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How to Prevent Diverticulitis Naturally through Diet

by Kelsey Kinney, RD

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Note: The Prescript-Assist supplements discussed in this article are no longer available. Please click here to learn more about a substitute, the Daily Synbiotic from Seed.

If you’ve ever experienced a diverticulitis attack, I’m sure you’d be the first to say that it’s not a pleasant experience. I bet you’d be willing to do a lot of things to prevent it from happening again! Or maybe you’re someone who has been diagnosed with diverticulosis by your gastroenterologist, but you’re not quite sure what to do to prevent those painful attacks you’ve heard about and you want to learn more. Whatever brought you here, I’m happy to have you. Today I’ll be providing tips on how to prevent diverticulitis attacks naturally.

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What Is Diverticular Disease?

Diverticular disease is the term used to encompass a spectrum of issues from diverticulosis (the presence of sac-like pouches called diverticula that protrude from the colonic wall) to diverticulitis (the inflammation of these pouches and the accompanying symptoms). Diverticular disease is common in the Western world, with the highest rates seen in the United States and Europe. Even in those countries the disease was almost unheard of in 1900, but by the 1970s it was the most common affliction of the colon. (1)

Diverticular disease has been shown to increase with age – by 80, it is estimated that approximately 70% of individuals have diverticular disease. (2) The highest estimates suggest that approximately 20% of patients with diverticulosis (remember these are the people with the pouches, not the acute inflammation of the pouches) will at some point develop diverticulitis. (3) However, newer and more accurate estimates suggest that this rate is somewhere between 1 and 5%, depending on the strictness of qualifying criteria. (4) This is important to note for those who have been diagnosed with diverticulosis but are currently asymptomatic – according to these newer estimates, it is unlikely that you will develop diverticulitis. However, if you have diverticulosis and want be sure to prevent any problems or you’ve had diverticulitis attacks in the past, continue reading!

Despite the fact that diverticular disease is so common, we know relatively little about it and the common recommendations are based on limited data. If you’ve been diagnosed with diverticulosis, you may have received advice from your gastroenterologist about avoiding nuts and seeds and eating more fiber. However, these recommendations are based on inconclusive research and may not provide much benefit to you. In fact, few studies show any benefit to avoiding nuts and seeds and one study even showed that intake of nuts and popcorn was associated with a decreased risk of diverticulitis and diverticular bleeding. (5) High fiber diets are also often recommended, despite inconclusive evidence. (6) It is evident that recommendations for diverticular disease are due for an update.

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Underlying Factors That Contribute to Diverticulosis

Newer research suggests that the factors underlying diverticular disease are the following: (7, 8)

Inflammation

While inflammation is well-accepted in the model of acute diverticulitis, more and more research points to the involvement of chronic low grade inflammation in the development of symptomatic diverticulosis. In fact, of 930 patients undergoing surgery for symptomatic uncomplicated diverticular disease (SUDD), approximately 75% of them had evidence of chronic inflammation in and around the diverticula. (9) It is for this reason that drugs used for treating inflammatory bowel disease like mesalamine are being used to treat diverticular disease with good results as well (but hang tight, we’ll talk about natural ways to prevent diverticulitis, of course!). This is also why chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen have been shown to increase the risk of diverticular complications (10, 11), since they are known to increase intestinal inflammation. (12, 13)

Fecal calprotectin can be measured to identify intestinal inflammation, and is high in those with symptomatic diverticular disease compared to those with functional digestive tract disorders like IBS and those with asymptomatic diverticular disease. (14) If you’re wondering whether you may have intestinal inflammation, it’s a great thing to get tested (and you can order a stool test from a specialty lab like Genova Diagnostics which will measure it). It is clear that chronic inflammation is involved in the development of diverticular disease, and that those who wish to prevent attacks should take steps to reduce intestinal inflammation.

Thankfully, one of the best ways to decrease intestinal inflammation is to eat a paleo diet! By avoiding potentially irritating and inflammatory foods such as grains, omega-6 fatty acids and lactose, we can reduce intestinal inflammation and encourage proper gut health. A paleo diet also positively influences gut bacteria, which in turn results in reduced inflammation as well. A paleo diet for diverticular disease should focus on gelatinous cuts of meat, bone broths, well-cooked vegetables, starchy tubers, and fermented foods.

