Diverticulitis & Diverticulosis

Transcript:

MELANIE: Good morning and welcome to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. We have had many listeners request a show about diverticulosis and diverticulitis. So I think this is timely. It is interesting to know that 30% of U.S. adults between the ages of 50 to 59 have diverticulosis, and 70% of those older than 80 struggle with diverticulosis; surprising Britni?

BRITNI: Big numbers.

MELANIE: Big numbers.

BRITNI: Yeah.

What is the difference between diverticulitis and diverticulosis?

MELANIE: The Cleveland Clinics reported that almost everyone over the age of 80 has diverticulosis. Today, we want to explain the difference between diverticulosis and diverticulitis. In addition, we want to describe what is happening in the colon when you have those conditions. We also plan to discuss on an eating plan to avoid these conditions. Good morning. I'm Melanie Beasley. I'm a registered and licensed dietitian. I work mainly out of the Eagan office, but I also work with clients throughout the U.S. through Zoom appointments, which I love; get to see their home, their pets. It's great.

BRITNI: Yes, it is fun.

MELANIE: I've been a registered dietitian for over 30 years. So I have seen and heard a lot.

BRITNI: I can only imagine.

MELANIE: When dinosaurs roamed the earth, Britni. Joining me as our cohost is Britni Vincent, who is a very experienced dietitian also. And we both work with difficult cases. Yes?

BRITNI: Yes. Well, I mean, I remember learning about this in school, and diverticulitis, diverticulosis. It, it got, I got confused. So we're going to clear all that up and, and talk about what each of those individual conditions are. So let's first dig into what is diverticulosis. First of all, it is a fairly common and common condition, and it usually doesn't cause symptoms or even need treatment. And people get diagnosed with this from a colonoscopy. But when the condition becomes diverticulitis, which means there's an infection, an inflammation, anything with “itis” means inflammation, then with diverticulitis treatment is absolutely required at that point.

MELANIE: Very painful.

BRITNI: Yes.

MELANIE: Very painful. Well, both dive diverticulosis and diverticulitis occur in your large intestine or your colon. Often people develop pockets or bulges in the wall of the colon and these pockets are called diverticula.

BRITNI: So what causes these pockets or these diverticula? Usually the cause is from excess pressure inside the colon. And these pockets or diverticula, they could be the size of a pea, or they could be significantly larger than that.

MELANIE: If you think of, of almost finger-like projections that come out of the colon. So we are trying to explain this condition in simple terms so everyone will understand. Diverticulosis is fairly common and is simply having small, tiny bulges or pockets in your colon. Diverticulitis is inflammation or infection like Britni said in one or more of the pockets. And clients tell me they feel pain. They have nausea. Often there's fever. This is a much more serious condition.

BRITNI: It is. Yeah. During my dietetic internship, I spent a lot of time in the hospital, on the floor where these patients with diverticulitis would be. And I remember seeing them in so much pain. I mean, they appeared miserable. So this is absolutely something you want to prevent. And you know, that begs the next question. Who's most likely to get diverticulitis or diverticulosis?

Who is most at risk for diverticulitis or diverticulosis?

So here are some of the risk factors: you're over 40, you're male, you're overweight. You don't eat many vegetables. You live on fast food and pizza. You frequently take anti-inflammatory drugs, such as aspirin, ibuprofen, NSAIDS, is the term. And you smoke. Those would be some risk factors.

MELANIE: Yeah. And I think too, I've had clients who have to be on the heavy-duty opioid painkillers that develop diverticulosis as well. So what is a possible cause? Experts have found that when people don't eat enough vegetables daily, they tend to become constipated. Many of the anti-inflammatory drugs like Advil, ibuprofen, certainly pain medication that we've discussed, the opioids, often cause constipation. And hard to pass waste from constipation puts extra strain on the walls of the colon. That increased pressure causes the little pockets to form in those weak areas of your colon.

Constipation is not your friend. I've had many clients who have experienced constipation for years and didn't realize the risk they were taking with their colon. So Britni, would you tell our listeners; define constipation: what we think constipation truly is.

What is the definition of constipation?

BRITNI: When you are not having a daily, easy bowel movement, then you would be constipated. So we really should be having at least one daily bowel movement and it should be easy to pass, not little pebble-like. And I've had, I'm sure you have too Melanie, many clients that come in and they have no idea that they're constipated.

