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INTRODUCTION

Diverticulitis is a condition of inflammation. The walls of the intestines balloon out forming pouches where undigested food particles, small seeds, [e.g. strawberries, raspberries] lodge (Goldberg, 1999; 685-689). These pouches, diverticula, become perforated, infected and inflamed.

Diverticula, due to frequent constipation and eating a low fiber diet, which is typical in the USA, contributes to the development of diverticulitis [“itis” meaning inflammation]. Low fiber diets produce maladaptive changes in the colon resulting in increased pressure that can cause pouches to form at weak points in the wall of the colon (Kamen, 1997; 67). When there is insufficient fiber to add bulk and the inability to soften stool, stools are harder to pass.

Other causes that are associated with diverticulitis include a family history of the disease,   thyroid deficiency, emotional stress causing colon spasm, hidden food allergies,  and may be related to vascular disorders or gallbladder disease (Goldberg, 1999; 685-689) as well as obesity, or a poor diet . It is well known that stress and smoking make symptoms worse (Balch, Balch 2000).

Diverticulitis is usually associated with constipation, but bouts of diarrhea should not be overlooked as well. Diarrhea is the result of insult and injury to the cells of the small intestine.

With diarrhea there is dehydration and a loss of electrolytes. Fluids are very important  for colon health as fluids help rid the body of toxins. Tests should be conducted to see if there is a bacterial infection, viral infection, or parasitic infection. **NOTE: artificial sweeteners cause diarrhea.

Symptoms of diverticulitis include episodes of lower abdominal pain and cramping, changes in bowel habits, and a sense of fullness in the abdomen. With chronic or severe cases, there might be fever, tenderness and rigidity of the abdomen over the area of the intestine involved (Murray, Pizzorno, 1998; 143)

RECOMMENDATIONS

Fiber, Fiber, Fiber!. Increasing fiber of cereal origin, whole grains, appears to be the most important component of dietary fiber for protection against diverticular disease [Medical Aspects of Dietary Fiber, 1980].

NCI, National Cancer Institute, did a study on Americans and fiber intake. The results showed that the personal daily intake of fiber ranged from 9.1-13.8 grams of fiber- well below what the institute expected (Kamen, 1997; 7) NCI has suggested between 25-35 grams of fiber a day for adults AND children. The American Dietetic Association agrees (Kamen, 1997; 7). Although no standard recommendation has been made by regulating agencies, many clinicians and researchers have come to the conclusion that 50 grams of fiber daily is optimal.

Most Fiber	Little less fiber	Less fiber	Even less fiber	No fiber
Wheat	Legumes	Root Vegetables	Fruits	Meat
Corn	Peas	Potatoes	Leafy vegetables	Chicken
Barley	Beans	Carrots	Lettuce	Fish
Rye	Lentils	Parsnips	Cabbage	Eggs
Oats	Dried Fruits	Turnips	Celery	Milk   Products
Buckwheat		Beets		Cheese
Brown rice				Yogurt
				Buttermilk

Digestive enzyme therapy is also used to correct digestion issues. Diverticulitis can be the result of poor digestion. Digestive enzyme therapy is used to help with digestive capabilities [assimilation of nutrients], soften stool, increase regularity, and reduce stress on the gastrointestinal mucosa (Cichoke, 1999; 209). Enzymes will normalize PH levels; help to detoxify the body; help promote healthy flora, and help to keep lowered pressure in the colon

Systemic enzyme therapy is used to reduce inflammation in the colon, stimulate the immune system, improve circulation, help speed tissue repair by bringing nutrients to the damaged area, and removing waste products, strengthen the body as a whole, build general resistances and improve wellness (Cichoke, 1999; 209).

