Diverticular disease (Or diverticulosis) – a pathological process affecting the intestine, a characteristic feature of which is the presence of protrusions of the intestinal wall. Multiple saccular protrusions (diverticula) affect the mucosa and submucosa and can be located in any hollow organ (intestine, gallbladder, bladder). However, their localization in the intestine is most frequent and can be observed in all parts of the digestive tract.
The cause of the formation of protrusions is the weakness of the connective tissue of the intestinal wall, which develops with age. In 80% of the elderly, these changes are found. In addition, a violation of the motor function of the intestine (inclination to constipation) leads to an increase in pressure inside the intestine and the appearance of protrusions in places of least resistance.
It is believed that this disease is a consequence of malnutrition. With the use of refined products, poor in fiber, long constipation occurs, which lead to overgrowth of the intestinal wall. If there is a chronic inflammatory process, then in the wall of the intestine morphological changes occur. A sedentary lifestyle only aggravates the situation – the intestinal peristalsis and the passage of stool are slowing down. In this regard, the appointment of therapeutic nutrition is of great importance in the treatment of this disease.
Diets with intestinal diverticulosis
Diverticulosis of the colon is more common than the small intestine. The main part of the large intestine is the colon. The length of the colon 1,5 m, and it has departments: ascending colon, transverse and sigmoid colon. The colon does not take part in digestion, but here water and electrolytes are absorbed, and the liquid contents from the small intestine in the colon turns into a harder one.
Of all its departments sigmoid diverticulosis is more common, due to its anatomical and functional characteristics: smaller diameter, a large number of bends (has the shape of the Latin letter “sigma”) and high pressure, since the sigmoid colon performs a reservoir function and the consistency of intestinal contents is more dense.
With asymptomatic flow in special treatment is not necessary. With diverticulitis and the presence of complaints, laxatives and regulating motor function, antispasmodics, anti-inflammatory drugs and antibiotics, drugs that normalize the flora of the intestine (colibacterin, bifikol or bifidumbacterin). Necessarily appointed therapeutic diet. In the majority of patients, conservative treatment produces a lasting effect.
In 80% of patients, the disease progresses favorably without complications throughout life. In 20% – there are exacerbations of the disease, and with every relapse the risk of serious complications increases. In such cases, surgical treatment is suggested – resection of the sigmoid colon.
In case of acute process or severe exacerbation of chronic diet therapy completely depends on the severity of symptoms: from the use of easily digestible food to the creation of complete rest intestine – hunger and intravenous nutrition.
During this period, fried, spicy dishes, smoked products, canned goods, any pastries, pickled and pickled vegetables, beans and mushrooms, halva, nuts, chocolate, any seeds, kvass, carbonated drinks, coffee, sour juices and alcohol are excluded.
- porridge in diluted milk or water (buckwheat, oatmeal);
- cereal soups (possibly adding rubbed vegetables with a loose fiber) and dairy;
- boiled fish and low-fat varieties of meat and poultry in the form of minced meat, steam cutlets, soufflé;
- steam omelets or soft-boiled eggs;
- cream, yogurt, cottage cheese, curdled milk, cream cheese;
- Cream, olive and sunflower oils, added to ready-made meals;
- vegetables boiled and wiped (potatoes, zucchini, pumpkin carrots, cauliflower, broccoli) in soups and garnishes. Vegetables and fruits should be used in small portions. In the first week after exacerbation, they are used only after thermal cooking. In the future, include non-rough fruit without peel in the form of puree, finely grated carrots, pumpkin and zucchini in fresh form;
- sweet fruits and berries can be consumed in the form of jelly, baked apples (peel to remove), crushed or wiped dried fruits from compote; allowed sugar, honey, pastille;
- A warm, weak tea with milk and sugar, a decoction of bran and an extract of rose hips.
Diet in diverticular disease of the colon outside the exacerbation is balanced and contains an increased amount of plant fiber, as the diverticulum slows down its evacuation function, constipation appears, which leads to the progression of the disease.
- The use of vegetable fiber should be within 30-35 g per day and it should be obtained from vegetables, fruits and grains (brown rice, sprouted grain, wholemeal bread). It is desirable to include in the diet of wheat bran, which reduce intracavitary pressure and greatly accelerate the rate of movement of the contents of the intestine, thus preventing its stagnation and increased pressure in the intestinal cavity. To a greater extent, this effect is rendered by bran.
- The amount of fiber should be increased gradually, and it is better to add bran and sprouted grain to dishes, and not to eat in kind, since there may be an increase in pain and flatulence.
- If tolerated, you can use seaweed.
- Abundant drink (1,5-2 L per day) in the absence of contraindications.
- With constipation necessarily include in the diet beets, prunes, sea kale. The means of choice for a propensity to constipation is lactulose, but its drugs should be used for a short time, and they do not replace nutrition with increased fiber and water content.
- It is important to exclude products that cause flatulence (beans, lentils, raisins, grapes, onions, whole milk, cabbage, fruits with skin).
- With diverticula, it is necessary to exclude products that cause constipation (blueberries, rice, strong tea, dogwood, kissels).
- It is necessary to exclude sunflower seeds and fruits with a large number of grains that are not digested, irritate the intestinal mucosa.
- Excluded from the diet are vegetables and fruits that contain excessively coarse fiber (pineapples, persimmons, turnips, radishes, radishes).