MELANIE: Sure.

BRITNI: Because we don't, we don't really sit around the dinner table talking about our, our stool habits. And so people just don't realize what's, what it should be.

MELANIE: And sometimes I feel like my clients are so relieved that someone is asking them.

BRITNI: Yeah.

MELANIE: Because they they're they've been miserable.

BRITNI: Yeah.

MELANIE: And don't feel like they can talk about it.

BRITNI: Yeah. Yeah.

MELANIE: We talk about everything don't we.

BRITNI: We sure do. And many people have these little pockets, but the damage occurs when the bacteria from that stool infects those little pockets. So then that turns into diverticulitis, that much more serious condition.

What are some symptoms of diverticulitis?

MELANIE: So what are the symptoms of diverticulitis or infection in those pockets? Let's talk about that. Most people experience pain and often this pain is the lower left side of the abdomen. You may have fever, you might have chills, you might experience cramps, have rectal bleeding, diarrhea, stools with mucus, you know, these are all symptoms that we have to be aware of once you know you have that diverticulosis.

BRITNI: Yeah.

MELANIE: And sometimes that's the initial way of finding out that they have it is they become infected.

BRITNI: Oh, absolutely. Yeah. I have had that happen to many, many clients. So if you have symptoms of diverticulitis, it is necessary to go see your medical provider because infection in these pockets is a very serious health condition. And I think people are so uncomfortable. They, it sends them to the ER.

MELANIE: Yes.

What can you do to prevent diverticulosis?

BRITNI: Yeah. So let's shift our discussion to talk about what you can do to prevent diverticulosis. So as a dietitian, sitting down with a client who's experiencing constipation, I focus on that first. And in our health history question, we ask, do you have constipation or diarrhea? And frankly, we ask, we get into the nitty gritty with your bowel movements because it tells us a lot about what's going on inside your body.

MELANIE: Yeah. We can't unzip you.

BRITNI: No. So it, your, your bowel habits are, you know, we literally ask our clients to become their own poop police.

BRITNI: Yep. For sure.

MELANIE: And that helps us know what's happening so we can help.

BRITNI: It is so helpful. So people, you know, people are generally ready to answer about diarrhea because that impacts your life. You know, having chronic diarrhea could prevent you from going to concerts or taking your grandchildren out. But many don't realize the harm that long term constipation can cause. Or like we talked about, many people don't realize they're even constipated to begin with. So I always ask people, are you having a daily, easy bowel movement? So then we, we can really gauge what's going on, but we take constipation problems very seriously because we know it's not good to put that pressure on the colon so these pockets form.

MELANIE: It's a bigger deal to deal with diverticulitis. So if we can get on top of that constipation, and you're just, the client feels so much more comfortable. And sometimes that bloating and that pain is miserable in itself. So we look first at what clients are eating. We know bread, buns, cereal, rice, processed boxed or bagged foods are just more constipating. We encourage clients to switch from grains to eating vegetables that have been sautéed in butter or coconut oil.

Often when clients decide to eat healthy, they start snacking on a lot of nuts, especially almonds. And a few nuts are good for most people, but several handfuls of nuts, that can be sometimes constipating. So I periodically encourage my clients who are constipated to avoid nuts, at least for a season. I also encourage clients to eat soft meat with bone broth. A perfect example might be pulled pork or pulled chicken that's been cooked in a crock pot. And then I always add some homemade bone broth for extra liquid. That's very soothing to the gut and that heals, that heals as well. So it's a process.

BRITNI: Yeah. It is a process. Well, it is already time for our first break.

MELANIE: Great. So you are listening to Dishing Up Nutrition. I have good news for you today. You can still sign up for the 12-week Nutrition for Weight Loss series starting the week of September 19th. If you are many of us, you're busy, you forgot to sign up, but lucky for you, you can still sign up today and start next week. Call us at (651) 699-3438. Ask your questions and they will get you signed up. We'll be right back.

