Constipation and diverticulitis

Constipation is a disorder characterized by the need to strain to pass hard stools and decreased frequency  of stools (two or three times a week). Chronic constipation lead to diverticulosis, in which multiple small sacs of chronic mucosa are pushed out through the muscle wall of the colon.

Diverticulosis occurs because chronic straining to pass feces produces increased pressure inside the colon. Inflammation often develops within the small sacs (diverticula) producing diverticulitis with abdominal pain and bleeding. Constipation and diverticulitis are so called “diseases of civilization.” It occurs in near epidemic proportions in the industrialized countries, where one- fifth of the adult population suffers from chronic constipation and diverticulosis occurs in about one- third of people older then 65 years.

Diet in constipation

The primary cause of both constipation and diverticulosis are highly refined and processed diets that are low in dietary fiber. Dietary fiber passes into colon intact and absorbs water- increasing the bulk of the stool and softening it. This stimulates peristalsis in the colon, pushing the stool forward more rapidly. Dietary fiber is found in large amount in whole grains, corn, vegetables, fruits (dried prunes, apples,raisins, and figs),seeds and legumes. Increasing intake of these legumes will soften the stool, and often eliminate constipation.                                          

Supplements of fiber, such as corn or wheat bran preparations, can also be beneficial. However because large amounts of fiber can produce gas and abdominal discomfort fiber intake should be increased gradually as tolerated over a period of several weeks. 

High dose calcium supplement (more than 2g/day) may worsen constipation. Chronic use of laxatives should be avoided. Most interfere with normal colonic  functions and reduce absorption of nutrients. They can also precipitate development of irritable bowl syndrome.