Why Am I so Tired with Diverticulitis – Everything you need to know

Why Am I So Tired with Diverticulitis? Unlike diverticulosis, diverticulitis causes symptoms that are often very uncomfortable. Characteristics are mainly dull and non-colicky pains, which are usually located in the lower left abdomen. You can find out everything you need to know about the symptoms of diverticulitis here.

Why Am I So Tired with Diverticulitis? This is what diverticulitis looks like

To get an idea of ​​diverticular disease, it is probably easier to imagine your intestines like a conventional bicycle tire: with a flexible inner tube (intestinal mucosa) and a rigid outer tube (intestinal muscle). When you pump air into the bike tube, the pressure (in the gut) increases due to the contents. If the outer tube has a weak point, the inner tube can force a hole, protrude through this hole, and form a small balloon (diverticula) on the outside. These look like marble-sized protuberances protruding through the colon wall. Click here if you want to see what diverticulitis looks like during a colonoscopy (endoscopic examination).Luckily, there’s a lot you can do to turn painful diverticulitis into pain-free diverticulosis . How you can help yourself with diverticulitis is explained below.

Terms you want to understand

Diverticulosis: When such protuberances are present but are not inflamed or painful.

Diverticulitis: When these protuberances become inflamed and therefore painful.

Uncomplicated Diverticulitis: When the protuberances become inflamed and therefore painful. Bleeding may occur (symptomatic uncomplicated diverticular disease, SUDD).

Complicated diverticulitis:If the sacs become infected and abscess form (fortunately fistulas are rare), pressure builds up inside the sac that can lead to free perforation (the sac rupturing), which in turn causes fecal peritonitis. Other complications include strictures (due to recurrent microinflammation causing scar tissue) and/or constipation (not passing stool).

Diverticula: Such a protruding bulge.

Diverticular disease (DD for short): The general term for a disease in which diverticula forms in the wall of the large intestine (sigma loop > colon).

Symptoms of Diverticulitis

Most diverticula do not cause any symptoms. A diverticular disease usually manifests itself as pain in the lower left abdomen, more rarely in the right. Bloating, constipation or diarrhea can also occur. The symptoms often disappear temporarily, but can also be permanent. They are often stronger after eating and weaker after a bowel movement . Diverticula can also sometimes bleed.

Inflammation of the diverticulum (diverticulitis) causes a sudden dull pain in the lower abdomen, accompanied by a slight fever. Other signs include constipation, diarrhea, bloating and nausea, sometimes cramps. Vomiting is rather rare. When the doctor presses on the abdomen, the abdominal muscles tense reflexively (defense tension). When you suddenly let go, the pain intensifies.

Causes and risk factors

Diverticula form in places where the intestinal muscles are weaker. They usually form in the sigmoid, a section of the large intestine that is about 40 to 45 centimeters long. The pressure of the stool on the intestinal wall is greatest in this S-shaped area in front of the rectum.

Some people are genetically more prone to diverticula. Weak connective tissue and disturbed bowel movements are other risk factors. Older people and people who are very overweight are also more likely to have diverticulosis.

The role played by lifestyle has not yet been fully elucidated. A low-fiber diet can lead to constipation and hard stools — suggesting it may increase the risk of diverticular disease. A diet high in red meat, smoking and little physical activity are suspected to be further risk factors for diverticular disease.

Why diverticula become inflamed and what increases the risk is still unclear. Reduced blood flow and the formation of fecal stones in the diverticula are thought to promote inflammation .

Complications are more common in people with a weakened immune system (e.g. after an organ transplant) or with severe kidney disease. Long-term use of certain medications presumably also increases the risk of a severe course. These include non-steroidal anti-inflammatory drugs (NSAIDs), corticoids ,acetylsalicylic acid(ACE) andopioids.

Prevention of Diverticulitis

A high-fiber diet ensures that the stool does not become too hard. This suggests it may protect people with diverticula from discomfort or inflammation. Lots of fiber can be found in whole grain products, vegetables, legumes and fruit. Physical exercise also stimulates digestion; it is not yet clear whether it can prevent symptoms.