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BRITNI: Welcome back to Dishing Up Nutrition. Many of our listeners have taken Nutrition for Weight Loss before, but maybe you took it five years ago and you were doing great with your eating plan and then the pandemic hit and the treats and maybe the glass of wine before dinner became a daily routine. So we understand, give yourself, but give yourself an hour each week to make the commitment to yourself to get back on track. Monday, September 19th, we will be in person at the Eagan location and on the 20th, we will be in Woodbury and September 21st, we will be in North Oaks and Maple Grove. So if you miss those, you can spend time with Amy and Mary in Wayzata on Thursday, September 22^nd. All classes start at 6:30 PM. If you have questions, call us at (651) 699-3438.

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Some diverticulitis research: are nuts and seeds harmful?

So before the break, Melanie, you were talking about some general recommendations that you provide to clients who struggle with a lot of constipation. And so we're going to continue that conversation about constipation. So years ago, gastroenterologists, they warned that small bits of food in a person's diet could block or irritate the little sacks that can form along the colon. Again, those are the diverticula that we've been talking about. And then these little bits of food could lead to diverticulitis, but there is no real evidence to support that theory, according to Harvard Health. So a large study published more than a decade ago in JAMA helped to put that myth to rest. So some 47,000 men; huge sample size.

MELANIE: That is big.

BRITNI: With no known diverticulitis were followed for 18 years. And the study found no increased risk for diverticulitis. In fact, nut and seed consumption appeared to be slightly protective.

MELANIE: I'm wondering if it was the fiber.

BRITNI: Yes.

MELANIE: Yeah.

BRITNI: Yeah. I was thinking the same thing. And recently the American Gastroenterologist Association said this: nuts, corn and popcorn consumption is not associated with an increased risk of diverticulitis. Likewise, it added, there's no proof of ingesting seeds, including tiny seeds found in strawberries, blueberries, to increased diverticulitis risk.

MELANIE: You know, however…

BRITNI: Yeah. There's always a however.

MELANIE: There's always a however. In clinic, you and I were talking before the radio show, I have had several clients that popcorn did cause diverticulitis. So it's not something we really recommend at Nutritional Weight and Wellness anyway. So I just have them avoid it.

BRITNI: Like anything, it's individualized, and, but generally speaking, you don't need to avoid nuts or seeds if you have diverticulosis.

MELANIE: Yes.

BRITNI: Yeah.

MELANIE: And we want to chew our food.

BRITNI: Yes.

MELANIE: If we chew our food carefully and we don't pill our food, of course our body can digest better. So digestion starts in the mouth. Let's make sure we're chewing our food. Just a little tip listeners: Make sure your food is the texture of baby food before you swallow it. Help your body out. Don't pill, chew, chew, swallow.

Drink sufficient water to prevent constipation

BRITNI: Mm-Hmm. That's great. And you know, another, another recommendation for constipation. I mean, we say this on almost every Dishing Up Nutrition's show; drinking half your body weight in ounces of water a day.

MELANIE: Take some time, listeners. Do a little math.

BRITNI: Yeah. Half your body weight in ounces a day. So if you are nowhere near this, I always love facial expressions when I say this because a lot of people are quite surprised.

MELANIE: Yes.

BRITNI: Slowly increase it if you are nowhere near that amount.

MELANIE: And your body will adapt.

BRITNI: They will. Yes. For sure. And if you're on a diuretic, you probably need to drink even more water than that. And I'm sure hearing that 30% of people of people with diverticulosis can and do develop that serious condition of diverticulitis. You're probably more motivated to start drinking more water.

MELANIE: Yeah.

BRITNI: So it might be an easier habit to start, but drinking water is key to prevention to help relieve constipation. I mean, I have had many clients where that is the only thing they change and their constipation improves. Of course, it's not always that simple, but…

MELANIE: It's magical.

BRTINI: Yeah. It's magical because it, if you think about it, we're eating food and that food has to be emulsified, saturated, liquified in order to pass. If we don't drink enough fluid, we are making concrete.

BRITNI: Yeah. Yeah. It's a good visual to, to think about the process. You know, and also 30% of people with diverticulitis develop abscesses in the colon, which is an even more serious complication. So drinking that water is so critical for prevention. And sometimes I'll have clients start their day with a cup of warm lemon water, and that the temperature, the warm liquid can stimulate the bowels. The lemon helps as just a little mild detoxification, and people, people notice a difference starting their day with that.

MELANIE: And they're starting out with some saturation. So I love that. It's great.

BRITNI: If you are a coffee drinker, you need to start with a glass of water before, before you start with your coffee.

