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The Impact of Probiotics on Diverticulitis

Now that we start the new year, I want to share some new information on other benefits of taking probiotics: the potential impact of probiotics on diverticulitis.

Recently, there has been a study evaluating probiotics as a therapy for diverticular disease in the colon.

First, a little background information; Diverticular disease is a disorder of the western world of the colon or colon. Diverticula is an outpocketing of the colonic layer that protrudes through the colon muscle wall. This development is usually due to low fiber diet.

Why fiber? Fiber absorbs water, helps make our impurities bigger and softer. Our western diet, inadequate fiber, leads to smaller impurities. As a colon contract to release this impurities, the pressure increases on the colon wall. This increase in pressure can lead to the development of outpockets or sacs, which are common in the lower part of the colon (1).

As we age, diverticula development is very common. Studies show that at age 70, over 60% of the population has diverticula or colon diverticulosis. This development usually begins after the age of 30 or 40 (1,2).

Most people with diverticulosis have no symptoms and are unaware they have this condition. Usually diverticula is found during colonoscopic examination or x-ray barium enema.

However, about 20% of individuals with diverticulosis will develop an inflammatory complication called diverticulitis. This is a bacterial infection involving one or more diverticula (2).

For many years it has been assumed that infections occur in the diverticulum when stains or food particles are created in the diverticulum. The result is an inflammation of the pockets of the spleen and infections or abscesses that develop, eventually rupturing to produce local drainage of the colon.

Fever and pain in the lower left stomach can be symptoms of acute diverticulitis. Today, abdominal CT scans can usually confirm the diagnosis of diverticulitis (1,2).

Treatment of diverticulitis depends on the severity of the episode. Patients usually start on antibiotics and prescribe a restricted diet. Sometimes patients need hospitalization, IV fluids and antibiotics. In severe cases surgery can be done.

Once the episode is over, patients are instructed to increase their dietary fiber and, in the past, have been advised to avoid whole grains, nuts and processed foods such as popcorn. Recent studies have proven the theory that seeds can cause episodes of diverticulitis (3).

New response to inflammation related to the lining (colon mucosa) surrounding the colon or diverticulum. Colonoscopic examination revealed an inflammatory layer and biopsy revealed microscopic colitis findings. It is believed that this low grade inflammation can develop into acute diverticulitis.

It is suggested that microscopic colitis of the diverticulum is caused by changes in gut bacteria or microflora. Alterations in microflora cause chronic inflammation that can cause diverticulitis (4).

There are several trials that have studied the benefits of adding probiotics to individuals who have had diverticulitis. Results have shown that probiotics appear to reduce recurrent episodes (4,5,6).

Further studies are underway to evaluate the long-term benefits of probiotics for individuals with recurrent diverticulitis. At the same time, it seems reasonable to add good probiotics, such as EndoMune, to the daily diet of high-fiber diets to prevent diverticulitis.

1) Diverticulitis: a new frontier for the elderly: risk factors and pathogenesis. NDSG.J Clin Gastroenterol. 2008 Nov-Dec; 42 (10): 1128-9.

2) diverticular disease and diverticulitis.Sheth AA, Longo W, Floch MH.Am J Gastroenterol. 2008 Jun; 103 (6): 1550-6. Epub 2008 May 13. Review.

3) Nut, corn, and the use of popcorn and diverticular disease incidence.Strate LL, Liu YL, Syngal S, Aldoori WH, Giovannucci EL.JAMA. 2008 August 27; 300 (8): 907-14.

4) Probiotics and their use in diverticulitis.White JA.J Clin Gastroenterol. 2006 August; 40 Suppl 3: S160-2. Surveys.

5) Effect of non-pathogenic Escheriachia coli on uncomplicated symptomatic diseases of the nodes. Rric P, Zavoral M. Eur J Gastroenterol Hepatol. 2003; 15: 313-315

6) Mesalazine and / or Lactobacillus casei in maintaining long-term recovery of uncomplicated diverticular disease symptoms from the colon.Tursi A, Brandimarte G, Giorgetti GM, Elisei W.Hepatogastroenterology 2008 May-Jun; 55 (84): 916-20.


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