 OTHER RECOMMENDATIONS

• Raw- 60% of the diet should include raw, enzyme-rich fruits and vegetables. If the body cannot tolerate raw, then lightly steam or sauté. These methods will not deplete the food of its nutrients. These foods contain good amounts of Vitamin C which reduce inflammation and boost the immune system
• Use digestive enzymes with each meal- e.g. bromelain/papaya or a formula such as Vitalzym Xe (World Nutrition) that fights inflammation and swelling, increases the rate of healing and stimulates proper digestion
• Use a fiber supplement to reach your optimal daily dosage of 35-50 grams of fiber- drink 8 8oz purified water, herbal teas, broths, and live juices which will help keep the diverticuli clean of toxic wastes, preventing inflammation
• Mild fruits and vegetables would include carrots, bananas, potatoes, yams, papayas, broccoli, and well-cooked black beans (Page, 2000;371), apple, lemon and pineapple- use carrot, celery, beet, cabbage and green juices especially during an episode(Goldberg Group,1999;68685-689).
• Miso or lamb bone broth is also good to drink during an attack [drink until episode subsides]
• Reduce wheat and dense grains, nuts and seeds during healing (Page, 2000;371).
• Include brown rice, millet, coucous, tofu, baked fish, and seafood as lean protein sources
• Remember that whole grains are good sources of fiber, minerals, and “B” vitamins (Murray, 1993; 156) B Vitamins are needed for all enzyme systems in the body and for proper digestion (Balch, Balch, 1999:329)
• Increase intake of enzyme enhancers- sprouts, raw honey, and wheat germ
• Cultured foods for Gastrointestinal health include yogurt which contains acidophilus/bifidus, kefir, miso and sea greens which contain chlorophyll that regulates cholesterol, improves bowel function, stimulates the growth of healthful bacteria, tempeh, soy sauce, sauerkraut- these contain enzymes and beneficial bacteria.
• Eat 4-5 small meals a day rather than 2-3 large meals. Eating smaller meals will allow the body’s enzymes to function more efficiently and effectively and will not overtax them (Cichoke, 1999; 437)
• Drink teas: slippery elm, comfrey-fenugreek reduces inflammation and pain; chamomile is an anti-inflammatory; cramp bark combination will help with bouts; Pau d’ arco tea- anti-inflammatory and immune system enhancer, antibacterial, cleansing and healing. Echinacea is an immune-enhancing herb that also reduce pathogenic bacteria (Bone, 2000; 178)
• Juice of one lemon in warm pure water upon rising will cleanse the liver and adjust Ph balance of the body if necessary
• To sooth stress/tension leading to spasm use acidophilus/bifidus. Probiotics help establish good flora in the small intestine to improve assimilation (Balch, Balch, 1999; 328)
• Use essential fatty acids and evening primrose oil to normalize bowel function (Goldberg Grop, 1999; 685-689). EFA’s help strengthen cell membranes, protects cells lining the colon wall (Balch, Balch, 2000; 329) and supports immune function. Or eat at least 3 servings of freshwater fish such as salmon, halibut, sardines, herring, tuna, mackerel, swordfish
• Add fresh garlic to the diet- 2 cloves daily/3 days a week- aids in digestion and destroys unwanted bacteria and parasites. Fights inflammation; stimulates the immune system and is a potent antioxidant.
• Add L-Glutamine: a major metabolic fuel for the intestinal cells; maintains villi, the absorption surfaces of the gut
• Periodically do a detox- enzyme kidney flush- Every day for one week, drink 6-8 8oz glasses of unsweetened cranberry juice- you may add a small amount of apple juice to sweeten it a bit, but be sure to begin with 8oz of cranberry juice.
• Or mix the juice of a lemon in 6-8oz pure water, 3 glasses per day along with 3 8oz glasses cranberry juice. AND add 500mg B6 3x/day; 6-10 grams Vitamin C; and 800-1000 IU Vitamin E per day for the week (Cichoke, 1999; 433)
• Traditional Chinese Medicine, Acupuncture, Biofeedback, Chiropractic, Osteoopathy, and massage may be useful
• During episode- aromatherapy – rub abdomen with olive oil/cinnamon (Goldberg Group; 1999; 685-689)

Assessments that should be considered: Hair analysis; Detoxification  profile; Comprehensive Digestive Stool Analysis;

AVOID THE FOLLOWING IN THE DIET

v  Avoid diets comprised of mostly cooked foods- heat kills enzymes

v  Avoid refined foods- they are enzyme depleted

v  Avoid fast foods- they are high in fat, cholesterol, calories and are low in enzymes, fiber, vitamins and minerals.