MELANIE: Yeah. I've heard it said that, well, for every cup of coffee, you need two cups of water because coffee's dehydrating.

BRITNI: Yeah. Yeah.

MELANIE: But, and I tell clients, get a water bottle that you love. Figure out how many times you have to fill it to get half your body weight. Put the number of rubber bands at the top that you need to fill it. Every time you fill and empty your water bottle, roll a rubber band down. All of your rubber bands are at the bottom. You get to go to bed.

BRITNI: Yeah. Perfect. And a larger water bottle, because let's face it. If we have to fill it up multiple times a day, you know…

MELANIE: We get our steps in.

BRITNI: Yeah. But you're probably less likely to do that. Cause you, you get busy with other things.

MELANIE: And a lot of times it's easier to get more fluid in with a straw.

BRITNI: Mm-hmm.

MELANIE: I think.

BRITNI: Yeah.

MELANIE: So let, let's have a serious conversation about adding extra fiber. We recommend adding cooked vegetables as the best source of fiber. Certainly adding cooked vegetables several times per day until there's no longer any constipation. In practice, I have found that bread and cereal and crackers are actually very constipating and they're also very inflammatory to the entire digestive tract. So we’ll talk about this when we get back. You're listening to Dishing Up Nutrition. Today's topic is covering nutrition for diverticulitis and diverticulosis. Stay tuned to learn more when we return from break.

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BRITNI: Welcome back to your Dishing Up Nutrition. Nutrition, what you eat affects every single part of your body in your brain. And often clients come to lose weight. And after a few weeks of attending the Nutrition for Weight Loss class, they make comments like, “My brain fog is gone. I'm having so much more energy. I don't have that afternoon slump anymore. I feel like my mood is better. I'm sleeping better. I'm not so crabby with my family.” I've heard that one many times actually.

MELANIE: Yes. They like me better.

BRITNI: Yeah. So to sign up, call 651-699-3438 or you can visit our website, weightandwellness.com. Good food is just so powerful.

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What should people be eating and not eating for diverticulosis/diverticulitis?

MELANIE: It is powerful. I want to recap a little bit what we were saying, is I think a lot of my clients come to me and they're thinking, man, I've got diverticulosis. I need to be eating whole grains and whole wheat bread and I need, and I find, and I think you do too in clinic, this is the opposite. I have so many clients that are so constipated and simply removing them from processed flour products: magical.

BRITNI: Yeah.

MELANIE: And so what we encourage is lots of good vegetables and while broccoli, kale, Brussels sprouts, green beans, spinach, any other greens; sauté them with some olive oil or coconut oil or some good grass fed butter. This helps normalize those bowel movements where they neither have constipation or diarrhea. And a little side note: protein bars can also be constipating. So it would be better to eat half a cup of melon or a small pear as a snack. And just pair that with some good animal protein, even an avocado, and that's going to help your blood sugar be balanced. You know, I love avocados because they're both anchoring that blood sugar and they have that natural roughage.

BRITNI: Yeah.

MELANIE: So it's a win-win and they taste delicious.

Typical supplement recommendations

BRITNI: They're a great food to incorporate for so many reasons. And I often recommend a variety of different supplements as a preventative measure. And our first step is to control that constipation. So I often recommend taking Mixed Magnesium, like four to six capsules a day. It can be beneficial to spread that out: two with each meal. And often on previous radio shows, we, you have probably heard us say take magnesium before bed, which yes, that is our general recommendation, but for constipation purposes, it can be helpful to, again, spread that out a little bit more. And the Mixed Magnesium, it actually contains two different types of magnesium: magnesium glycinate to relax the colon. And then magnesium citrate will actually pull fluid to the, to the colon and loosen our stool. So it, I mean it works wonders and it takes a little trial and error to figure out how much you need.

MELANIE: Mm-hmm.

BRTINI: I generally recommend start on the lower end, increase until you're having that daily easy bowel movement.

MELANIE: Just a little side note I'd like to add too is listeners, here's your homework for today. Go to your cupboard and see your medicine cabinet and see what kind of magnesium you're taking. Because the types of magnesium that you were talking about not only help to loosen the stool, the citrate and the glycinate together, but you're also absorbing the magnesium so it's doing the body benefit.

BRITNI: Yeah. Many other benefits.