Reducing your stress level is also important for bringing down levels of intestinal inflammation, as stress has been shown to activate inflammation in the intestine. (15) Stress can absolutely wreak havoc on the gut, so it is essential that any program focused on preventing diverticulitis attacks include proper stress management. This means incorporating mind-body activities such as yoga, meditation, tai chi, etc on a regular basis. If you’re someone who’s constantly stressed out and never takes time to take care of your own well-being, it’s unlikely you’ll be successful in preventing diverticulitis attacks even if you implement all the other suggestions outlined in this article. This one is important!

Another way to reduce an inflamed intestine is to supplement with soothing and healing demulcent herbs – deglycyrrhizinated licorice (DGL) has been shown to reduce mucosal damage and inflammation in rodents (16, 17) and it is likely that other demulcent herbs such as slippery elm and marshmallow root may have the same effect. Take chewable DGL tablets or mix a spoonful of slippery elm or marshmallow root powder in a small amount of water and drink 1-3 times per day to help soothe and heal an inflamed intestine. Another healing substance for the gut – bone broth – should be liberally consumed for this purpose as well.

Altered Intestinal Bacteria

Small intestinal bacterial overgrowth (SIBO) is common in diverticulitic patients. (18) Rifaximin, a non-absorbable antibiotic (meaning it only affects the gut, not the rest of the body), has been shown to effectively treat SIBO (19) and this treatment has also been shown to improve diverticular disease outcomes. (20) Bacterial overgrowth, along with fecal stasis inside the diverticula, can contribute chronic dysbiosis which can lead to low-grade inflammation (21), so improving gut bacterial balance is crucial to reducing intestinal inflammation.

Probiotic supplementation has been shown to be safe and potentially useful in diverticular disease (22) and is likely to be even more beneficial when combined with other therapies. If you’re not already consuming probiotics from your food (in the form of kefir, kombucha, kimchi, etc) then you should consider adding a supplement like VSL #3 or Prescript Assist (though even if you are consuming probiotics, a supplement isn’t a bad idea!). As Chris has mentioned, Prescript Assist tends to be the probiotic of choice for those suffering from constipation so start with that if you tend to err on the side of decreased motility.

Prebiotics are also very useful for correcting dysbiosis, and should be considered by those with diverticular disease. Prebiotics “stimulate selectively the growth and/or activity of intestinal bacteria associated with health and well-being” (23), which is exactly what we want when we’re trying to shift the balance of the microbes back to the good guys. My go-to prebiotic is Pure Encapsulations fructo-oligosaccharide (FOS) powder, but others include GOS and even lactulose. Supplementation with 10g of FOS per day has been shown to increase counts of bifidobacteria. (24) As with all prebiotics, it’s important to start with a very small amount and increase slowly. If you’re sensitive to FODMAPs you’ll want to be particularly careful as prebiotics are also FODMAPs. However, if you tolerate them well I think prebiotics can be a powerhouse when it comes to correcting imbalanced gut flora.

Most importantly, it’s crucial to treat SIBO or dysbiosis. As we’ve discussed, these conditions are very common in those with diverticular disease so it’s worth checking on your gut bacteria to see how they’re doing, using specialty labs such as Genova Diagnostics (and get your calprotectin tested while you’re at it!). It’s best to work with a practitioner who can test and treat you for these conditions.

Abnormal Colonic Motility

Researchers have found that those suffering from symptomatic uncomplicated diverticular disease have what they like to call a “spastic colon” in the areas affected by diverticulosis. (25) This is similar to what is found in patients with constipation predominant IBS and in functional constipation.  These same researchers also found that patients with diverticulitis disease have reduced density of interstitial cells of Cajal (ICC for short – a fun name for the “pacemaker cells” of the intestine). (26) In studies on animals with a lack of ICC networks, delayed or absent intestinal motility is noted. (27, 28) What this means for diverticular patients is that these lack of networks and a spastic colon can cause increased symptoms in terms of constipation and bloating/pain. Though we’re not entirely sure what we can do to directly affect these cells (yet), it’s important to use therapies aimed toward improving motility if this is an issue for you.

Know that correcting SIBO and dysbiosis will go a long way toward improving constipation, so this is a good place to start. Given that our stool is mostly made up of dead bacteria, one can imagine that without proper amounts of good bacteria we’re going to have a tough time bulking the stool. Prebiotics can be particularly useful for constipation given that they selectively increase good bacteria like bifidobacteria. However, if you’re still struggling after correcting dysbiosis, here are some additional recommendations.