v  Avoid foods containing artificial additives, including colors, flavors, and preservatives

v  Avoid foods that have been irradiated. Irradiation kills enzymes

v  Avoid foods grown with pesticides, fungicides, herbicides and do not eat products grown close to highways (cadmium and other toxins from tires of cars and trucks float through the air and deposit in the soil)

v  Reduce or eliminate alcohol, coffee and other caffeine-containing fluids

v  Don’t cook with aluminum pans- aluminum can be toxic

v  Avoid chlorinated or fluoridated water. Chlorine kills good bacteria living in the gastrointestinal tract. Fluoride increases free radical production leading to tissue damage and aging. Fluoride inhibits enzymes and the immune system.

v  Avoid very cold liquids as they shock the stomach and inhibit the production of hydrochloric acid needed to stimulate the production of enzymes responsible for digestion.

v  And try to eliminate sugar from the diet as much as possible.

Complements of The Complete Book of Enzyme Therapy, Dr Anthony J Cichoke

CASE HISTORY EXAMPLE

USING HERBS

Case History-

A male patient aged 72 suffered an attack of acute diverticulitis and was concerned to prevent another episode.

Treatment consisted of the following prescription (based on 1 week).

Echinacea Angustifolia           1:2       25ml

Hydrastis Canadensis             1:3       20ml

Viburnum Opulus                    1:2       20ml

Matricaria Chamomilla          1:2       20ml

Propolis                                   1:10   15ml

Total: 100ml

 

Dose 5ml with water 3x day.

Slippery elm powder, one heaping teaspoon with water before each meal, was also prescribed.

The patient was also advised to have more fiber in his diet, particularly more fruit. Fresh garlic, one to two cloves a day, was also recommended for 3 days every week. After 6 months the herbal treatment was discontinued but the fresh garlic (for 1-2 days a week), slippery elm and dietary changes were stilled observed. Several years later, the patient has not experienced any recurrence of acute diverticulitis.

Complements of Principles and Practice of Phytotherapy, Kerry Bone 2000

NUTRITIONAL SUPPLEMENT RECOMMENDATIONS

These are recommended additionally to the above diet. However, if the diet is high in all of these agents, then some may not be needed.

1.      Probiotic: ½-1 tsp daily  Metagenics, Ultra Flora Plus

2.      Garlic: 1caps/2xday with meal  Metagenics Super Garlic 6000

3.      EFA complete: 2 gel caps/2xday with meal  Nordic Natural

4.      Fiber: 1 tbsp in 8oz fluid  Nutritech All One Fiber

5.      Vitamin B complex: 100mg/2xday   Vitaline B Complex 100

6.      Multi-enzyme complex: 2/3xday with meal   Vitaline Formulas Catalytic Formula

7.      Chlorophyll Complex: 3/2x/ day  Standard Process Chlorophyll Complex Perles

8.      Flaxseed oil: 1-2 tbsp/day   Barleans Essential Woman

9.      Vitamin C: 3-8 grams  Nutritech  Vitamin C

10.  Multi Vitamin/mineral: 1 tbsp Nutritech  All One Green Phyto

11.  Antioxidant formula:3 daily  Metabolic Maintenance  Deluxe scavengers

12. L-Glutamine: 1 tbsp/2x/ day  Metagenics  Glutagenics

 

References:

Burton Goldberg Group. Alternative Medicine, Future Medical Publishing Inc., Tiburon California;1999.

Michael  Murray ND and Joseph Pizzorno ND. Encyclopedia of Natural Medicine. Prima Health;1998

Michael  Murray ND.  Healing Power of Foods. Prima Health; 1998

Robert C Atkins MD. Dr. Atkins’ Vita-Nutrient Solution. Fireside Books, Rockefeller Center, NY, NY; 1999

Betty Kamen PhD.  New Facts About Fiber. Nutrition Encounter Inc., Novato, California 1997

Dr. Anthony Cichoke .  Complete Book of Enzyme Therapy. Avery Publishing Group, Garden City Park, NY; 1999

Phyllis A Balch CNC and James F Balch MD.  Prescription for Nutritional Healing. Avery Publishing, Penguin Putnam Inc, NY, NY; 2000

Linda Page.  Healthy Healing. Traditional Wisdom Inc.; 2000

Kerry Bone.  Principles and Practice of Phytotherapy. Churchill Livingston, Harcourt Publishers; 2000