MELANIE: There's a lot of magnesium; magnesium oxide we don't even really absorb. So we're not getting the benefit that we need.

BRITNI: Yeah. Such a great point. Yeah. And you know, then after the Mixed Magnesium, I often recommend clients take two Bifido Balance capsules, and bifido is a type of probiotic. And taking that before breakfast and lunch, and then two Acidophilus capsules before dinner and at bedtime. And the Acidophilus is the probiotic for the large intestinal tract. It also lines our stomach, bladder and vaginal tract. And then the bifido bacteria, that helps to digest our food and is used by the small intestinal tract. And when I'm working with a client, you know, I'll often adjust these up or down, you know, there might be more individualized recommendations once we know the whole big picture of what's going on.

MELANIE: You know, and I think a bonus, I had a client who was having so many troubles, not only with constipation, but urinary tract infections.

BRITNI: Mm. Yeah.

MELANIE: And so when we got her on the, the right amount of acidophilus, which you mentioned is important for bladder, not only did her stools correct, but she stopped having urinary tract infections. So she, she loved me.

BRITNI: Yeah. Oh, I bet she did. Yeah. Acidophilus is amazing for that too.

MELANIE: Well, we often add GLA, which is gamma linoleic acid. It's a fatty acid that helps heal and hydrate the whole intestinal track. The bonus is it makes your skin soft. And I usually recommend four to six softgels taken throughout the day. GLA is an anti-aging fatty acid because it supports all of the tissues in your body. If you've got cracked heels, this is wonderful. I also add about four to six omega-3 fish oil softgels to reduce the inflammation of the intestinal tract. Now this is a healing protocol, right?

Some examples of what to eat for diverticulitis/diverticulosis

Now let's talk about what to eat. Britni, let's go over some great ideas for a safe and effective eating plan for breakfast, lunch, dinner. You always have such great meal ideas.

BRITNI: Oh gosh. I don’t know about that.

MELANIE: You do.

BRITNI: Well, let's talk about what we ate this week. Because it's top of mind. This week I made the hamburger soup recipe from our website.

MELANIE: Love that.

BRITNI: It's delicious.

MELANIE: And it's very forgiving. You can add the vegetables you want to use up.

BRITNI: Yeah. Oh yeah. I have, I've made it many times and varied it. It’s wonderful. And then for the healthy fat, I usually add some avocado on top. And, and then I just made a huge pot. So some days I had it for lunch. Sometimes I had it for dinner. The whole family ate it. It was wonderful.

MELANIE: I love to freeze extras in Mason jars. Because they, you know, they work really well from frozen to microwave to…

BRITNI: Great idea.

MELANIE: It's great. It makes a big batch. So it's lovely to have, and then you can look in your freezer and say, oh, I've got all these lovely choices when I don't feel up to food prep.

What about adding extra fiber?

BRITNI: Yeah. You will thank yourself later. We often get the question: What about adding extra fiber? Either ground up flaxseed or some other type of fiber product? I mean there's so many out there nowadays. So if you have diarrhea, a fiber product can be, can be helpful. Sometimes they can actually increase constipation. Everybody's different. But I think a big mistake, a lot of people make is they, they add too much fiber too soon and then they're not drinking enough water.

MELANIE: Exactly. We're making concrete.

BRITNI: Yep, exactly. So that water, I would, I recommend slowly increasing that fiber. So your, your bowels get used to it and then again, making sure you're getting enough water to flush everything out.

MELANIE: Wonderful. It's wonderful. And it's so important. I mean, we're supposed to be getting the minimum of 30 grams of fiber a day.

BRITNI: Mm-Hmm. It's a lot. Yeah.

MELANIE: That's it's a lot of fiber. We just don't, Americans on the average are getting 15 grams.

BRITNI: Yeah.

MELANIE: We're setting ourselves up.

BRITNI: And you know, those fiber supplements, they should not replace your vegetables.

MELANIE: No. And they should not have colors or artificial sweeteners. So sometimes just the ground flax, some chia seeds. I love a chia pudding.

BRITNI: Yep. Me too.

MELANIE: So here's another supplement that I use sometimes with clients. I use an L-glutamine product called Glutagenics that contains L-glutamine, aloe and licorice; not the licorice that you eat on a road trip. Usually one or two scoops servings is all that is needed. And that's very healing to the lining of the gut. I love L-glutamine. They use it in burn units to help heal skin. So the interior of your digestive tract is skin.

