Diverticulosis, Diverticulitis and Intestinal Permeability

Diverticulosis, a condition characterized by sacs or pockets in the colon with no inflammation, is a disease seen most frequently in elderly patients.  It affects up to 20% of the population by the age of retirement, and two-thirds by the age of 85. A.R.P. Walker pioneered the research into the association between food, gut function and disease patterns.  He recognized that South African blacks have a very low incidence of colonic problems such as diverticulitis, adenomatous polyps and carcinoma.  Consequently, he postulated that the traditional high-fiber African diet was important for maintaining colonic health (O’Keefe, 1995), with follow-up studies showing disease symptoms could be substantially improved with a diet high in fiber-containing whole-wheat bread, cereals with bran, vegetables and fruits (Painter, 1985). While I agree that fiber is of therapeutic importance, we must also consider the other factors discussed throughout this section, especially long-term neglected constipation. Also, any of the digestive system can create a condition of increased intestinal permeability, allowing toxins to enter the bloodstream and disturb the immune system.

We can treat diverticulosis and intestinal permeability conservatively but effectively with a high-fiber diet, accompanied by membrane- strengthening herbs suc as tien chi root, DGL licorice root, gotu kola, and liquid chlorophyll, or mucilagenous herbs that coat like slippery elm bark. Carotenoid rich carrot juice is also often helpful.  According to tolerance ginseng root or white atractylodes can be gradually added to strengthen the internal energy. Basic vitamins and minerals are also important.  In many cases, balancing intestinal flora is also needed.

Diverticulitis is a progression of diverticulosis, caused by inflammation and subsequent perforation of one or more of the sacs in the colon. Milder forms of diverticulitis begin with gradually increasing symptoms emanating from the lower left quadrant of the abdomen.  Cases of acute complicated disease present with dramatic onset of abdominal pain, followed by fever. Chronic diverticulitis can be debilitating. The treatment is the same as described, but often requires more sophisticated formula changes over a long period of time, along with the addition of anti-inflammatory herbs like scute root, coptis rhizome, dandelion root, persica seed (tao ren or Prunus persica), red peony root, and boswellia gum. These must be prescibed by a competent practitioner, and only in conjunction with appropriated membrane strengthening strategies. The Ayurvedic bowel tonic Triphala is also quite helpful for long term treatment.

Nai-shing has noticed that there is often internal bowel tension contributing to this problem, which accords with both TAM correlation of bowel dysfunction with neurological disturbance (Vata), and the Western clinical observation that antispasmodics of clinical use with this disease (Lux et al., 1998). If there are signs of tension along with the pain, kava root or ashwaghanda root can be added to your formula. Peppermint oil or stoneroot tincture can be used independently. Use of omega-3 oils like flaxseed or fish oils are also of benefit to lubricate and reduce inflammation.