Some dietary recommendations advise against certain foods, particularly nuts, grains, corn, and popcorn. It has long been suspected that small residues of these foods get stuck in the diverticula and promote inflammation. However, studies have disproved this. So you don’t have to do without nuts, for example.

Tips on diverticulitis

Solid foods: Foods that are good for diverticulitis are very different from foods that are good for diverticulosis.

Water: No, this doesn’t just mean drinking water (it should be 2 to 2.5 liters per day for mostly sedentary adults), even if it starts with that, of course. By the time the indigestible matter has reached the large intestine, most of the nutrients and up to 90% of the water have already been absorbed by the small intestine. So how do you get the remaining 10% of the water to stay in the sigmoid loop and rectum to keep the stool soft? From the above, you know that certain dietary fibers retain water. A survey of 300 GPs in the UK found that one in five visits to the doctor is due to tiredness and fatigue. Most of these patients, unless there are serious problems, are dehydrated .

Oil: A teaspoon to a tablespoon of olive oil in the morning can help lubricate the inside of the intestines and allow for a smoother passage of contents. In 2015, the Journal of Renal Nutrition published that olive oil, flaxseed oil, and mineral oil are all equally effective in relieving constipation symptoms. Oil can serve as an emollient if consumed in excess of the capacity of the small intestine (minimum 1 teaspoon, maximum 1 tablespoon). A little oil can help you relieve the high pressure in the “inner hose”.

Anti-inflammatory:You must not take nonsteroidal anti-inflammatory drugs (such as ibuprofen or aspirin) as they increase the risk of bleeding and other complications. You can eat natural foods that have anti-inflammatory properties such as: Like the curcumin, the safe and beneficial aloe vera in Aloeride, and certain veggies we use in our clever smoothies. For diverticulitis, a herbal capsule of Aloeride twice a day is a good start, which can be supplemented with a tablespoon of turmeric in a smoothie daily. Feel free to read up on how to make the latter tasty. 

In addition, very regular exercise that stimulates respiratory rate and heart rate is an important means of controlling both the symptoms of dyslipidemia (e.g., abnormal cholesterol, triglycerides) as well as to counteract systemic inflammation. Everything you need to control inflammation is in your blood. If you pump harder and more regularly, the systemic inflammation will decrease. Good news – and not only for diverticulitis! Controlling your blood lipid levels (total cholesterol, HDL/LDL ratio) can be easily helped by eating high in fiber (yes, that’s a diet that includes clever smoothies).

Diverticulitis: What Foods Should You Avoid?

If you have diverticulitis (inflammation), you should eat foods that will not irritate the inflamed areas (hence low in fiber) or bloat the gut (hence no fermentables). Avoid foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) to keep the gut from bloating. The keyword is fermentable, because fermentation produces gas that bloats the intestines and can irritate the protuberances. FODMAP avoids apples, pears and plums, dairy products like milk, yogurt and ice cream, fermented foods like sauerkraut or kimchi and beans, cabbage, Brussels sprouts, onions and garlic. I personally believe that foods that have been properly fermented outside of the body are fine. For example, the Specific Carbohydrate Diet recommends doubly fermented yoghurt (i.e., fermenting for 24 hours instead of 12 hours in one pot) so you get the good probiotics but don’t have gas build-up in your gut.

Diverticulitis: What Foods Should You Eat?