BRITNI: Yep.

MELANIE: So we want to heal that.

BRITNI: It, it does make a huge difference for digestive symptoms. You know, one of the statistics we talked about earlier is over the age of 80, you are much more likely to develop diverticulosis. And often as people age, I mean, frankly, they're not eating enough, not drinking enough water and then they become constipated. So these little pockets start to form. It's so important as you age to cook your vegetables. I mean, cooked vegetables are a lot easier to break down for your system. And continuing to incorporate those vegetables into your diet. Having one or two servings of fruit a day. Also that three to four ounces of cooked meat or fish at least three times a day is really important. And the healthy fat. Melanie, you had mentioned the avocado as a great option. We want to be adding about a tablespoon of good fat to each meal or half an avocado, olives, butter, or olive oil.

MELANIE: Good bacon fat.

BRITNI: Yep. All of those would be healthy fat. And that helps to keep the tissue hydrated and then helps keep us satiated, balance our blood sugar.

MELANIE: Makes our food taste delicious.

BRITNI: Yeah. Exactly. So for diverticulosis or diverticulitis again, prevention is the best plan.

MELANIE: So keeping in mind, think about what you ate this past week listeners. Why is it from a package? Was it from the garden? Was it from the farm or was it from a box? So when you start looking at these foods that are packaged, I want you to tell yourself I'm choosing to decrease my risk of diverticulosis, which in turn can become a real problem as I age. Nobody wants that burden and nobody wants to be dealing with that pain. And 80% over, what was it: 80? We don't want, we don't want that risk. We're dealing with enough as we age. Right?

BRITNI: Right.

MELANIE: So it's almost time for break. So we'll go ahead. You are listening to Dishing Up Nutrition. We've been on the air for the past 18 years talking about the healing power of real food, and we invite you to join our Dishing Up Nutrition Facebook page. So you can let us know what topics you want us to present. We would also like to hear your successes. Changing from a high sugar processed convenience food diet to real food eating plan, it's not easy, but you are so worth it. So we would love to hear your success stories. We'll be right back.

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BRITNI: Welcome back to Dishing Up Nutrition. Later this month on September 28th, Marianne our culinary nutrition educator will be showing you how to enjoy more vegetables. Perfect for this show.

MELANIE: Yes.

BRITNI: And how to use and enjoy raw vegetables, how to roast them, how to steam them, how to sauté vegetables. It'll be just a wealth of information.

MELANIE: It's so fun. Her classes are so fun. You get such great ideas and recipes. So, and where can you do a culinary show for that price? It's fantastic.

BRITNI: Yeah. So there, it's a Zoom format. It's only $25. Class starts at six, ends at 7:15. And everyone that registers for the class will receive access to the recording for three days. So if you aren't available on the 28th, you don't need to attend the class live. You can still sign up. And then again, you get access to the recording for three days. It's a great time of year to add more vegetables into your diet.

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Two amazing client success stories

MELANIE: It is, and the farmer's markets are just exploding. I wanted to go today, but we'll see. Alright. So I want to talk about a wonderful client that I have, and she was an amazing success story. I remember that she came to me because she had three bad diverticulitis flares in six months.

BRITNI: Oh my gosh.

MELANIE: She'd been a client of mine previously for weight reduction, but this, she said, you've got to help me. And I don't blame her. Well, these episodes are not only painful, but they're scary. And one of them, she ended up in the ER. She, her very first one, and she'd been placed on multiple doses of heavy duty antibiotics to clean up the infection. But now she was also experiencing some ill effects from the antibiotics such as heartburn and anxiety.

So we initially worked on allowing her bowels to heal and calm down. We did a low roughage, but very nourishing plan. I placed her on the probiotic, Bifido, Acidophilus, the Glutagenics, and a lot of bone broth where she cooked her meats and some root vegetables. I took her off caffeine because it was dehydrating the tissues and that can lead to constipation like we've talked about. Well, we really worked on removing inflammatory substances, like soybean oils and canola oils and sugar and processed foods with grains.

