Complaints & connections · borters.ch
Pouches in the bowel are common from midlife and usually harmless — only inflammation causes illness.
Also known as: diverticulitis · diverticulosis · inflamed diverticula
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Diverticula are small pouches in the colon wall — beyond 60, more than half of people have them, usually without knowing. If one becomes inflamed, it is called diverticulitis: persistent pain typically in the left lower abdomen, fever, changed bowel habits, raised inflammatory markers. Mild cases often settle without antibiotics; severe ones need medical treatment, rarely surgery. A fibre-rich diet is considered sensible for prevention. The old advice to avoid seeds and nuts has not held up in studies.
With an uncomplicated flare without fever, without high inflammatory values and without other illness, watchful waiting is today equally good. That has changed in recent years.
For a few days liquid to light food, then step by step back. Between flares the opposite applies: plenty of fibre, plenty to drink, movement — that lowers the relapses.
The old rule that they get caught in the pouches has not been confirmed — quite the opposite. Anyone who avoids them loses fibre that protects here.
After the first flare the bowel is examined with a camera if that has not been done — because a tumour can cause the same complaints. Not during the flare itself, but once everything has settled.
Increasing pain, a hard belly wall, a high fever, vomiting, or no stool and no wind any more: that speaks for a perforation or a narrowing and belongs in the clinic at once.
Antibiotics are no longer standard in the uncomplicated form: the body usually settles the inflammation itself, and rest for the gut plus painkillers often suffice. The pouches stay, they do not go back — so this is about the coming years, not this week.
From sixty, about half of all people have diverticula, more still from eighty — the vast majority never notice. Only about four in a hundred ever develop an inflammation. A finding of diverticula is therefore a normal finding of age, not a diagnosis.
A lasting, pressing pain in the lower left belly over days — not in waves like a colic. It is therefore spoken of as the appendicitis of the left side.
Mild to moderate fever, with constipation or diarrhoea, bloating and nausea. The combination of pain in one place and fever tells the inflammation apart from the pouches themselves, which usually do nothing at all.
A sudden, often heavy bleed from the back passage without pain and without fever also comes from the pouches — but it is not an inflammation and is treated differently.
A board-hard belly, high fever, vomiting with a standstill of stool and wind, air or stool in the urine, or discharge from the vagina. That belongs examined at once.
Soluble fibres like psyllium and oats bind water and make the stool supple. Wheat bran and a lot of raw vegetables, by contrast, increase bloating and pain in a sensitive gut — this distinction explains most of the failures.
Fibre without water makes the stool harder instead of softer. The two belong together, and the effect only sets in after some days.
Draws water into the bowel and therefore works with a sluggish stool. The belly shows the upper limit: if the stool gets too loose, the dose at once was too high.
Yoghurt, kefir, sauerkraut and the like bring living cultures with them. Many tolerate them well; with a strongly bloated belly they can also do the opposite in the first weeks.
After the flare settles, not during it. 5–10 g a day in plenty of water, built up over 2–4 weeks — fibre prevents new flares.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
Cortisone at higher doses dampens the signs of inflammation — fever and pain can be absent although the bowel is at risk. Anyone on cortisone belongs looked at earlier with belly pain, not later.
The old warning against nuts, seeds and popcorn was not confirmed in a large follow-up study — flares were not more frequent there.
In an acute flare start low-fibre and liquid; after it settles build up over 2–4 weeks to 25–30 g fibre a day — which prevents new flares.
After the acute phase a fibre-rich diet protects against the next flare — not during it.