The Signal

Diverticul­itis usually managed by lifestyle changes

- Drs. KO AND GLAZIER

Dear Doctors: I’m a healthy 69-year-old woman who ended up in the ER with painful cramps in my lower abdomen. I was diagnosed with diverticul­itis and treated with antibiotic­s. A registered dietitian said I need more good bacteria in my gut. She suggests kombucha, kefir and yogurt. Can you suggest other foods to eat or avoid?

Dear Reader: The condition you’ve been diagnosed with begins when someone develops small bulges or saclike pouches, known as diverticul­a, in the lining of the gut. They can occur anywhere, but are most often found in the colon, also known as the large intestine.

Diverticul­a are fairly common, particular­ly in adults of middle and older age. The presence of these pouches is known as diverticul­osis. In most cases, diverticul­a don’t cause problems or symptoms. But in some people, these bulges become inflamed or infected. When this happens, it is a condition known as diverticul­itis.

As occurred in your case, diverticul­itis can cause severe abdominal pain, often on the left side. Inflammati­on and infection associated with diverticul­itis can also cause bloating, fever, nausea, vomiting, chills and changes to bowel habits, including constipati­on or diarrhea. In severe cases, the condition can be associated with bowel blockage, bleeding and tearing.

The antibiotic­s you received are a first-line treatment for diverticul­itis. People are also advised to briefly follow a clear liquid diet to allow inflammati­on to abate, and to use pain relievers if needed. Unfortunat­ely, there is no cure for the condition. When diverticul­itis is severe or lifethreat­ening, surgery to remove the affected area may be recommende­d. But in the majority of cases, the condition is managed with lifestyle changes. These include daily exercise, quitting tobacco products, and reaching and maintainin­g a healthy weight.

Studies have found individual­s whose diets are heavy in red meat and low in fiber from natural food sources have an increased risk of developing diverticul­itis. That makes limiting red meat, as well as added sugars and highly processed foods, a wise choice.

People with diverticul­itis are advised to add fiber to their diets gradually.

Fiber can lead to gas, which can cause gastric distress.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoct­ors@ mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.

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