So it was not only about nourishing with the good foods, but removing the inflammation foods is key. Once she was healed and feeling good, then we slowly advanced her vegetables and some fruits. She tolerated that really well. So then we began adding in some uncooked fruits and vegetables, lots of leafy greens and a good healthy fat with each meal, and her meats and some eggs.

And this helped to support those intestinal tissues with the continued healing. I had her always pay attention to her body with each step we took. We did it very slowly. And I also had her add in some ground flax eventually and chia way down the road. I had her blend the chia, so it was smooth. She, we were, you know, she was just nervous. So I said, let's just blend that chia in a coffee grinder. She made some chia puddings.

She had salads daily; made sure we kept the stools soft. I really encouraged at least a hundred ounces of filtered water consumed daily. And then those supplements that we talked about. So I'm happy to report after four years, she has not had a single flare.

BRITNI: That's amazing.

MELANIE: She let some caffeine back in and I said, let's don't go there. You know, she checks in with me and then, you know, we correct course a little bit. Now Britni, you were talking about some of your clients that you had great success with. Let's talk about those.

BRITNI: Well kind of a similar one of my clients, similar situation to yours, she was already a previous client of mine. She set up an appointment because she randomly got a diverticulitis flare, and she didn't even know that she had diverticulosis. So ended up in the hospital, kind of same situation: antibiotics. And so I went through a similar healing plan as you did. And for her it was different because she never struggled with constipation.

MELANIE: What was the piece there?

BRITNI: It took some investigative work, but she previously was on Prilosec, an antacid for years. And she was seeing some food particles in her stool. She was like, well maybe she's not digesting her food very well. Maybe those food particles are getting in the pockets and that could create some infection.

MELANIE: Yeah.

BRITNI: So we put her on some digestive enzymes to help her to break her food down. And it worked wonders. She really in general felt so much better digestively. And then she went off of them at one point. And I, and what she described is she would then feel like a little twinge of pain in her abdomen.

MELANIE: That lower left area.

BRITNI: Yeah. But she described it as a twinge, not a full-blown painful episode. And then once she restarted those enzymes, that twinge of pain went away.

MELANIE: Wow.

BRITNI: Yeah. So Key Digestive Enzymes. I had her do one, one with each meal and…

MELANIE: You know, it's like we were talking about. It's good to look at your stool. Do you see food in your stool? Because we paid for that food.

BRITNI: Yeah. We want to make sure we're actually utilizing it.

MELANIE: We're utilizing the food and we're getting the nourishment that we paid for. And so as we age, sometimes we need that.

BRTINI: Yeah.

MELANIE: So diverticulosis is very common in developing countries. Westernized countries have a higher incidence of lifestyle related diverticulosis, and it's estimated that approximately 27% or more of first world countries have diverticulosis, with roughly 15% of them experiencing those symptoms: diverticulitis. So what symptoms of diverticulitis would we recap, Britni, would you say to look for?

Recap of diverticulitis symptoms

BRTINI: Well that attacks of abdominal pain sometimes triggered just by eating again, generally very painful bloating, changes in bowel habits, constipation more than diarrhea, maybe some mucus in the stool, fullness, tenderness, and that left lower quadrant of the abdomen. Fever is very common, constant, severe abdominal pain. So all of those could be experienced when you have diverticulitis.

And it is unclear why some people with diverticulosis develop inflammation or infection of the diverticula, which then is considered diverticulitis. But that diverticulitis often causes that extreme pain. Again, with fever, nausea, constipation, and with the diverticulitis, complications can develop such as bleeding, intestinal blockages, a burst of a diverticulum leading to a leakage of intestinal contents into the abdominal cavity. I mean, sounds like a…

MELANIE: The worst scenario.

BRITNI: So not a good situation at all.

Recap of preventing diverticulosis

MELANIE: So how do we go about preventing diverticulosis? This was what we were talking about. You know, the answer's quite simple. Roughage from plants, mostly vegetables, eating natural fiber from whole plant foods performs essential functions in our bodies. One of these functions is to protect the intestines from getting these little bulges or herniations. This means that while getting in a variety of whole fruits, vegetables, nuts, and seeds, legumes in your diet every day, you’re directly lowering your risk for diverticulosis. Our goal at Nutritional Weight and Wellness is to help each and every person experience better health through real food. It's a simple yet powerful message. Eating real food is life changing. Thanks for joining us today.

BRITNI: Thank you.