Managing Both IBS and Diverticulosis

Has your healthcare provider diagnosed you with having diverticulosis alongside your irritable bowel syndrome (IBS)? Do you wonder if there is a relationship between the two? And do you find it challenging to figure out what to eat so as not to make the symptoms worse of either of the two health problems? Let's take a look at any possible overlap and then discuss what you can do to take care of yourself when you have both.

Doctor and patient going over medical history
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What Is Diverticulosis?

Diverticulosis is a health condition in which tiny pockets (sacs) are present in the lining of the large intestine. These sacs are known as diverticula, and they push outward on the wall of the colon. They are most likely to be found in the sigmoid colon, which is the lowest part of the large intestine.

Diverticulosis is one of the three conditions classified as a diverticular disease (DD)—the other two being diverticulitis and diverticular bleeding, Diverticulitis is where the pockets or sacs become infected or inflamed. Diverticular bleeding is when the diverticula start to bleed.

Symptoms 

For many people, diverticulosis causes no symptoms. In others, the presence of these sacs may contribute to constipation, diarrhea, abdominal pain, and bloating, which are symptoms of IBS as well.

The symptoms of diverticulitis can be more severe. Pain can range from mild to severe, and come on quickly or gradually worsen. Pain may wax and wane. Other symptoms of diverticulitis include:

  • Abdominal pain and cramping
  • Abrupt change in bowel habit, i.e. constipation or diarrhea
  • Chills
  • Fever
  • Lower abdominal tenderness, particularly on the left side
  • Vomiting

A dangerous risk with untreated diverticulitis is bowel perforation—a potentially life-threatening condition that requires surgery.

Diverticular bleeding is typically evidenced by a sudden, large amount of bright red to dark maroon blood in the stool. Bleeding usually stops on its own, but if you experience any bleeding in your stool or from your rectum, you must see a healthcare provider to accurately evaluate what caused the bleeding.

Possible Connection Between IBS and Diverticulosis

There may be a connection between IBS and diverticulosis.

One 2013 study followed over one thousand people who were diagnosed with diverticulitis, with no previous history of a functional gastrointestinal disorder (FGD), such as IBS, over a period of approximately six years. Compared with a control group, they found that these individuals were at an almost five times greater risk for developing IBS. These results led this group of researchers to propose the notion of "post-diverticulitis IBS" (PDV-IBS), though it is not yet considered an official sub-type of IBS.

Other researchers have concluded that a link may exist, but that the connection and its implications for treatment are not yet clear.

What to Do If You Have Both

It can seem very challenging to figure out what to do if you have both health problems. Luckily, some of the same treatment recommendations for IBS also apply to diverticular disease:

  • Increase your fiber intake: You can do this by eating a high-fiber diet or taking a fiber supplement.Although research is not conclusive, there is some evidence that fiber may help to protect the colon from DD.
  • Take probiotics: Research is not conclusive, but there is some indication that probiotics can help to prevent diverticulitis in individuals who have diverticulosis, according to a 2013 study. You can find probiotics in supplement form or in fermented foods.

There are also certain lifestyle changes that can reduce problems from diverticular disease. Although these factors are not necessarily associated with IBS, making these changes will help to improve your overall and digestive health:

  • If you are a smoker, take steps to stop.
  • Be sure to exercise regularly.
  • Maintain a healthy weight.
  • Keep alcohol use to a minimum.
  • Keep your use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) to a minimum.

People with IBS may also find it helpful to:

  • Keep a diary of foods, symptoms, and bowel habits to see if patterns emerge.
  • Limit intake of gas-forming foods like beans and cruciferous vegetables (broccoli, cauliflower and cabbage).
  • Limit or eliminate intake of milk or dairy to see if it helps IBS symptoms. Lactose (the natural sugar in milk) is a common food intolerance.

Before making any major changes to your diet, it is best to talk to your healthcare provider for advice.

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10 Sources
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