First, serotonin is an important player in gut motility. Serotonin concentrations in those with colonic diverticulosis are significantly lower than normal controls and contribute to the type of bowel habit following a test meal. (29) Serotonin transporter (SERT) transcript levels are also lower in those with a history of diverticulitis compared to controls and those with asymptomatic diverticulosis. (30) Inflammation is also known to decrease SERT expression and function (31, 32), so following the recommendations to lower intestinal inflammation is of course the first step to improving gut motility. In addition, it is also likely that supplementation with 5-HTP (a precursor to serotonin) may alleviate constipation and increase motility since it will increase serotonin levels. Note: do not take 5-HTP without talking to your doctor first if you are on an SSRI medication.

Second, if you’re currently on a low carbohdyrate paleo diet, you may want to consider increasing your carbohydrate intake. In my experience working with those with constipation on a paleo diet, this is the single most effective diet-based recommendation I’ve seen. If you’re at a loss as to what starches to add in, check out this excellent handout from Balanced Bites. Note: since SIBO is so common for those with diverticulosis, this step may need to wait until that has been treated, and may not be appropriate for some people.

Magnesium supplementation can also be very useful for people with constipation. Given that only about half of US adults consume the RDA for magnesium (33), it’s safe to say that a lot of us probably aren’t getting enough. This is due to the fact that not many foods naturally contain high amounts of magnesium, and even those that do have less due to the depletion of magnesium from our soil. Check out this magnesium soil content map to see how your local area is doing (and think about where most of your food comes from – if you’re not eating local you may not even know what soil your food is being grown in!).

Conclusion

By reducing our intestinal inflammation, balancing our gut bacteria, and improving our intestinal motility it is likely that we can prevent diverticulitis attacks. I’ll leave you with a set of action steps so you remember exactly what to do to improve these underlying factors.

Action Steps to Prevent Diverticulitis Attacks:

  • Eat a paleo diet!
  • Reduce stress
  • Use demulcent herbs such as DGL, slippery elm, and marshmallow root to soothe and heal the intestine
  • Take probiotics like VSL #3 or Prescript Assist
  • Take prebiotics like FOS powder
  • Treat SIBO or dysbiosis
  • Reduce intestinal inflammation to increase SERT functioning, and consider supplementation with 5-HTP
  • If you’re currently on a low carbohdyrate paleo diet, consider adding some starchy tubers to your diet
  • Supplement with magnesium
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Kelsey Marksteiner
Kelsey Kinney, RD

Kelsey Kinney, RD, is devoted to helping the world achieve great digestive health through her blog, private practice, and prebiotic & probiotic drink mix company Gut Power Drinks. Check out her blog, Gut Power Drinks website, or visit her on Facebook for more.

Kelsey is a registered dietitian specializing in digestive and hormonal health. She graduated from New York University with a Bachelor of Science degree in Nutrition and Dietetics and went on to complete her dietetic internship at Milford Regional Medical Center in Milford, Massachusetts. She also has a Master of Science degree in Human Nutrition and Functional Medicine from the University of Western States.

Kelsey loves helping people find their unique, personalized diet that will help them heal, not anyone else. She has always been interested in nutrition and health, and is honored to now help people find a diet that brings them happiness and longevity.

Professional website: https://kelseykinney.com

Gut Power Drinks website: https://gutpowerdrinks.com

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759 Comments

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  1. Excellent article! I was frustrated with mild diverticulitis on-and-off. Not too much info address this issue. Had an attacked early this year; took antibiotics to calm it down. Thanks for all the info that you provide here. It answered a lot of my questions regarding my colon’s “strange behavior” lately. My mother died of colon cancer 10 years ago; I’m very careful when it comes to “colon health”.

  2. What form of magnesium do you guys recommend for supplementing… citrate or glycinate? And how the heck do you read the magnesium soil content chart for our areas? The number make no sense and don’t define in layman’s terms.

    Thanks!

  3. Regarding chlorine: I installed a carbon filter under my kitchen sink and piped it to a small faucet. All my drinking and cooking water is chlorine-free.

    • Richard
      I have had a kitchen sink top water filter faucet for some years now but it isn’t enough. Apparently we inhale more chlorine, in the form of gas, when taking a bath of shower than drinking tap water!
      We also absorb chlorine through the skin – so washing up gloves seem necessary.
      I have just ordered a Whole House water filter (although quite expensive) as a means of avoiding chlorine by drinking, inhaling and skin contact – also residue on washed clothing.
      Hope it works!

  4. I found this article to be really informative and useful. Could you tell me what is “gelatinous meat” is? Does it refer to an animal part that has more gelatin or to certain animals whose meat is more gelatinous? Thanks.