Once a flare of diverticulitis (inflammation) begins, switch to a liquid diet for a few days. The intestinal break is comparable to intermittent fasting, supported by a vegetable capsule of Aloeride that you take in the bathroom in the morning and, if necessary, another capsule in the evening. Here are some safe things to eat if you have diverticulitis:

• Filtered water and herbal teas to your liking

• Clear broths and very finely pureed soups (use a hand blender) to your liking

• Premium-quality, latex-free aloe vera

• Natural, full-fat yogurt (in listed on the FODMAP list but beneficial for the gut microbiome ie consume carefully and ideally make double-fermented yoghurt)

• Juice fruits and raw vegetables (ie no smoothies, because smoothies contain pulp) and avoid sweetening juices (ie keep them low on the glycemic index and avoid packaged/bottled juices, which often contain more sugar, than you think). By the way: the seeds in tomatoes, courgettes, cucumbers, strawberries and raspberries do not aggravate diverticulitis, nor do sesame seeds

• rice (basmati or white)

• mashed potatoes (peel the potatoes beforehand)

• egg white and egg yolk

• gelatine (e.g. for the production of collagelatine and a sugar-free green juice mix for gummy bears)

The more digestive rest you allow your intestines, the faster acute diverticulitis can resolve on its own. If you don’t feel better within two or three days, you should see your doctor.

Can diverticulitis be life-threatening?

Uncomplicated diverticulitis won’t kill you, but complicated diverticulitis can be life-threatening. You should therefore act before a manageable, uncomplicated intestinal problem becomes a complicated one. Diverticulitis is considered the most common cause of intestinal perforation and is associated with a significant mortality rate from emergency surgery. The mortality rate after surgery for complicated diverticulitis ranges from 6% to 17%. If free perforation and fecal peritonitis (inflammation of the tissue that lines the inside wall of your abdomen and covers and supports most of your abdominal organs) occurs, the mortality rate increases to 22% to 39%. Fortunately, diverticulitis can be treated conservatively in about 85% of cases.


Can diverticulitis heal without antibiotics?

The cornerstones of treatment for uncomplicated diverticulitis (inflammation) are antibiotic therapy (to reduce the risk of infection) and bowel rest (to relieve pressure quickly). Two randomized controlled trials suggest that an observational approach to acute uncomplicated diverticulitis is not inferior to antibiotic treatment and does not lead to an increased rate of complications or recurrence. [ Source: Management of Acute Uncomplicated Diverticulitis May Exclude Antibiotic Therapy. Mayl J, Marchenko M, Frierson E; Cureus 2017 May 15;9(5):e1250] Bowel rest is always crucial, but even more important than antibiotics are anti-inflammatory molecules. Inflammation may play a role in the early stages of diverticulosis. They are found in colonic diverticula without evidence of clinical diverticulitis. [Source: Diverticular disease in the elderly. This is where high-dose, pure, latex-free aloe vera can be of particular natural benefit. My clever smoothies are especially helpful with diverticulosis or if the diverticulitis is not acute.

Can Diverticulitis Cause Anemia?

Just as heavy menstrual bleeding can lead to anemia, a ruptured blood vessel in the wall of a diverticulum can lead to bleeding in the colon. Depending on how far up the colon the bleeding occurs, you may see blood in the stool (the stool may appear dark and tarry) or blood from the anus, and if this goes on long enough, it can lead to anemia. Symptoms may improve if you eat more iron, vitamin B12, or folic acid. However, it would be wiser to consume more nutrients that are known to speed up wound healing so that the bleeding stops as soon as possible.

Are Diverticulitis and Irritable Bowel Syndrome Linked?

Only in that those people who suffer from IBS-C (predominantly constipation) and IBS-M (mixed or alternating irritable bowel syndrome alternating from constipation to diarrhea and back) experience periods of reduced bowel time and harder bowel movements and therefore a exert higher pressure for emptying. Only in this way are the two ‘related’.

Can diverticulitis lead to weight loss?

Significant, rapid and unexplained weight loss must always be evaluated by your GP. If diverticulitis causes lower abdominal pain, bloating, and possibly mucus or blood in your stools, it can affect your appetite, so you may lose weight over time. Because increased body mass index (BMI), increased waist circumference, and increased waist-to-hip ratio significantly increase the risk of diverticulitis and diverticular bleeding, weight loss can be a welcome side effect.

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