Last year a 73 year old man we’ll call David came to my clinic with acute abdominal pain. Doctors know that the cause of acute abdominal pain can be as benign as gas pains or as serious as cancer. I set out to diagnose his pain by asking questions and examining him. His lower abdomen was tender, his stool had changed and he felt ill. Blood work hinted at an infection, so I sent him to emergency where my diagnosis of diverticulitis was confirmed. Diverticulitis occurs when pouches form in the colon and then get inflamed and infected. It is very common to have diverticulosis, which is the presence of multiple tiny pouches in the colon. In fact, at 60 years old, 30% of the population have diverticuli, increasing to 50-80% by the age of 80. The vast majority of divertuli never cause any problems. Only about 5% of those pouches will ever get infected and be called diverticulitis, but when they do get infected it is considered a medical emergency and is generally treated with antibiotics.
When David returned to my office 10 days later, our goal was to heal the intestine and prevent future infections. Since he had taken intravenous antibiotics, I gave him high doses of quality probiotics to replace the good bacteria in the intestines. These probiotics serve as a natural slow release antibiotic, preventing future infections. They also help to prevent a serious side effect of antibiotics, called c. difficile diarrhea. This debilitating and sometimes life threatening bowel infection can occur when strong antibiotics wipe out the protective bacteria in the intestine and allow an opportunistic overgrowth of a common strain of bacteria.
I also counselled him on a nutritious but gentle diet once he was ready to introduce food. We used herbs that sooth and heal the intestinal lining and assist in digestion. Two weeks later he was feeling much stronger and his stools had returned to normal. The goal at this point was to prevent future flare ups of diverticulitis. He will always have pouches, but we can prevent them from getting infected. In the past, doctors advised patient like him to avoid nuts and seeds that could become lodged in the pockets. While this advice makes intuitive sense, it hasn’t held up in clinical research. Eating a high fiber diet and avoiding constipation does reduce relapses, but avoiding nuts and seeds does not.
Reducing inflammation in the intestine is also important for preventing diverticulitis. Ironically, some drugs that reduce inflammation in the joints can increase inflammation in the intestines. The common anti-inflammatory drugs, like ibuprofen, diclofenac and naproxen, all can increase the risk of diverticulitis. Also, eating foods one is allergic to, high fat foods, and sugar are all pro-inflammatory to the bowel. There are herbs that reduce inflammation in the bowel and help to maintain the integrity of the intestinal lining.
After the pain that David had experienced with his acute flare up, he was very motivated to change his diet and take natural medicines designed to prevent reoccurrences. However, he was reticent to stop taking daily ibuprofen because he suffered from arthritis in his knee and hated to miss his morning dog-walks on the beach. We treated his arthritic knee with a safe and effective treatment for arthritis called cold laser therapy, which allowed him to subsequently get off ibuprofen. A year later he returned to treat a shoulder injury (caused by the dog) and reported that his knee was still pain free and he’d had no bowel problems since getting on the naturopathic protocol. This case shows that sometimes the best solution is a blend of conventional and naturopathic medicine.