  5. Chris
    Some views on your article regarding Diverticulitis.
    1. There is a danger with slippery elm! I tried it and ended up with a blockage which was only removed by Castor Oil. White chunks came out!
    2. I have also taken DGL for a stomach ulcer, it was very good.
    3. Probiotics have NEVER worked for me! I have spent hundreds of pounds on them to no avail. I believe that this is because all marketed probiotic formulas have only a few strains of bacteria. It is said that we have between 300 and a thousand strains of bacteria . How do we get them back? Also, proponents of probiotic products never consider the Chlorine in water killing the bacteria daily!
    4. FOS powder did nothing for me. What is the use of trying to feed bacteria if chlorine is constantly killing them!
    5. Magnesium is great but supplementation if not recommended for those with weak kidneys. I found that a product with Magnesium Oxide effectively reduced faecal matter to soup and cleared mucoid plaque very effectively when taken following the directions. It works by oxygenating the intestinal pathway.

  6. I had diverticulosis which was diagnosed following a colonoscopy.

    If I ate popcorn or a lot of peanut butter and other such foods I would pass blood for 10 days.

    I don’t remember taking magnesium at the time but I may have but what I did mainly was eating oatmeal for breakfast five days a week. I was not on any so called “paleo” diet at the time but was avoiding refined flour and sugar which I am still doing.

    After a year of eating oatmeal five days a week, I can now eat anything I want including all the popcorn I want and I have no problems. And although my wife and I did eat a mostly vegan diet for two years [following Dr. Fuhrman’s protocol] for the last three years we have been eating low carb and a balanced diet of meat and vegetables and still avoiding refined flours, sugars etc. most of the time.

    I have had no symptoms of diverticulosis for six years now.

  7. Heya Kelsey, great post. It’s lovely to see you sharing your hard-earn knowledge and showing that there are others who can provide the kind of comprehensive integrative perspective that we all worry only Chris can give us!
    I have used slippery elm many times before during gut woes, but never marshmallow root powder. What a nice idea. I can’t wait to get some.
    Do you have any thoughts on kudzu root powder? In macrobiotics they tend to say it cures all digestive ills…When I have tried it it certainly seemed really soothing and demulcent, but I think it is quite starchy.
    Alison

  8. I’m not sure it’s really possible to prevent diverticulosis. After two and half years of feeling amazingly well and digestively perfect on paleo, I was hospitalized with diverticulitis, then had a second attack 42 days later. A colonoscopy in 2010, before going paleo, showed no diverticuli, and a colonoscopy after the attacks this summer (2013) showed diverticuli “scattered throughout” the colon. The very way of eating that I thought would save me from digestive health problems seems to have brought this on.

    But was it the diet? Is it genetic? Is it inevitable as we age? Would the diverticuli have formed had I not gone on the paleo diet? I had no constipation, no diarrhea, no nothing … I was digestively robust as I have been throughout my life. Now I am using probiotics, eating far less meat and almost no red meat, having more fruit, sometimes using psyllium fiber, and trying to get back on track digestion-wise after the heavy-duty antibiotics used to treat diverticulitis. I live in fear of it happening again.

    • I too live in fear of another attack. Afraid to take any pills, supplements, etc. Everything I read sounds hopeful and ooops – here comes another attack anyway. Interesting site, interesting comments, but I am at a place now where I am listening closely to my own body. Stress is #1 for me. Magnesium caused severe stomach cramps – 3 days and had to stop. I eat small portions, mostly bread -white, rice, mac and cheese, eggs, only cooked fruits, canned veg’s but no corn or peas; soups. Fish, soft cooked meats.

    • @Becky, did you by any chance have a baby during that time? Pregnancy, especially with a larger baby, as well as pushing the baby out can cause diverticuli to form.

      • @Stephanie FINALLY – i loved your comment! I am 35 years old with no prior history of divertriculitis. As soon as I gave birth to my 9 lbs 13 ounce baby boy via c section (i was absolutely HUGE) – no more then a week later I started having symptoms. Of course we all thought the pain and low grade fever was due to the c section and some sort of infection of the uterus or UTI. After 3 months of suffering, eating corn and popcorn during a full fledged attacks, i finally went to the ER for a catscan and it showed diverticulitis! Now i am just trying to figure out the right way to eat for the rest of my life to prevent this from happening again. It took so long to go away completely. Thank the good lord no perforation or abscesses and thank the good lord I did not have an attack while pregnant with my son!!! I’m wondering if there are any women out there that developed this after pregnancy. Would love to hear from them if they are out there!!

      • Pushing the baby out should NOT be the ROOT cause of the diverticulitis. Diverticulitis is simply a bacteria out of control in the intestine. I would make a guess that it was always there and borderline and that the process of having the baby just tip things in favor of the bacteria. You probably would have eventually developed it down the road.

