Irritable Bowel Syndrome

In addition to the symptoms of chronic constipation or diarrhea, the association of altered bowel function and abdominal pain is commonly recognized as irritable bowel syndrome (IBS). This is sometimes associated with abdominal bloating and passage of gas. These symptoms may be reduced by dietary supplementation with single probiotics like Bifidobacterium infantis or combination probiotics, such as VSL#3. Probiotics are discussed below under inflammatory bowel diseases.

Diverticulosis and Diverticulitis

Diverticulosis refers to a disorder in which pouches develop in weakened areas of the intestinal wall, typically at the site where arteries normally penetrate from the outside of the wall toward the internal lining or mucosa. Most people with diverticulosis are asymptomatic. However, some people may develop inflammation (diverticulitis), typically when the pouch is blocked; this can manifest as persistent abdominal pain, and alternating constipation and diarrhea, with possible loss of fluids and electrolytes. Patients have tenderness on examination over the inflamed area of the colon.

About 10% of Americans older than age 40 and about 50% of people over 60 years have colonic diverticulosis [21]. A major risk factor for developing this includes a low-fiber diet. Such a diet facilitates development of increased intraluminal pressure that induces tubular sacs or pouches to form and protrude on the serosal side, away from the intestinal lumen of the colon.

Nutrition may play a role in treatment of diverticulosis and diverticulitis. When diverticulitis occurs, a low-fiber diet is recommended to facilitate smooth passage of stools through the inflamed area. Once healing is restored, the approach is to encourage an increase in fluids and the insoluble fiber content of the diet to prevent future diverticuli. Previous recommendations for patients with diverticular disease to avoid nuts and seeds are no longer indicated since there is no firm evidence that these foods trigger inflammation.

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