

http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101840.shtml

2. Johnson HC Jr, Block MA. Diverticular disease. Current trends in therapy. Postgrad Med. Sep1985;78(3):75-9, 82.

3. Ozick LA, et al. Pathogenesis, diagnosis, and treatment of diverticular disease of the colon. Gastroenterologist. Dec1994;2(4):299-310.

4. Leahy AL. High fibre diet in symptomatic diverticular disease of the colon. Ann R Coll Surg Engl. May1985;67(3):173-4.

5. Pizzorno JE and Murray MT, eds. Encyclopedia of Natural Medicine, revised 2nd edition, CA: Prima Publishing, 1998: 142

6. Saavedra, J.M. Clinical applications of probiotic agents. Am. J. Clin. Nutr. 2001 Jun; 73(6): 1147S-1151S.

7. Clements ML, et al. Exogenous lactobacilli fed to man: their fate and ability to prevent diarrheal disease. Prog Food Nutr Sci 1983 (7): 29-37.

8. Gotz VP et al. Prophylaxis against ampicillin-induced diarrhea with a lactobacillus preparation. Am J Hosp Pharm 1979 (36): 754-7.

9. Hills JM et al. The mechanism of action of peppermint oil in gastrointestinal smooth muscle. An analysis using patch clamp electrophysiology and isolated tissue pharmacology in rabbit and guinea pig. Gastroenterology 1991 (101): 55-65.

10. Somerville K et al. Delayed release peppermint oil capsules (copermin) for the spastic colon syndrome: a pharmacokinetic study. Br J Clin Pharmacol 1984 (18): 648-40.

11. May B et al. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneim forsch 1996 (46): 1149-53.

12. Pizzorno JE and Murray MT, eds. Encyclopedia of Natural Medicine, revised 2nd edition, CA: Prima Publishing, 1998: 612

13. Bisignano G, et al. “On the in-vitro antimicrobial activity of oleuropein and hydroxytyrosol. J Pharm Pharmacol. 51 (6) (1999): 971-4

14. Visioli F, et al. Oleuropein, the bitter principle of olives, enhances nitric oxide production by mouse macrophages. Life Sci 62 (6) (1998): 541-6.

15. Dorman HJ, et al. Antimicrobial agents from plants: antibacterial activity of plant volatile oils. J Appl Microbiol. Feb2000;88(2):308-16.

16. Force M, et al. Inhibition of enteric parasites by emulsified oil of oregano in vivo. Phytother Res. May2000;14(3):213-4.

17. Lamaison JL, et al. Medicinal Lamiaceae with antioxidant properties, a potential source of rosmarinic acid. Pharm Acta Helv. 1991;66(7):185-8.

18. Marino, M., Bersani, C., Comi, G. Impedance measurements to study the antimicrobial activity of essential oils from Lamiaceae and Compositae. Int. J. Food Microbiol. 2001 Aug 5; 67(3): 187-95.

19. Ionescu G, et al. Oral Citrus seed extract. J Orthomolecula Med. 1990;5(3):72-74. 22. 20. Arimi SM. Campylobacter infection in humans.East Afr Med J. Dec1989; 66 (12):851-5.

21. Sandoval CM, et al. Cat’s claw inhibits TNFalpha production and scavenges free radicals: role in cytoprotection. Free Radic Biol Med. 2000 Jul 1;29(1):71-8.

22. Lamm S, Sheng Y, Pero RW. Persistent response to pneumococcal vaccine in individuals supplemented with a novel water soluble extract of Uncaria tomentosa, C-Med-100. Phytomedicine. Jul2001;8(4):267-74.

23. Lemaire I, Assinewe V, Cano P, Awang DV, Arnason JT. Stimulation of interleukin-1 and -6 production in alveolar macrophages by the neotropical liana, Uncaria tomentosa (una de gato). J Ethnopharmacol. Feb1999;64(2):109-15.

24. Stoppard M. Family Health Guide, New York: DK Publishing, 2002

25. R. Berkow, ed. The Merck Manual of Diagnosis and Therapy, 14th edtion, Rahway, NJ: Merck & Co., Inc, 1982.