        When the only option is surgery, it is scary. BUT there are OTHER OPTIONS I listed below in my posts. One shouldn’t have to live in fear of diverticulitis anymore. It is also a message from the gut communicating that there is a problem. One shouldn’t have to go on some exotic diet either. It is about debugging your intestine / gut problems. As one ages, one will need to make more adjustments. I keep a bottle of AMP to nip any diverticulitis infection in the bud. It also works against other infections.

        If you find that you have a little gluten sensitive so one makes adjustment for that. If that were so, you may find switching to the wheat grown in Italy – ancient wheat more acceptable. Even though wheat grown in US is not GMO, it is MUTATED wheat. It is different than the wheat that was available some decades back which I never had a problem with. I think this is why there is an explosion of gluten sensitivities happening.

        The lesson is that you have to learn about what you are actually eating. I tend to minimize grains in general due to their anti nutrients. I use them when I really have to.

        Researchers have found three basic types of gut flora in the populations and a lot of that has to do with diet. There is no one size fits all approach. It is a trial and error approach. You have to experiment and learn. No doctor will be able to address this. You have to do it.

        KNOWLEDGE IS POWER.

          • >What is AMP

            it’s written all over the comment section. just search for all my comment posts.

            • It’s a highly concentrated and purified form of the active ingredient in Aloe Vera. One bottle of AMP capsules is like drinking around 70 gallons of Aloe Vera without the inherent toxins. It acts like a natural antibiotic.

              Like any supplement, it is an option to consider.

                • Here is a chart. It could be outdated though.

                  http://aloereviews.com/Reviews.aspx

                  I use the Aloe MP Plus.

                  I can’t tell you which is technically the best because I have done no comparison testing. They may all be pretty much the same. Nice thing about the chart is that it may point out some of the things to consider. Price is a major consideration.

    • I had exactly the same experience. I have been following a paleo diet and exercising regularly and feeling really well, then suddenly developed excrutiating pain for the last 3 weeks which led to several emergency visits to the GP and Hospital. They found diverticula and believe I have diverticulitis and told me it was due to a western diet! All I can think is that the diverticula formed in my bowel before I started eating paleo and something, like a stomach bug, just triggered this off?! But I am guessing, like the doctors! It seems the relief from this condition is to eat all the stuff we have been told over the years to actually avoid – white bread, white rice, limited vegetables! Where is the sense in that! At the moment I have had a liquid diet for 3 days, followed by a low residue diet and will try and introduce food one at a time and see how I go. The pain is more manageable at the moment, but hasnt gone away completely, I am exhausted from the severe pain I have been having for the last 4 weeks and I am petrified it will return! i am also going to try some apple cider vinegar which others seem to recommend. I know doctors rubbish anything remotely homeopathic, but they seem to forget that is where their own medications originated from! They may have more knowledge and control over their medications, but they are also full of other no doubt other chemicals which cause further problems.

      • I have theories. Meat has no fiber and if you have any tendency (known or unknown) to digestive difficulty, meat could be a problem. The week before my attack I ate out a lot as we were having new floors laid. Restaurants often serve lots of meat but few veggies, unlike at home where I usually load up on the veggies. I clearly remember having Osso Bucco and trying to eat up every little bit of onion that came with it, because that was the only veg.

        Secondly, that same week ate a ton of coconut chips and coconut butter, and bread made of coconut flour. Coconut has a LOT of insoluble fiber, which can either move stuff through or stop it up, depending on liquid intake. Insoluble fiber also plays greater host to pathogenic bacteria than soluble fiber does.

        Third, before both attacks I had a higher intake of sweets, and sugar feeds pathogenic bacteria.

        The two rounds of Cipro and Flagyl have done a big number on my digestion and now, one year later, I am still dealing with it.

        My strategy includes collagen (Great Lakes gelatine), carbs (yams, green plantains, green bananas, some rice, oat bran now and then, plenty of fruit) and Vitamin C. The Collagen, Carbs, C approach is from the Perfect Health Diet. Paul Jaminet got diverticulosis on a very low carb diet and theorizes that a healthy intestine needs carbs to feed the bacteria that generate short-chain fatty acids, which keep the bowel mucosa in good shape.

        I have stopped red meat, and of course coconut, except for the oil, and eat smaller meals, and have a pineapple/kale/coconut water/turmeric/ginger smoothie most days. Raw kale, as in salads and smoothies, seems to make the bowel happy.

        I knew someone like you would post sooner or later! Although it would be easy to say that the paleo diet gave us diverticulitis, I still don’t feel inclined to go back to grains, although I contemplate having oatmeal … but haven’t yet.

