Diverticula

Diverticula are small bulging pouches that develop within weakened areas of the digestive tract, most commonly in the lower part of the large intestine. However, when one or more become inflamed or infected, the condition is referred to as diverticulitis.

Within naturopathic medicine, diverticular disease is often approached in two different ways, depending on whether or not an infection is present. During an active flare up, the priority usually centres around calming inflammation and allowing the bowel to rest. Longer term support, meanwhile, tends to focus on improving digestive movement while strengthening the health of the bowel lining itself.

Therefore, it is thought that low fibre intake, chronic constipation and straining during bowel movements are commonly associated with the development of diverticula because increased pressure within the colon may gradually weaken the bowel wall over time.

Some people may experience no symptoms, especially in the earlier stages of diverticulosis.

But, when symptoms do appear, they may include bloating, abdominal discomfort or changes in bowel habits. During diverticulitis flare ups, pain often becomes more noticeable, particularly on the lower left side of the abdomen, while fever or digestive upset may also develop (1). If these signs of diverticulitis do appear, please consult a medical professional.

During a flare up, a temporary liquid diet or low fibre approach may sometimes be introduced in order to reduce irritation and allow the bowel to rest more fully. Then, as inflammation subsides, fibre is generally reintroduced gradually.

In the long term, both soluble and insoluble fibre are usually encouraged because they help create softer, bulkier stools that move more comfortably through the colon. Adequate fluid intake is considered especially important here, that’s because fibre without hydration may worsen constipation rather than improve it (2).

From a nutritional therapy perspective, supporting the gut microbiome is often considered an important part of long term bowel health (3). For this reason, fermented foods such as kefir, kimchi and sauerkraut are sometimes introduced by nutritional therapists supporting people with diverticula, alongside targeted probiotic supplements in order to encourage beneficial bacteria within the digestive tract.

Another important suggestion includes reducing ultra processed foods, particularly where inflammation appears to be ongoing. Alongside this, oily fish rich in omega 3 fatty acids may be encouraged to support a healthier inflammatory response within the gut (4).

Within herbal medicine, practitioners often select herbs according to how they interact with the digestive lining. Some examples include Slippery Elm and Marshmallow root, as they naturally contain mucilage, which is essentially a gel-like substance that coats and soothes irritated tissues within the digestive tract (5,6).

Where cramping or abdominal discomfort becomes more pronounced, herbalists may introduce chamomile, peppermint or liquorice root due to their traditional association with relaxing smooth muscle tissue within the bowel (7).

While the above herbal applications are directed at soothing the symptoms and calming inflammation, some herbs are selected specifically for their connection to tissue repair and bowel wall integrity.

For example, Gotu Kola and plantain are traditionally associated with supporting connective tissue recovery (8), meanwhile turmeric/ curcumin is commonly used because of its anti-inflammatory properties (9).

In situations where infection risk becomes a concern, garlic or standardised allicin preparations may also be introduced carefully because of their natural antimicrobial activity (10).

Diverticulitis flare ups can become serious if inflammation progresses or infection develops.

Persistent abdominal pain, fever, vomiting or significant digestive changes should always be assessed by a medical professional, particularly in cases where symptoms worsen suddenly.

Please note that high fibre foods are not always appropriate during acute flare ups and may sometimes aggravate irritation if introduced too early.

People using medications, managing inflammatory bowel conditions or recovering from bowel surgery should always seek professional guidance before introducing concentrated herbal preparations or major dietary changes.

Holistic approaches to diverticular disease tend to focus on calming inflammation during flare ups while supporting bowel motility, microbiome balance and digestive tissue health. 

During recovery from diverticular infection or inflammation, practitioners commonly encourage gradual fibre reintroduction alongside regular movement and adequate fluid intake in order to support bowel motility more comfortably.