        I’ve had a few minor attacks, and stop eating for a few days, then start back with applesauce, scrambled eggs, fruit, yogurt … everyone is different but you do listen to your body and some things seem more friendly and calm than others. I keep a list of what I eat and have got a fairly long one now of things that don’t bother me.

        Probiotics are key. Don’t be discouraged; I have felt like giving up but the body is a tremendously adaptive organism. Don’t obsess over stories you read online. Think and believe healing can take place. Quietly observe, as you already are. It does put food, and eating out, into a new place in your life but there are aspects of that that are actually positive.

        Another theory I have, and am trying out, is having a little bit of a lot of things, to keep my gut bacteria variety higher. The gut bacteria adapt to what we are eating, very quickly in fact. Ironically, going without sugar for 2-1/2 years can create a gut microbiome unable to digest it well, so when I indulged in a milkshake before my second attack, I think the pathogenic bacteria had a feeding frenzy on it.

        Just my thoughts and experience.

        • I’m wondering if the food appetites we have that linger over the years aren’t a guide? For me, eating beets, butter beans, and taking a Manganese mineral substitute are three things “suggested” that seem okay. At my home I’ve planted fruit trees–all kinds–and I eat the fruit directly from the trees, or if the crop is too big, then I dry the fruit. Apricots, plums, cherries, apples all can grow nicely, although a moth consistently wrecks apples. Bird netting is no option, but a requirement if you want fruit that lasts on the trees until ripe. Forget growing pears, “blight” makes healthy trees problematic. Disease on neighbors’ trees just moves across the fence, to yours. Heirloom lettuce in a garden re-seeds it self for the next season, so that is a benefit as well. As to sweetness, or saltiness: diminish the sugar and salt dramatically and the “need” for it also diminishes to where food tastes good without these additives.

  9. All the supplementation mentioned here seems to increase intestinal motility, thereby alleviating constipation. What about addressing the needs of those of us who suffer from chronic diarrhea as well as diverticulosis?

    • Hi John, good question. Really the only change I’d make in that case is not supplementing with magnesium since that gets the bowels moving, and you may not need as much carbohydrate. In the study on patients with diverticulitis and their serotonin levels, even those who had diverticular disease with diarrhea vs. constipation had low serotonin levels.

        • There is the question I was looking for. I have diverticulosis but not with constipation. With diarrhea for almost 10-12 hours when I have attacks. I am also lactose intolerance. I cant eat popcorn without suffering the next day for hours. I only take multi vitamins, vit C, Vit D 2000 IU, calcium, Livalo (cholesterol med) and an aspirin daily. I am also a vegan so I do eat a lot of vegetables. I have found out that eating an apple a day does stop the diarrhea but then started to get constipated, so I only eat an apple every other day. I just want the pain to stop and be normal again.

  10. HI Kelsey, good to see more discussing convertional medical diagnoses in the context of more up to date theories of intestiional funtion/dysfuntion.
    I wonder if you would be able to give your opinion on these questions…
    1) when you eat prebiotics/FODMAPS( assuming you are not sensitive) which your good bacteria need to thrive – don’t you simultaneously feed the bad bacteria as well, increasing the likelihood of SIBO or other conditions of dysbiosis?

    2) Why don’t probiotics “set up shop”in, ie colonize, your intestine as other bacteria do (such as the pathogenic ones)? Why are they transients and therefore you require daily intake?

    • Prebiotics selectively feed only good bacteria, not bad bacteria (that’s part of their definition, actually).

      Not entirely sure why probiotics don’t set up shop – I think we need a little more research on that question!! Hopefully someday we’ll find out 🙂

    • “2) Why don’t probiotics “set up shop”in, ie colonize, your intestine as other bacteria do (such as the pathogenic ones)? Why are they transients and therefore you require daily intake?”

      Transient, but still effective. They support your digestion, immune system, and your residential flora.

      It is a strange mystery, but supplemental probiotics seem to communicate with the residential bacteria and your immune system, and for some reason they make their leave about two weeks after your last dose. Perhaps because we each have a unique gut microbiome (like a fingerprint), only bacteria with a specific genome make themselves at home. The “visitors” (supplements) are allowed to stay for a while, do their thing, and then peacefully exit.

  11. This is SO GREAT to see in print. I had a horrible attack with a perforation in my ascending colon almost 2 years ago. 5 days in the hospital and barely avoiding the OR changed my life. Immediately after I began to follow a paleo diet trying to find a way to avoid the OR. Many thought I was crazy- my results showed them how wrong they were. I have started a whole blog relating to this issue and my resulting incredible recovery. I am so pleased to see this!!!!

    • Hi Jessica, I too have diverticulitis and would love to get more information from you.

    • I’m currently in the hospital recovering from a microperforation. I was able to avoid surgery as well, but NEVER want to feel that pain again!!! Would love to read your blog.

  12. Hi Kelsey,

    What do you think about using L-tryptophan instead of 5HTP to increase serotonin levels?

  13. Hi there. I have suffered from this for many years, but I now don’t get any symptoms at all. I started following a Paleo diet three years ago and it did take the first twelve months before it went away. I avoid wheat and grains and eat low amount of diary foods. I had a bad attack of IBS earlier this year due to high stress levels, but now I am clear.

  14. Have been reading conflicting info on 5-HTP. Paul Jaminet does not recommend and states it could cause bacterial growth. What do you recommend as a time frame for supplementation: full time, day or week-long breaks, limited run?
    Great article!

  15. Hi Chris and Kelsey,

    I have been diagnosed with diverticulitis by my gastroenterologist. I take prescription Previcid and use Healther’s Tummy Acacia fiber which has pre and probiotics. It has been a life saver when I do have an attack and to prevent attacks. I highly recommend it. I am also slowly incorporating Paleo into my diet. I appreciate this information because I am more motivated to modify my diet based on this article. Many thanks!

    • Please read my comment below on AMP (Aloe Muciliginous Polysaccharide). This is the stuff you use for more serious cases.

        • What you really want to know if it will work for you.

          Just like any supplement, there are no guarantees. It is only expensive if it doesn’t work. When it does work, it will be the best money you ever spent.

          Lot of chronically ill people are on very tight budgets so it is a very financially painful purchase to make especially if one doesn’t know for certain if it will help.

          One really needs to bite the bullet and commit to 3 months ($378). It could resolve the problem quickly so one may need less. In the last 3 years, I have only bought 5 bottles. Most of the 5th bottle I still have.

          I would try the cheaper options first.

          Fiber
          Grape Seed Fruit extract
          Aloe Vera Juice

          Do your own research and find less expensive alternatives

          If those still don’t work, I’d go with the AMP

          If you still have to keep fighting it to keep it at bay then it means the infection is still brewing and maybe only need one bottle to knock it out.

          Having parts of ones intestines cut out will be the most expensive solution especially in terms of post operation recovery and complications and ones long term healthy. The infection can still come back so you may need another operation. There are complications to the gut when surgery is done on it.

          My focus is on helping people who are faced with going down the surgery route circumvent that outcome. It is also for people who want to avoid the antibiotic route.

      • You don’t need any colonoscopy. You are dealing with an infection. The test won’t change that. Colonoscopy’s are risky. They can pass along infections and damage gut flora.

        AMP heals diverticulitis pouches and colonitis ulcers. I did try it on an ulcer and it did work. I can actually feel it working for ulcer within a week. Pouch healing time varies depending on severity.

        How you Take it ….

        You take it sometime before bed and upon rising on an empty stomach in divided doses.

        I would not eat anything for an hour after rising dose. This is just to minimize dilution. Not sure if this is necessary but that is the way I did it.

        Optionally you could minimize foods that irritate your pouches until they heal. I did this.

        Your colon should heal within 1 or 2 months or maybe a lot quicker. You should have no diet restrictions after healing.

        Optionally you could experiment and throw in some (2g) L-glutamine powder 3 or 4 times a day. Maybe this will speed things up, I didn’t try this.

        A week or two after you feel yourself getting better, you could lower dose. You can play it by ear at that point. I cut dose in half after I didn’t feel the pouches,

        If money isn’t an object, you could experiment with doses higher than 9 capsules a day and even take a dose in the middle of the other two.

        • Does this AloeVera Amp actually get rid of the pouches or just heal infected ones?

          • I believe that once you have pouches you’ll have them for the rest of your life. They do not go away. But you can keep them from getting infected like I have. I have taken Aloe Vera gel tabs to help heal the infected (inflamed) pouches but it was the change in diet that really got me out of the woods. I still have the pouches but as far as I’m concerned they are not there because I never get symptoms because I stopped eating all the foods that cause the inflammation.

            Treblig

      • You don’t need any colonoscopy. You are dealing with an infection. The test won’t change that. Colonoscopy’s are risky. They can pass along infections and damage gut flora.

        AMP heals diverticulitis pouches and colonitis ulcers. I did try it on an ulcer and it did work. I can actually feel it working for ulcer within a week. Pouch healing time varies depending on severity.

        How you Take it ….

        You take it sometime before bed and upon rising on an empty stomach in divided doses.

        I would not eat anything for an hour after rising dose. This is just to minimize dilution. Not sure if this is necessary but that is the way I did it.

        Optionally you could minimize foods that irritate your pouches until they heal. I did this.

        Your colon should heal within 1 or 2 months or maybe a lot quicker. You should have no diet restrictions after healing.

        Optionally you could experiment and throw in some (2g) L-glutamine powder 3 or 4 times a day. Maybe this will speed things up, I didn’t try this.

        A week or two after you feel yourself getting better, you could lower dose. You can play it by ear at that point. I cut dose in half after I didn’t feel the pouches,

        If money isn’t a problem, you could experiment with doses higher than 9 capsules a day and even take a dose in the middle of the other two.

        • I don’t know much about hernias. I never had one so it is something for someone who does have one to experiment and report back. I have no idea how well it works on them. If a hernia has it’s root cause in infection then I could see there being a chance to fix it, Anything noninfection caused will need some other treatment.

          • Just because one gets rid of an infection, it doesn’t mean it can’t come back. Why something came back, we may never know for certain. We can only make a ballpark guess.

            This is the problem with diverticulitis surgery, it doesn’t mean it won’t get reinfected. Once we have something natural that can cure it without side effects, it doesn’t become a big deal anymore. we become self sufficient. no need for doctors or surgery.

            Food can contain a lot of bacteria. In most cases, it never effects us. As we age, we may become more vulnerable to things. This may be a conduit for some.

            I hadn’t taken the AMP for around 2.5 years . I just started taking it again when I realized I had the infection.

            I had rheumatoid arthritis which seem not a problem anymore after the borax protocol. I noticed the problem coming back for some weeks. I didn’t know why. Once I started to address the colon infection, the rheumatoid arthritis receded again. Then I realized what was going on.

            It is well known among doctors who cure RA that in order to cure RA, one must address the co-infections also. Co-infections will seemingly activate the RA (probably mycoplasma) and give it more strength again to multiply.

            There are all sorts of microbes that inhabit us. It is when some of them get out of control that it becomes a problem. We don’t necessary get rid of everything.

            As an example …

            H Pylori is known to cause some ulcers. H. Pylori exists in virtually everyone virtually all the time. You really can’t get rid of it. Neither should you try. It probably has a beneficial purpose. It’s when the H Pylori start to dominate that it becomes a problem. The key is keeping things in balance within the gut.

            I suspect the infection was there but just simmering below surface. Now that I know it exists, I was able to address that also.

            For me, the reason may have been that I played around with amoxicillin for many months in experimenting with dental problems a while ago so that may have had something to do with it. I didn’t use probiotics either while experimenting. this is only a guess.

            Another observation is that I believe my low level shingles acts up when something is not right with the colon. when an imbalance occurs, it gains strength. microbes interact with each other. they can act in coalitions with each other.

      • Hi – thanks for your helpful comment re the AMP. I’m wondering what your background is and what recommendations and non-biased research studies you know of that support the use of this product.

    • Have multitude of allergies autoimmune disorders and Gastro issues any suggestions?
      Don’t eat red meat can’t eat ant type of fish veggies are off limits due to allergies except for cauliflower mushrooms and cooked carrots cannot eat fruits

      • Many decades ago I was unable to almost eat anything probably due to immune system problems. I was put on a diet of fish, beans, spring water and a some butter and sea salt. I was on it for two years. I decided to see if I could eat regular food again. I found that I could eat almost anything without a problem. I have been eating well ever since.

        Many people react to certain foods and stop eating them and to them, that is a fix for them. I don’t agree with that since something is still broken in the body. They don’t attempt to find a work around by experimenting with supplements etc. They deny themselves what they like to eat.

        I don’t think you have to go as far as I have since there are more options around but it proves that allergies are not forever if you work at it and that the body will heal itself with proper nutrients.

        I have Rheumatoid Arthritis and resolved it with the borax protocol. I later realized that ice cream aggravated it. I found out that when I ate the ice cream with CLA supplement I did not react to it.

        I would go to a site called http://www.earthclinic.com and research there.

        • Thanks Chris,
          Yes I need to gain at least 10 lbs back. It’ll strenghthen me.
          It sounds like you did not have the surgery and isn’t the bag temporary?
          Is this your job or are we in different time frames?

          • Chris,

            Can you please tell me since a cat scan showed that I do have diverticulosis, why should I still have a colonoscopy done?